Dissociation and symptom dimensions of obsessive-compulsive disorder. A replication study.
BACKGROUND
Obsessive-compulsive disorder (OCD) is a phenotypically very heterogeneous disease with high rates of comorbid psychiatric pathology. Previous studies have indicated that OCD is associated with higher levels of dissociation. The aims of the present study were to replicate and extend previous findings of a significant link between certain OCD symptom dimensions and dissociation.


METHODS
The study sample comprised 50 patients with OCD, as confirmed by the Mini International Neuropsychiatric Interview,who had a score of at least 16 on the Yale-Brown Obsessive-Compulsive Scale. All patients were assessed with the short version of the Hamburg Obsessive-Compulsive Inventory and the Dissociative Experience Scale (DES). Correlation analyses and multiple regression analyses were performed to evaluate the relationship between OCD symptom dimensions and dissociation.


RESULTS
The checking dimension was most strongly related to dissociation, followed by the symmetry/ordering and obsessive thoughts dimensions. In contrast, no significant relationship was found between dissociation and the washing/cleaning, counting/touching, and aggressive impulses/fantasies dimensions. Multiple regression analyses revealed that: (1) only the checking dimension showed an independent positive correlation with dissociation, and (2) only higher scores on the DES subscale "amnestic dissociation" were associated with higher scores for checking compulsions.


CONCLUSIONS
Our results suggest that there might be a specific link between checking behavior and dissociation in OCD. Moreover, checking compulsions seem to be particularly associated with amnestic dissociation. Further studies focusing on amnestic dissociation as a potentially important determinant of checking compulsions are warranted.
Rufer
Michael
M
University Hospital of Zürich, Department of Psychiatry, Zürich, Switzerland. michael.rufer@usz.ch
Fricke
Susanne
S
Held
Dada
D
Cremer
Julia
J
Hand
Iver
I
D000328:Adult; D000647:Amnesia / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D001521:Behavior Therapy; D015897:Comorbidity; D004213:Dissociative Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008960:Models, Psychological; D009771:Obsessive-Compulsive Disorder / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D015203:Reproducibility of Results; D016896:Treatment Outcome