Neuropsychological performance and predictors of pharmacological treatment response in obsessive compulsive disorder

J Affect Disord. 2022 Nov 15:317:52-58. doi: 10.1016/j.jad.2022.08.063. Epub 2022 Aug 24.

Abstract

Background: Obsessive Compulsive Disorder (OCD) is characterized by the presence of executive dysfunctions. As organizational strategies may play an important role as a possible endophenotype of the disorder, we decided to investigate non-verbal memory and organizational abilities in OCD. We also investigated how organization and non-verbal memory differ between responder and non-responder patients to pharmacological treatment, to test whether cognitive functions can predict the response to pharmacological treatment.

Methods: In Study 1, executive and clinical functioning measures were applied to 162 OCD and 95 controls. In Study 2, clinical, intelligence and executive functioning measures were applied to 72 OCD responders and 63 OCD non-responder patients.

Results: OCD patients and controls from Study 1 differed in copy organization (p < 0.01) and delayed recall (p = 0.048). In Study 2, the OCD responders displayed better copy organization (p = 0.013) and lower depressive, anxious and OCD symptoms (p < 0.01 in the three cases). Scores in the following instruments were found to predict the response to pharmacological treatment: HDRS, Y-BOCS, Raven progressive matrices, and Direct digit subtest from the Wechsler's scale (p < 0.01 in all four cases).

Limitations: In Study 1, the imbalance of the sample can be considered a limitation, whilst in Study 2, some of the levels of pharmacological resistance were not represented.

Conclusions: In this study, non-verbal memory and organization was affected in OCD. Responder patients also displayed better executive functioning and fluid intelligence. Organizational ability is a predictor of pharmacological response to SSRI monotherapy in a predictive model controlling for anxious symptoms.

Keywords: Executive function; Memory; Obsessive-compulsive disorder; Organizational strategies; Pharmacological response prediction; ROCFT.

MeSH terms

  • Cognition
  • Cognitive Dysfunction* / diagnosis
  • Cognitive Dysfunction* / drug therapy
  • Executive Function
  • Humans
  • Neuropsychological Tests
  • Obsessive-Compulsive Disorder* / psychology