Obsessive compulsive disorder

Cognitive deficits are often seen in obsessive-compulsive disorder (OCD) or other disorders of impulsivity, reflecting underlying dysfunction of neurotransmitter function and cortico-subcortical circuitry^{1-3, 4}. Cognitive deficits represent core targets for existing and novel treatments. Our recommended test battery for OCD and other impulse disorders assesses the key cognitive domains often impaired, as well as those that can be affected by interventions.

The tests in this battery are sensitive to neuropsychological impairment across the spread of disease severities, from people at risk of developing OCD, through to severe disease⁵. Patients with OCD have shown response inhibition deficits on the Stop-Signal Test (SST) compared to controls and the extent of this deficit correlates significantly with lower cortical grey matter and greater grey matter in sub-cortical habit generating regions¹.

The tests in this battery are also sensitive to effects of cognitive enhancement as well as to sedating medications⁴.

Measures

• Sustained attention
• Episodic memory
• Working memory
• Response inhibition

CANTAB Tests

• Rapid Visual Information Processing (RVP): 7 minutes
• Paired Associates Learning (PAL): 8 minutes
• Spatial Working Memory (SWM): 4 minutes
• Stop Signal Task (SST): 14 minutes

Key References

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 May;29(3):399-419.

Shin NY, Lee TY, Kim E, Kwon JS. Cognitive functioning in obsessive-compulsive disorder: a meta-analysis. Psychol Med. 2014 Apr;44(6):1121-30.

Öst LG, Havnen A, Hansen B, Kvale G. Cognitive behavioral treatments of obsessive-compulsive disorder. A systematic review and meta-analysis of studies published 1993-2014. Clin Psychol Rev. 2015 Aug;40:156-69.

Morein-Zamir S, Craig KJ, Ersche KD, Abbott S, Muller U, Fineberg NA, Bullmore ET, Sahakian BJ, Robbins TW. Impaired visuospatial associative memory and attention in obsessive compulsive disorder but no evidence for differential dopaminergic modulation. Psychopharmacology (Berl). 2010 Oct;212(3):357-67. doi: 10.1007/s00213-010-1963-z. Epub 2010 Jul 27.

Chamberlain SR, Fineberg NA, Menzies LA, Blackwell AD, Bullmore ET, Robbins TW, Sahakian BJ. Impaired cognitive flexibility and motor inhibition in unaffected first-degree relatives of patients with obsessive-compulsive disorder. Am J Psychiatry. 2007 Feb;164(2):335-8.

---

1. _{Chamberlain SR, Menzies L. Endophenotypes of obsessive-compulsive disorder: rationale, evidence and future potential. Expert Rev Neurother. 2009 Aug;9(8):1133-46.}
2. _{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 May;29(3):399-419.}
3. _{Shin NY, Lee TY, Kim E, Kwon JS. Cognitive functioning in obsessive-compulsive disorder: a meta-analysis. Psychol Med. 2014 Apr;44(6):1121-30.}
4. _{Morein-Zamir S, Craig KJ, Ersche KD, Abbott S, Muller U, Fineberg NA, Bullmore ET, Sahakian BJ, Robbins TW. Impaired visuospatial associative memory and attention in obsessive-compulsive disorder but no evidence for differential dopaminergic modulation. Psychopharmacology (Berl). 2010 Oct;212(3):357-67. doi: 10.1007/s00213-010-1963-z. Epub 2010 Jul 27.}
5. _{Chamberlain SR, Fineberg NA, Menzies LA, Blackwell AD, Bullmore ET, Robbins TW, Sahakian BJ. Impaired cognitive flexibility and motor inhibition in unaffected first-degree relatives of patients with obsessive-compulsive disorder. Am J Psychiatry. 2007 Feb;164(2):335-8.}