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  • 1 Mott House Specialist Rehab Unit, West London Mental Health NHS Trust, Southall, UB1 3EU, UK
  • 2 National OCDs Service, Hertfordshire Partnership NHS Foundation Trust, Queen Elizabeth II Hospital, Welwyn Garden City, AL74HQ, UK
  • 3 College Lane, University of Hertfordshire, Hatfield, Herts, UK
  • 4 Addenbrookes Hospital, Cambridge University School of Clinical Medicine, Cambridge, UK
  • 5 Mott House Specialist Rehab Unit, West London Mental Health NHS Trust, Uxbridge Road, Southall, UB1 3EU, UK
Open access

Abstract

Background

Obsessive-compulsive disorder (OCD) is a biologically heterogeneous neuropsychiatric disorder. It is associated with impulsive as well as compulsive neurocognitive mechanisms. Cigarette smoking is common among most psychiatric patients; however, OCD patients are thought to show reduced rates. OCD smokers may thus represent a relatively uncommon OCD subtype, characterised by increased impulsivity. In this study, we aim to establish the prevalence of smoking in a large, well-defined OCD cohort. We investigate whether smokers with OCD differ from non-smokers with OCD on clinical measures of behavioural impulsivity and domains of personality and temperament, including reward-dependence and novelty-seeking.

Method

183 of 200 outpatients with DSM-IV OCD were interviewed to determine smoking status. A sub-sample of 10 smokers was compared with 10 non-smokers, pair wise matched for age and gender. Patients were assessed for DSM co-morbidity, symptom profile, OCD severity, behavioural impulsivity and personality dimensions.

Results

Only 10 individuals (5.46%; five males) were smokers. Compared to OCD non-smokers, OCD smokers scored significantly higher on the Barratt Impulsiveness Scale (p < 0.001). They also scored significantly higher on TCI measures of novelty seeking (p < 0.001) and reward dependence (p < 0.001) and significantly lower on measures of harm avoidance (p < 0.001).

Conclusions

Tobacco smoking is rare in OCD. Significantly higher levels of behavioural impulsivity and temperamental factors associated with reward driven impulsivity are seen in OCD smokers compared to non-smokers. Tobacco smoking may indicate a possible source of neurocognitive heterogeneity in OCD.

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  • M. Amering B. Bankier P. Berger H. Griengi J. Windhaber H. Katschnig 1999 Panic disorder and cigarette smoking behaviour Comprehensive Psychiatry 40 35 38.

    • Search Google Scholar
    • Export Citation
  • M. Ansseau 1996 Serotonergic antidepressants in obsessive personality (NR198) 149 th Annual Meeting of the American Psychiatric Association American Psychiatric Association New York, NY 121 122.

    • Search Google Scholar
    • Export Citation
  • S. L. Baker-Morissette S. B. Gulliver M. Wiegel D. H. Barlow 2004 Prevalence of smoking in anxiety disorders uncomplicated by comorbid alcohol or substance abuse Journal of Psychopathology and Behavioral Assessment 26 2 107 111.

    • Search Google Scholar
    • Export Citation
  • S. Bejerot M. Humble 1999 Low prevalence of smoking among patients with obsessive-compulsive disorder Comprehensive Psychiatry 40 268 272.

    • Search Google Scholar
    • Export Citation
  • O. J. Bienvenu J. F. Samuels L. A. Wuyek K. Y. Liang Y. Wang M. A. Grados G. Nestadt 2012 Is obsessive-compulsive disorder an anxiety disorder, and what, if any, are spectrum conditions? A family study perspective Psychol. Med. 42 1 1 13.

    • Search Google Scholar
    • Export Citation
  • N. Breslau 1995 Psychiatric comorbidity of smoking and nicotine dependence Behaviour Genetics 25 95 101.

  • N. Breslau M. Kilbey P. Andreski 1991 Nicotine dependence, major depression, and anxiety in young adults Archives of General Psychiatry 48 1069 1074.

    • Search Google Scholar
    • Export Citation
  • G. D. Chiara 2000 Role of dopamine in the behavioural actions of nicotine related to addiction European Journal of Pharmacology 393 1–3 295 314.

    • Search Google Scholar
    • Export Citation
  • C. R. Cloninger 1987 A systematic method for clinical and description and classification of personality variant Arch. Gen. Psychiatry 44 584 587.

    • Search Google Scholar
    • Export Citation
  • C. R. Cloninger 1994 The temperament and character inventory (TCI): A guide to its development and use Center for Psychobiology of Personality, Washington University St. Louis, MO.

    • Search Google Scholar
    • Export Citation
  • C. Cruz-Fuentes C. Blas L. Gonzalez B. Camarena H. Nicolini 2004 Severity of obsessive-compulsive symptoms is related to self-directedness character trait in obsessive-compulsive disorder CNS Spectr. 9 8 607 612.

    • Search Google Scholar
    • Export Citation
  • N. A. Fineberg M. Potenza S. R. Chamberlain H. A. Berlin L. Menzies A. Bechara B. J. Sahakian E. Hollander 2010 Probing compulsive and impulsive behaviours, from animal models to endophenotypes: A narrative review Neuropsychopharmacology 35 3 591 604.

    • Search Google Scholar
    • Export Citation
  • General Household Survey. Smoking and drinking among adults, 2007. Office for National Statistics.

  • A. H. Glassman 1993 Cigarette smoking: Implications for psychiatric illness American Journal of Psychiatry 150 546 553.

  • W. K. Goodman L. H. Price S. A. Rasmussen C. Mazure R. L. Fleischmann C. L. Hill D. S. Charney 1989 The Yale-Brown Obsessive Compulsive Scale Arch. Gen. Psychiatry 46 11 1006 1016.

    • Search Google Scholar
    • Export Citation
  • W. Guy 2000 Clinical Global Impressions (CGI) Scale. Modified from: Rush, J. et al.: Psychiatric Measures APA Washington DC.

  • J. Himle A. B. Thyer D. J. Fischer 1988 Prevalence of smoking among anxious outpatients Phobia Practice and Research Journal 1 1 25 31.

    • Search Google Scholar
    • Export Citation
  • J. R. Hughes D. K. Hatsukami J. E. Mitchell L. A. Dahlgren 1986 Prevalence of smoking among psychiatric outpatients American Journal of Psychiatry 143 993 997.

    • Search Google Scholar
    • Export Citation
  • Khan, A. A., Jacobson, K. C., Gardner, C. O., Prescott, C. A. & Kendler, K. S. (2005). Personality and comorbidity of common psychiatric disorders. British Journal of Psychiatry, 190196.

    • Search Google Scholar
    • Export Citation
  • G. F. Koob M. Le Moal 2001 Drug addiction, dysregulation of reward, and allostasis Neuropsychopharmacology 24 2 97 129.

  • O. Le Bon P. Basiaux E. Streel J. Tecco C. Hanak M. Hansenne M. Ansena I. Pelc P. Verbanck S. Dupont 2004 Personality profile an drug of choice: A multivariate analysis using Cloninger's TCI on heroin addicts, alcoholics, and a random population group Drug Alcohol Depend. 73 2 175 182.

    • Search Google Scholar
    • Export Citation
  • R. E. McCabe S. M. Chudzik M. M. Antony L. Young R. P. Swinson M. J. Zolvensky 2004 behaviours across anxiety disorders Journal of Anxiety Disorders 18 7 18.

    • Search Google Scholar
    • Export Citation
  • L. Menzies S. Achard S. R. Chamberlain N. A. Fineberg C. H. Chen N. D. Campo E. Bullmore 2007 Neurocognitive endophenotypes of obsessive-compulsive disorder Brain 130 12 3223 3236.

    • Search Google Scholar
    • Export Citation
  • S. A. Montgomery M. Asberg 1979 A new depression scale designed to be sensitive to change British Journal of Psychiatry 134 4 382 389.

  • A. Padhi A. M. Mehdi K. Craig N. A. Fineberg 2010 Current classification of impulse control disorders: Cognitive versus behavioral impulsivity and the role of personality M. N. Potenza J. E. Grant Oxford handbook of impulse control disorders Oxford University Press Oxford.

    • Search Google Scholar
    • Export Citation
  • J. M. Patton M. S. Stanford E. S. Barratt 1995 Factor structure of the Barratt Impulsiveness Scale Journal of Clinical Psychology 51 768 774.

    • Search Google Scholar
    • Export Citation
  • B. F. Piko A. Luszczynska F. X. Gibbons M. Tekozel 2004 A culture-based study of personal and social influences of adolescent smoking European Journal of Public Health 15 4 393 398.

    • Search Google Scholar
    • Export Citation
  • E. C. Pooley N. A. Fineberg P. J. Harrison 2007 The met158 allele of catechol-O-methyltransferase (COMT) is associated with obsessive-compulsive disorder in men: Case-control study and meta-analysis Molecular Psychiatry 12 556 561.

    • Search Google Scholar
    • Export Citation
  • C. X. Poulos A. D. Le J. L. Parker 1995 Impulsivity predicts individual susceptibility to high levels of alcohol self-administration Behavioural Pharmacology 6 810 814.

    • Search Google Scholar
    • Export Citation
  • M. C. Rosario-Campos E. C. Miguel S. Quatrano P. Chacon Y. Ferrao D. Findley J. F. Leckman 2006 DYBOCS to assess different symptom profile Mol Psychiatry 11 5 495 504.

    • Search Google Scholar
    • Export Citation
  • D. V. Sheehan Y. Lecrubier K. H. Sheehan P. Amorim J. Janavs E. Weiller G. C. Dunbar 1998 The MiniInternational Neuropsychiatric Interview (M.I.N.I): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10 J. Clin. Psychiatry 59 20 22 33.

    • Search Google Scholar
    • Export Citation
  • Stamm & Rudolph (1996–97). The Life Status Review to assess social adjustment — Loners versus friends.

  • R. A. Wise 2002 Brain reward circuitry: Insights from unsensed incentives Neuron 36 229 240.

  • H. U. Wittchen F. Jacobi J. Rehm A. Gustavsson M. Svensson B. Jönsson H.-C. Steinhausen 2011 The size and burden of mental disorders and other disorders of the brain in Europe 2010 European Neuropsychopharmacology 21 655 679.

    • Search Google Scholar
    • Export Citation
  • M. Zuckerman 1983 Sensation seeking: The initial motive for drug abuse E. H. Gottheil K. A. Druley T. E. Skoloda H. M. Waxman Etiological aspects of alcohol and drug abuse Charles C. Thomas Springfield, IL 202 220.

    • Search Google Scholar
    • Export Citation

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