Obsessive Compulsive Disorder at Johns Hopkins

1. Are there higher occurrences of other mental disorders among individuals with OCD?
2. What exactly are you looking for in the blood?
3. How is my confidentiality assured?
4. Are other universities besides Johns Hopkins involved in OCD Family study?
5. Have there been any recent developments in drug treatments for OCD or related disorders?
6. Are writer's cramp and OCD linked?
7. Are ADHD-like symptoms in youth a separate disorder from OCD?
8. Is pregnancy or childbirth related to the onset of OCD symptoms?
9. Is there any information about OCD and PANDAS?
10. What other areas of brain imagining are researchers studying?

Q2: What exactly are you looking for in the blood?
A: DNA will be extracted from the blood obtained from participants. From these DNA samples, we will test whether genetic variations are associated with the presence of OCD in individuals and families. This analysis is a long and arduous process and results are not likely to emerge rapidly.

Q3: How is my confidentiality assured?
A: The study methods, and the method for ensuring our participants’ confidentiality, is reviewed and approved by the Johns Hopkins Institutional Review Board. Moreover, we have secured a Certificate of Confidentiality from the federal government that assures our participants that all the information that they provide cannot be divulged. No names or other identifying material is maintained on participant records; all material has only a coded ID number. We also maintain locked files for all materials.

Q4: Are other universities besides Johns Hopkins involved in OCD Family study?
A: In this second phase of the project, we are collaborating and pooling resources with Massachusetts General Hospital, Brown University, Columbia University, UCLA, and National Institutes of Mental Health.

Q5: Have there been any recent developments in drug treatments for OCD or related disorders?
A: Please see this secion.

Q6: Are writer's cramp and OCD linked?
A: A team of researchers in Japan found that individuals with writer's cramp were 5 times more likely to experience OCD symptoms. They suggest that both conditions may derive from the same nerve area of the brain. (Journal of Neurology, Neurosurgery, and Psychiatry, 2001, 71.)

Q7: Are ADHD-like symptoms in youth a separate disorder from OCD?
A: In a recent study, researchers concluded that symptoms of ADHD may be considered a separate disorder in adolescents with OCD. Therefore, if your adolescent has OCD as well as ADHD symptoms, speak to your doctor about potentially treating both conditions separately. (Journal of Americian Academy of Child & Adolescent Psychiatry, 2002, 41.)

Q8: Is pregnancy or childbirth related to the onset of OCD symptoms?
A: Several research studies have investigated whether stressful life events trigger the onset of OCD. Results have suggested that pregnancy and the period after delivery is associated with an increased risk of developing OCD in some women. "Postpartum OCD" may often remain undiagnosed and untreated, therefore awareness of this vulnerable time period is important for relieving the suffering of these individuals. Typically, symptoms developing at the time of pregnancy and/or delivery consist of obsessive, intrusive thoughts concerning fears of harming the newborn, and may also include compulsions. Fortunately, preliminary research has shown that medications and cognitive-behavioral therapy are effective treatments for these symptoms that arise at postpartum (Archives of Women's Mental Health, April 2004; Journal of Anxiety Disorders, 2003, 17; Epidemiologia e Psichiatria Sociale, Apr-Jun 2001; Psychiatry Research, Dec 1999). Interestingly, one study described some men who developed obsessions and compulsions while their spouses were pregnant or delivered. Each of these men responded well to cognitive-behavioral therapy using exposure procedures (Psychosomatics, Sept-Oct, 2001).

Q9: Is there any information about OCD and PANDAS?
A: Researchers at the National Institute of Mental Health have been studying pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, which is referred to as PANDAS. Children with PANDAS experience a worsening of OCD symptoms and/or tic disorders following streptococcal infections. In this study, 23 children with PANDAS were enrolled into a double blind, randomized controlled trial. Prophylaxis penicillin or azithromycin was administered for 12 months and results were compared with the child’s previous year of infections and symptoms. Streptococcal infections were significantly reduced, as were neuropsychiatric symptoms, during the 12 months of taking these medications. (Biological Psychiatry, 2005).

Q10: What other areas of brain imagining are researchers studying?
A: There is a lot of interest in better understanding the differences between people who develop early and late-onset of OCD. Researchers have provided evidence of neuropsychological differences between these two groups, and further noticed differences in brain activity related to the age of onset. Both, positron emission tomography (PET) and functional MRI (fMRI) will be helpful in understanding the relationship between cognitive functioning and brain activity in early and late onset of OCD (J Neuropsychiatry Clin Neurosci, 2005)

An abstract of an upcoming journal article provides information about Low-resolution electromagnetic tomography (LORETA), which is a 3-dimensional intra-cerebral distribution of neuronal electrical activity. Researchers in Brazil utilized LORETA to predict the response of patients to medication therapy for OCD symptoms. They compared the brain activities of ten patients who responded to therapy and seven who did not. The results demonstrated a significant pattern of activity within the frontal lobe that predicted a therapeutic response. More research is needed in the various neuroimaging techniques to help develop a better understanding of brain functioning and treatments for OCD. (Int. J. Neuropsychopharmacol, 2005).