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Impaired executive functions in paediatric obsessive-compulsive disorder patients

Published online by Cambridge University Press:  24 June 2014

Yasemen Isık Taner ,
Emel Erdogan Bakar  and
Ozgur Oner
Yasemen Isık Taner
Affiliation:
Department of Child and Adolescent Psychiatry, Gazi University Faculty of Medicine, Ankara, Turkey
Emel Erdogan Bakar*
Affiliation:
Department of Psychology, Ufuk University, Ankara, Turkey
Ozgur Oner
Affiliation:
Department of Child and Adolescent Psychiatry, SSK Children Hospital, Ankara, Turkey
*
Dr Emel Erdoğan Bakar, Department of Psychology, Ufuk University, Doktor Sadik Akin Caddesi No 35, Ek Bina:3 06520-Balgat, Ankara, Turkey. Tel: +90 532 559 7901; Fax: +90 312 286 2395; E-mail: bulentbanrs@yahoo.com
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Extract

Isık Taner Y, Erdogan Bakar E, Oner O. Impaired executive functions in paediatric obsessive-compulsive disorder patients.

Objective: There are only few studies which investigated the neuropsychological performances of paediatric patients with obsessive-compulsive disorder (OCD). Previous studies show that most of adult OCD patients had an onset of their first symptoms before the age of 15. Our objective was to evaluate the neuropsychological functions in paediatric patients with OCD.

Methods: We compared the executive functions and general intelligence of child and adolescent OCD patients (n = 20) with age- and gender-matched healthy controls (n = 20). To compare mentioned skills, a neuropsychological test battery including Wechsler Intelligence Scale for Children-Revised (WISC-R), Wisconsin Card Sorting Test (WCST), Stroop Test and Verbal Fluency Test was performed.

Result: Performances of the OCD and control subjects on neuropsychological tests were statistically analysed by using multivariate analysis of covariance (MANCOVA), in which Full Scale Intelligence Quotient (FSIQ) results were taken into consideration as a covariate to observe FSIQ's effect on test scores. Our results showed that the differences in WISC-R Picture Arrangement and Coding scores remained significant when co-analysed with FSIQ scores. In a similar manner, the OCD group exhibited worse performances on STR1-duration, STR3-duration, STR3-error, STR4-duration, STR4-error, STR5-correct response, and STR5-error as compared with the control group when FSIQ scores were taken into calculation. Some variables of the WCST (perseverative responses, percent errors, abstraction-flexibility and categories completed) also yield lower test scores in the OCD group. There was no significant difference between the groups regarding Verbal Fluency Test scores.

Conclusion: Our results suggested that paediatric OCD patients had worse abstraction-flexibility, mental set-shifting, verbal comprehension and visuospatial/construction abilities.

Keywords

adolescentschildrenexecutive functionobsessive-compulsive disorder
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 23 , Issue 6 , December 2011 , pp. 272 - 281
Copyright
Copyright © Cambridge University Press 2011

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References

1.Alsobrook, JP, Leckman, JF, Goodman, WK, Rasmussen, SA, Pauls, DL.Segregation analysis of obsessive-compulsive disorder using symptom-based factor scores. Am J Med Genet 1999;88:669–675.3.0.CO;2-N>CrossRefGoogle Scholar
2.Rosenberg, DR, Keshavan, MS.Toward a neurodevelopmental model of obsessive-compulsive disorder. Biol Psychiatry 1998;43:623–640.CrossRefGoogle Scholar
3.Geller, DA, Biederman, J, Faraone, S et al. Developmental aspects of obsessive compulsive disorder: findings in children, adolescents, and adults. J Nerv Ment Dis 2001;189:471–477.CrossRefGoogle ScholarPubMed
4.Savage, CR, Deckersbach, T, Wilhelm, S et al. Strategic processing and episodic memory impairment in obsessive compulsive disorder. Neuropsychology 2000;14:141–151.CrossRefGoogle ScholarPubMed
5.Penadés, R, Catalán, R, Andrés, S, Salamero, M, Gastó, C.Executive function and nonverbal memory in obsessive-compulsive disorder. Psychiatry Res 2005;133:81–90.CrossRefGoogle ScholarPubMed
6.Behar, D, Rapoport, JL, Berg, CJ et al. Computerized tomography and neuropsychological test measures in adolescents with obsessive compulsive disorder. Am J Psychiatry 1984;141:363–369.Google ScholarPubMed
7.Cox, CS, Fedio, P, Rapoport, JL. Neuropsychological testing of obsessive ± compulsive adolescents. In: Rapoport, JL, ed. Obsessive ± compulsive disorder in children and adolescents. Washington: American Psychiatric Press, 1989: 73–85.Google Scholar
8.Andrés, S, Lázaro, L, Salamero, M, Boget, T, Penadés, R, Castro-Fornieles, J.Changes in cognitive dysfunction in children and adolescents with obsessive-compulsive disorder after treatment. J Psychiatr Res 2008;42:507–514.CrossRefGoogle ScholarPubMed
9.Irak, M, Flament, MF.Neuropsychological profile of childhood-onset obsessive-compulsive disorder. Turk Psikiyatri Derg 2007;18:293–301.Google ScholarPubMed
10.Diniz, JB, Rosario-Campos, MC, Shavitt, RG et al. Impact of age at onset and duration of illness on the expression of comorbidities in obsessive-compulsive disorder. J Clin Psychiatry 2004;65:22–27.CrossRefGoogle ScholarPubMed
11.Kuelz, AK, Hohagen, F, Voderholzer, U.Neuropsychological performance in obsessive-compulsive disorder: a critical review. Biol Psychol 2004;65:185–236.CrossRefGoogle ScholarPubMed
12.Moritz, S, Jacobsen, D, Kloss, M, Fricke, S, Rufer, M, Hand, I.Examination of emotional Stroop interference in obsessive-compulsive disorder. Behav Res Ther. 2004;42: 671–682.CrossRefGoogle ScholarPubMed
13.Constans, JI, Foa, EB, Franklin, ME, Mathews, A.Memory for actual and imagined events in OC checkers. Behav Res Ther 1995;33:665–671.CrossRefGoogle ScholarPubMed
14.Randomsky, AS, Rachman, S.Memory bias in obsessive compulsive disorder (OCD). Behav Res Ther 1999;37: 605–618.CrossRefGoogle Scholar
15.Radomsky, AS, Rachman, S, Hammond, D.Memory bias, confidence and responsibility in compulsive checking. Behav Res Ther 2001;39:813–822.CrossRefGoogle ScholarPubMed
16.Ceschi, G, Van der Linden, M, Dunker, D, Perroud, A, Brédart, S.Further exploration memory bias in compulsive washers. Behav Res Ther 2003;41:737–748.CrossRefGoogle ScholarPubMed
17.MacDonald, PA, Antony, MM, Macleod, CM, Richter, MA.Memory and confidence in memory judgements among individuals with obsessive compulsive disorder and non-clinical controls. Behav Res Ther 1997;35:497–505.CrossRefGoogle ScholarPubMed
18.Tolin, DF, Abramowitz, JS, Brigidi, BD, Amir, N, Street, GP, Foa, EB.Memory and memory confidence in obsessive-compulsive disorder. Behav Res Ther 2001;39:913–927.CrossRefGoogle ScholarPubMed
19.Flament, MF, Koby, E, Rapoport, JL, et al. Childhood obsessive-compulsive disorder: a prospective follow-up study. J Child Psychol Psychiatry 1990;31:363–380.CrossRefGoogle ScholarPubMed
20.Cox, C.Neuropsychological abnormalities in obsessive compulsive disorder and their assessments. Int Rev Psychiatry 1997;9:45–59.CrossRefGoogle Scholar
21.Abbruzzese, M, Ferri, S, Scarone, S.The selective breakdown of frontal functions in patients with obsessive-compulsive disorder and in patients with schizophrenia: a double dissociation experimental finding. Neuropsychologia 1997;35:907–912.CrossRefGoogle ScholarPubMed
22.Bohne, A, Savage, CR, Deckersbach, T et al. Visuospatial abilities, memory, and executive functioning in trichotillomania and obsessive compulsive disorder. J Clin Exp Neuropsychol 2005;27:385–399.CrossRefGoogle ScholarPubMed
23.Moritz, S, Fricke, S, Wagner, M, Hand, I.Further evidence for delayed alternation deficits in obsessive-compulsive disorder. J Nerv Ment Dis 2001;189:562–564.CrossRefGoogle ScholarPubMed
24.Cavedini, P, Ferri, S, Scarone, S, Bellodi, L.Frontal lobe dysfunction in obsessive-compulsive disorder and major depression: a clinical neuropsychological study. Psychiatry Res 1998;78:21–28.CrossRefGoogle ScholarPubMed
25.Rowe, JB, Owen, AM, Johnsrude, IS, Passingham, RE.Imaging the mental components of a planning task. Neuropsychologia 2001;39:315–327.CrossRefGoogle ScholarPubMed
26.Spitznagel, MB, Suhr, JA.Executive function deficits associated with symptoms of schizotypy and obsessive-compulsive disorder. Psychiatry Res 2002;110:151–163.CrossRefGoogle ScholarPubMed
27.Beers, SR, Rosenberg, DR, Dick, EL et al. Neuropsychological study of frontal lobe function in psychotropic-naive children with obsessivecompulsive disorder. Am J Psychiatry 1999;156:777–779.CrossRefGoogle Scholar
28.Simpson, HB, Rosen, W, Huppert, JD, Lin, SH, Foa, EB, Liebowitz, MR.Are there reliable neuropsychological deficits in obsessive-compulsive disorder? J Psychiatr Res 2006;40:247–257.CrossRefGoogle ScholarPubMed
29.Insel, TR.Toward a neuroanatomy of obsessive-compulsive disorder. Arch Gen Psychiatry 1992;49:739–744.CrossRefGoogle Scholar
30.Fitzgerald, KD, Welsh, RC, Gehring, WJ et al. Error-related hyperactivity of the anterior cingulate cortex in obsessive-compulsive disorder. Biol Psychiatry 2005;57: 287–294.CrossRefGoogle ScholarPubMed
31.Aouizerate, B, Guehl, D, Cuny, E et al. Pathophysiology of obsessive-compulsive disorder: a necessary link between phenomenology, neuropsychology, imagery and physiology. Prog Neurobiol 2004;72:195–221.CrossRefGoogle ScholarPubMed
32.Henry, JD.A meta-analytic review of Wisconsin Card Sorting Test and verbal fluency performance in obsessive-compulsive disorder. Cogn Neuropsychiatry 2006;11: 156–176.CrossRefGoogle ScholarPubMed
33.Shin, MS, Choi, H, Kim, H, Hwang, JW, Kim, BN, Cho, SC.A study of neuropsychological deficit in children with obsessive-compulsive disorder. Eur Psychiatry 2008;23: 512–520.CrossRefGoogle ScholarPubMed
34.Stuss, DT, Benson, DF.The frontal lobes. New York: Raven, 1986.Google Scholar
35.Tallis, F.The neuropsychology of obsessive-compulsive disorder: a review and consideration of clinical implications. Br J Clin Psychol 1997;36:3–20.CrossRefGoogle ScholarPubMed
36.Andrés, S, Boget, T, Lázaro, L et al. Neuropsychological performance in children and adolescents with obsessive-compulsive disorder and influence of clinical variables. Biol Psychiatry 2007;61:946–951.CrossRefGoogle ScholarPubMed
37.Gladstone, M, Carter, AS, Schultz, RT, Riddle, M, Scahill, L, Pauls, DL.Neuropsychological functioning of children affected with Tourette syndrome and obsessive ± compulsive disorder. J Clin Exp Neuropsychol 1993;15:70.Google Scholar
38.Douglass, HM, Moffitt, TE, Dar, R, McGee, R, Silva, P.Obsessive-compulsive disorder in a birth cohort of 18-year-olds: prevalence and predictors. J Am Acad Child Adolesc Psychiatry 1995;34:1424–1431.CrossRefGoogle Scholar
39.Kaufman, J, Birmaher, B, Brent, D et al. Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (KSADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 1997;36:980–988.CrossRefGoogle Scholar
40.Gökler, B, ÜNal, F, Pehlivantürk, F, Kültür, EÇ, Akdemir, D, Taner, Y.Reliability and Validity of Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version-Turkish Version (K-SADS-PL-T). Çocuk Gençlik Ruh Sağlığı Dergisi 2004; 11:109–116.Google Scholar
41.Savasır, I, Sahin, N.Wechsler Çocuklar Icin Zeka Ölçeği (WISC-R) El Kitabı. Ankara: Türk Psikologlar Derneği Yayınları, 1995.Google Scholar
42.Karakaş, S, Erdoğan, E, Sak, L, Soysal, AŞ, Ulusoy, T, Yüceyurt, İ.Stroop Test-TBAG Form: standardisation for Turkish culture, reliability and validity. Clin Psychiatry 1999;2:75–88.Google Scholar
43.Karakas, S.BILNOT Bataryası El Kitabı: Nöropsikolojik Testler için Arastırma ve Gelistirme Çalısmaları (2. baskı). Ankara: Eryılmaz Offset Matbaacılık Gazetecilik, 2006.Google Scholar
44.van Mourik, R, Oosterlaan, J, Sergeant, JA.The Stroop revisited: a meta-analysis of interference control in AD/HD. J Child Psychol Psychiatry 2005;46:150–165.CrossRefGoogle ScholarPubMed
45.Heaton, RK, Chelune, GJ, Talley, JL, Kay, GG, Curtiss, G.Wisconsin Card Sorting Test Manual, Revised and Expanded. Odessa: Psychological Assessment Resources, 1993.Google Scholar
46.Parker, DM, Crawford, JR. Assessment of frontal lobe dysfunction. In Crawford, JR, McKinlay, W, Parker, DM, eds. Handbook of neuropsychological assessment. Hove: Erlbaum and Associates, 1992: 267–291.Google Scholar
47.Howienson, DB, Lezac, MD, Loring, DW.Neuropsychological assessment. Oxford: Oxford University Press, 2004: 696.Google Scholar
48.Burke, DM, Light, LL.Memory and aging: the role of retrieval processes. Psychol Bull 1981;90:513–546.CrossRefGoogle ScholarPubMed
49.Stuss, DT, Benson, DF.Neuropsychological studies of the frontal lobes. Psychol Bull 1984;95:3–28.CrossRefGoogle ScholarPubMed
50.Brown, GG, Kindermann, SS, Siegle, GJ, Granholm, E, Wong, EC, Buxton, RB.Brain activation and pupil response during covert performance of the Stroop Color Word task. J Int Neuropsychol Soc 1999;5:308–319.CrossRefGoogle ScholarPubMed
51.Bush, G, Whalen, PJ, Rosen, BR, Jenike, MA, McInerney, SC, Rauch, SL.The counting Stroop: an interference task specialized for functional neuroimaging: validation study with functional MRI. Hum Brain Mapp 1998;6:270–282.3.0.CO;2-0>CrossRefGoogle ScholarPubMed
52.Leung, HC, Skudlarski, P, Gatenby, JC, Peterson, BS, Gore, JC.An event related functional MRI study of the Stroop Color Word interference task. Cereb Cortex 2000;10:552–560.CrossRefGoogle ScholarPubMed
53.Fitzgerald, KD, Welsh, RC, Gehring, WJ et al. Error related hyperactivity of the anterior cingulate cortex in obsessive-compulsive disorder. Biol Psychiatry 2005;57: 287–294.CrossRefGoogle ScholarPubMed
54.Cavedini, P, Riboldi, G, D'Annucci, A, Belotti, P, Cisima, M, Bellodi, L.Decision-making heterogeneity in obsessive-compulsive disorder: ventromedial prefrontal cortex function predicts different treatment outcomes. Neuropsychologia 2002;40:205–211.CrossRefGoogle ScholarPubMed
55.Chamberlain, SR, Fineberg, NA, Blackwell, AD, Clark, L, Robbins, TW, Sahakian, BJ.A neuropsychological comparison of obsessive-compulsive disorder and trichotillomania. Neuropsychologia 2007;45:654–662.CrossRefGoogle ScholarPubMed
56.Chamberlain, SR, Fineberg, NA, Menzies, LA et al. Impaired cognitive flexibility and motor inhibition in unaffected first-degree relatives of patients with obsessive-compulsive disorder. Am J Psychiatry 2007;164:335–338.CrossRefGoogle ScholarPubMed
57.Pennington, BF, Ozonoff, S.Executive functions and developmental psychopathology. J Child Psychol Psychiatry 1996;37:51–87.CrossRefGoogle ScholarPubMed
58.Cummings, JL.Anatomic and behavioral aspect of frontal-subcortical circuits. Annu N Y Acad Sci 1995;769:1–13.CrossRefGoogle ScholarPubMed
59.Drewe, EA.The effect or type and area of brain lesion on Wisconsin Card Sorting Test performance. Cortex 1974;10:1589–1670.CrossRefGoogle ScholarPubMed
60.Nelson, HE.A modified Card Sorting Test sensitive to frontal lobe damage. Cortex 1976;12:313–324.CrossRefGoogle Scholar
61.Phelps, EA, Hyder, F, Blamire, AM, Shulman, RG.FMRI of the prefrontal cortex during overt verbal fluency. NeuroReport 1997;8:561–565.CrossRefGoogle ScholarPubMed
62.Pujol, J, Vendrell, P, Deus, J et al. Frontal lobe activation during word generation studied by functional MRI. Acta Neurologica Scandinavica 1996;93:403–410.CrossRefGoogle ScholarPubMed
63.Gambini, O, Abbruzzese, M, Scarone, S.Smooth pursuit and saccadic eye movements and Wisconsin Card Sorting Test performance in obsessive-compulsive disorder. Psychiatry Res 1993;48:191–200.CrossRefGoogle ScholarPubMed
64.Head, D, Bolton, D, Hymas, N.Deficit in cognitive shifting ability in patients with obsessive compulsive disorder. Biol Psychiatry 1989;25:929–937.CrossRefGoogle ScholarPubMed
65.Hymas, N, Lees, A, Bolton, D, Epps, K, Head, D.The neurology of obsessional slowness. Brain 1991;114:2203–2233.CrossRefGoogle ScholarPubMed
66.Boone, KB, Ananth, J, Philpott, L, Kaur, A, Djenderedjian, A.Neuropsychological characteristics of nondepressed adults with obsessive-compulsive disorder. Neuropsychiatry Neuropsychol Behav Neurol 1991;4:96–109.Google Scholar
67.Cavallaro, R, Cavedini, P, Mistretta, P et al. Basalcorticofrontal circuits in schizophrenia and obsessive-compulsive disorder: a controlled, double dissociation study. Biol Psychiatry 2003;54:437–443.CrossRefGoogle ScholarPubMed
68.Kim, MS, Park, SJ, Shin, MS, Kwon, JS.Neuropsychological profile in patients with obsessive compulsive disorder over a period of 4 month treatment. J Psychiatric Res 2002;36:257–265.CrossRefGoogle Scholar
69.Roth, RM, Baribeau, J, Milovan, DL, O'Connor, K.Speed and accuracy on tests of executive function in obsessive-compulsive disorder. Brain Cogn 2004;54: 263–265.CrossRefGoogle ScholarPubMed
70.Fenger, MM, Gade, A, Adams, KH, Hansen, ES, Bolwig, TG, Knudsen, GM.Cognitive deficits in obsessive-compulsive disorder on tests of frontal lobe functions. Nord J Psychiatry 2005;59:39–44.CrossRefGoogle ScholarPubMed
71.Welsh, MC, Pennington, BF, Groisser, DB.A normative-developmental study of executive function: a window on prefrontal function in children. Dev Neuropsychol 1991;7:131–149.CrossRefGoogle Scholar
72.Hervey, AS, Epstein, JN, Curry, JF.Neuropsychology of adults with attention-deficit/hyperactivity disorder: a meta-analytic review. Neuropsychology 2004;18:485–503.CrossRefGoogle ScholarPubMed
73.Romine, CB, Lee, D, Wolfe, ME, Homack, S, George, C, Riccio, CA.Wisconsin Card Sorting Test with children: a meta-analytic study of sensitivity and specificity. Arch Clin Neuropsychol 2004;19:1027–1041.CrossRefGoogle ScholarPubMed
74.Evans, DW, Lewis, MD, Iobst, E.The role of the orbitofrontal cortex in normally developing compulsive-like behaviors and obsessive-compulsive disorder. Brain Cogn 2004;55:220–234.CrossRefGoogle ScholarPubMed
75.Chamberlain, SR, Blackwell, AD, Fineberg, NA, Robbins, TW, Sahakian, BJ.The neuropsychology of obsessive compulsive disorder: the importance of failures in cognitive and behavioural inhibition as candidate endophenotypic markers. Neurosci Biobehav Rev 2005;29:399–419.CrossRefGoogle ScholarPubMed
76.Tolin, DF, Hamlin, C, Foa, EB.Directed forgetting in obsessive-compulsive disorder: replication and extension. Behav Res Ther 2002;40:793–803.CrossRefGoogle ScholarPubMed
77.Voglmaier, MM, Seidman, LJ, Niznikiewicz, MA, Dickey, CC, Shenton, ME, McCarley, RW.Verbal and nonverbal neuropsychological test performance in subjects with schizotypal personality disorder. Am J Psychiatry 2000;157:787–793.CrossRefGoogle ScholarPubMed