Cross-diagnostic cognitive heterogeneity in body dysmorphic disorder and obsessive-compulsive disorder

Amy Malcolm; Toni Pikoos; David J Castle; Susan L Rossell

doi:10.1016/j.jbtep.2021.101674

Cross-diagnostic cognitive heterogeneity in body dysmorphic disorder and obsessive-compulsive disorder

J Behav Ther Exp Psychiatry. 2021 Dec:73:101674. doi: 10.1016/j.jbtep.2021.101674. Epub 2021 Jul 1.

Authors

Amy Malcolm¹, Toni Pikoos², David J Castle³, Susan L Rossell⁴

Affiliations

¹ Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, VIC, Australia. Electronic address: amalcolm@swin.edu.au.
² Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, VIC, Australia.
³ Department of Mental Health, St Vincent's Hospital, Melbourne, VIC, Australia; The University of Melbourne, Melbourne, VIC, Australia; Centre for Addiction and Mental Health and the Department of Psychiatry, University of Toronto, Canada.
⁴ Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, VIC, Australia; Department of Mental Health, St Vincent's Hospital, Melbourne, VIC, Australia.

PMID: 34242980
DOI: 10.1016/j.jbtep.2021.101674

Abstract

Background and objectives: Previous research has indicated that body dysmorphic disorder (BDD) and obsessive-compulsive disorder (OCD) often demonstrate similar cognitive impairments across multiple domains. However, findings for both disorders have not consistently shown impaired cognition. As such, BDD and OCD might share an overlapping pattern of cognitive heterogeneity, characterised by subgroups with different cognitive profiles.

Methods: To evaluate this possibility, we compared 26 BDD, 24 OCD, and 26 healthy control participants on a comprehensive eight-domain cognitive battery. Then, cluster analysis was performed on the BDD and OCD participants' combined data to explore for cognitive subgroups.

Results: No significant differences were found between the three groups' cognitive functioning, except for poorer visual learning in OCD relative to healthy controls. Cluster analysis produced two cognitive subgroups within the combined BDD and OCD data, characterised by intact cognition (52%) and broadly impaired cognition (48%). Each subgroup comprised both BDD and OCD participants, in similar proportions. The subgroups did not differ in clinical or demographic features.

Limitations: Sample sizes were moderate. Future research should investigate clustering patterns both in larger groups and separately in BDD and OCD samples to determine replicability.

Conclusions: These findings suggest that BDD and OCD may involve similar patterns of cognitive heterogeneity, and further imply that individuals with either disorder can show a wide range of cognitive profiles, thus necessitating a nuanced approach to future cognitive research in BDD and OCD.

Keywords: Body dysmorphic disorder; Cognition; Cognitive dysfunction; Neurocognition; Neuropsychology; Obsessive-compulsive disorder.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Body Dysmorphic Disorders* / complications
Cognition
Humans
Obsessive-Compulsive Disorder* / complications