Document Type : Original Article
Authors
- Ali Keyhani 1
- Mohammad Javad Shabani 2
- Farnaz Etesam 3
- Nasim Rezaeimanesh 4
- Amirreza Azimi 4
- Abdorreza Naser Moghadasi 4
1 Student Counseling Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran Razi Educational and Therapeutic Psychiatric Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
2 Department of Clinical Psychology, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
3 Department of Psychiatry, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
4 Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
Abstract
Background: The present study examined the prevalence of obsessive-compulsive disorder (OCD) among Iranian patients with multiple sclerosis (MS) and the relationship between OCD and the patient’s demographic characteristics.
Methods: The present study used a cluster sampling method to randomly select 297 patients with MS from the patients referred to the MS Clinic and Research Center of Sina University Hospital, Tehran, Iran, during 2018-2019. To gather the required data, a questionnaire consisting of demographic characteristics and disease information sections was used. Moreover, Yale-Brown Obsessive Compulsive Scale (Y-BOCS), Obsessive-Compulsive Inventory-Revised (OCI-R), and Hospital Anxiety and Depression Scale (HADS) were employed in the present study.
The comparison of qualitative and quantitative values between OCD-positive and negative groups was examined with chi-square test and independent samples t-test, respectively. Binary logistic regression was used as multivariate modeling to adjust the effects of potential confounders that could distort the relation of OCD with intended variables. Data were analyzed using SPSS software. The significance level was considered lower than 0.05.
Results: Of the total of 297 patients, 77.8% were women. Moreover, analysis of the data obtained from the HADS questionnaire revealed that 11.44% (n = 34) and 15.15% (n = 45) of patients had severe depression and severe anxiety, respectively. The results of Y-BOCS indicated that the prevalence of severe OCD among patients was 19.9%. The OCI-R questionnaire revealed that the prevalence of OCD was 47.8%, which was consistent with the total of moderate, severe, and extreme values of Y-BOCS (47.9%). Furthermore, the subscales of ordering-arranging with 69 patients (22.9%) and obsessing with 46 patients (15.5%) indicated the highest frequencies as compared to other subscales. Moreover, OCD had a significant relationship with depression, anxiety, and type of MS in this regard.
Conclusion: In this study, the prevalence rate of OCD among patients with MS was higher than its rate among the general population.
Keywords
- Pappalardo JL, Hafler DA. Multiple sclerosis enters a grey area. Nature 2019; 566(7745): 465-6.
- Galetta KM, Bhattacharyya S. Multiple sclerosis and autoimmune neurology of the central nervous system. Med Clin North Am 2019; 103(2): 325-36.
- Stenager E. A global perspective on the burden of multiple sclerosis. Lancet Neurol 2019; 18(3): 227-8.
- Zurawski J, Glanz BI, Healy BC, Tauhid S, Khalid F, Chitnis T, et al. The impact of cervical spinal cord atrophy on quality of life in multiple sclerosis. J Neurol Sci 2019; 403: 38-43.
- Halper J, Nancy Holland NJ. Multiple sclerosis: A self-care guide to wellness. 2nd New York, NY: Springer; 2005.
- Olsson T, Barcellos LF, Alfredsson L. Interactions between genetic, lifestyle and environmental risk factors for multiple sclerosis. Nat Rev Neurol 2017; 13(1): 25-36.
- Sahebi R, Amiri M, Jami MS. Multiple sclerosis in Iran. Int J Epidemiol Res 2018; 5(1): 30-3.
- Hyman BM, Pedrick C. Obsessive-compulsive disorder. Minneapolis, MN: Twenty-First Century Books; 2011.
- Melin K. Long-term outcomes of obsessive-compulsive disorder in children and adolescents [PhD Thesis]. Gothenburg, Sweden: University of Gothenburg. Sahlgrenska Academy; 2019.
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5™. 5th ed ed. Arlington, VA: American Psychiatric Publishing, Inc.; 2013.
- Sayyah M, Bagheri P, Karimi N, Ghasemzadeh A. The effectiveness of group cognitive behavioral therapy in treating obsessive-compulsive disorder in women with multiple sclerosis (MS): A randomized double-blind controlled trial. Electron Physician 2016; 8(4): 2243-8.
- Douzenis A, Michalopoulou PG, Voumvourakis C, Typaldou M, Michopoulos I, Lykouras L. Obsessive-compulsive disorder associated with parietal white matter multiple sclerosis plaques. World J Biol Psychiatry 2009; 10(4 Pt 3): 956-60.
- Hoekstra PJ, Minderaa RB. Tic disorders and obsessive-compulsive disorder: Is autoimmunity involved? Int Rev Psychiatry 2005; 17(6): 497-502.
- Fontenelle LF, Harrison BJ, Yucel M, Pujol J, Fujiwara H, Pantelis C. Is there evidence of brain white-matter abnormalities in obsessive-compulsive disorder?: A narrative review. Top Magn Reson Imaging 2009; 20(5): 291-8.
- Foroughipour M, Behdani F, Hebrani P, Marvast MN, Esmatinia F, Akhavanrezayat A. Frequency of obsessive-compulsive disorder in patients with multiple sclerosis: A cross-sectional study. J Res Med Sci 2012; 17(3): 248-53.
- Shabani A, Nikravesh S, Panaghi L. Obsessive-compulsive disorder: Is it common in multiple sclerosis? Iran J Psychiatry Clin Psychol 2006; 12(3): 209-15. [In Persian].
- Mohamadirizi S. The survey of obsessive-compulsive disorder symptoms in patients with multiple sclerosis and its association with eating attitudes. J Mult Scler (Foster City) 2016; 3(3): 179. 2023.
- Rajezi Esfahani S, Motaghipour Y, Kamkari K, Zahiredin A, Janbozorgi M. Reliability and validity of the Persian version of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Iran J Psychiatry Clin Psychol 2012; 17(4): 297-303. [In Persian].
- Foa EB, Huppert JD, Leiberg S, Langner R, Kichic R, Hajcak G, et al. The Obsessive-Compulsive Inventory: Development and validation of a short version. Psychol Assess 2002; 14(4): 485-96.
- Mohammadzadeh A, Vahedi M. The correlation between obsessive compulsive features and dimensions of pathological eating attitudes in non-clinical samples. Qom Univ Med Sci J 2016; 10(10): 41-9. [In Persian].
- Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 67(6): 361-70.
- Kaviani H, Seyfourian H, Sharifi V, Ebrahimkhani N. Reliability and validity of Anxiety and Depression Hospital Scales (HADS): Iranian patients with anxiety and depression disorders. Tehran Univ Med J 2009; 67(5): 379-85. [In Persian].
- Sarokhani D, Sarokhani M, Sayehmiri K, Zamanian Azodi M. The evaluation of obsessive-compulsive disorder prevalence in Iran: A metaanalysis and systematic review. Int J Pharm Technol 2016; 8(4): 21482-92.
- Ettinger AB, Weisbrot DM, Gallimore CE. Synopsis of neurology, psychiatry and related systemic disorders. Cambridge, UK: Cambridge University Press; 2019.
- Feinstein A, O'Connor P, Gray T, Feinstein K. The effects of anxiety on psychiatric morbidity in patients with multiple sclerosis. Mult Scler 1999; 5(5): 323-6.
- Korostil M, Feinstein A. Anxiety disorders and their clinical correlates in multiple sclerosis patients. Mult Scler 2007; 13(1): 67-72.
- Wahl K, Ehring T, Kley H, Lieb R, Meyer A, Kordon A, et al. Is repetitive negative thinking a transdiagnostic process? A comparison of key processes of RNT in depression, generalized anxiety disorder, obsessive-compulsive disorder, and community controls. J Behav Ther Exp Psychiatry 2019; 64: 45-53.
- Gentes EL, Ruscio AM. A meta-analysis of the relation of intolerance of uncertainty to symptoms of generalized anxiety disorder, major depressive disorder, and obsessive-compulsive disorder. Clin Psychol Rev 2011; 31(6): 923-33.
- McNally RJ, Mair P, Mugno BL, Riemann BC. Co-morbid obsessive-compulsive disorder and depression: A Bayesian network approach. Psychol Med 2017; 47(7): 1204-14.
- Kirchner T, Lara S. Stress and depression symptoms in patients with multiple sclerosis: The mediating role of the loss of social functioning. Acta Neurol Scand 2011; 123(6): 407-13.
- Liu XJ, Ye HX, Li WP, Dai R, Chen D, Jin M. Relationship between psychosocial factors and onset of multiple sclerosis. Eur Neurol 2009; 62(3): 130-6.
)