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November 18, 1988, Vol 260, No. 19 >
ARTICLE | November 18, 1988

The Neurobiology of Obsessive-Compulsive Disorder FREE

Judith L. Rapoport, MD
[+] Author Affiliations

Presented Jan 27, 1988, at Clinical Center Grand Rounds, National Institutes of Health.

Reprint requests to National Institute of Mental Health, Bldg 10, Room 6N-240, Bethesda, MD 20892 (Dr Rapoport).


JAMA. 1988;260(19):2888-2890. doi:10.1001/jama.1988.03410190136037
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References

SELECTED CASE  AN 18-YEAR-OLD high school girl from a small town in Maine was brought to a psychiatrist by her mother because of her excessive showering and dressing rituals. Showers lasted two hours; it took a half hour to dress. Each act of dressing was counted and had to be repeated precisely 17 times. These behaviors had begun gradually at age 15 years, causing chronic tardiness at school; two months of counseling with the school psychologist was not helpful. When the psychiatrist was consulted, the patient's circle of friends and activities had narrowed, and she was missing school one or two days a week.She had been an outgoing, popular girl, with average grades, who had not previously exhibited unusual concern for neatness, expressed odd thoughts or preoccupations, or presented any behavioral problems of note. When interviewed, she was embarrassed discussing her washing and counting behaviors. She said she "knew

REFERENCES

1 +
Young FE, Norris JA, Levitt JA, et al:  The FDA's new procedures for the use of investigational drugs in treatment . JAMA 1988;;259:2267-2270.
2 +
Swedo S, Rapoport J:  Phenomenology and differential diagnosis of obsessive compulsive disorder , in Rapoport J (ed): Obsessive Compulsive Disorder in Children and Adolescents Washington, DC, American Psychiatric Press Inc, in press.
3 +
Rapoport J: The Boy Who Couldn't Stop Washing . New York, EP Dutton, in press.
4 +
Black A:  The natural history of obsessional neurosis , in Hoch PH, Zubin J (eds): Obsessional States . New York, Methuen & Co Ltd, 1974;, pp 19-54.
5 +
Robins L, Helzer J, Weissman M, et al:  Lifetime prevalence of specific psychiatric disorders . Arch Gen Psychiatry 1984;;41:449-458.
6 +
Karno M, Golding J, Sorenson S, et al:  The epidemiology of obsessive compulsive disorder in five US communities . Arch Gen Psychiatry , in press.
7 +
Flament M, Whitaker A, Rapoport J:  Obsessive compulsive disorder in adolescence: An epidemiologic study . J Child Psychol Psychiatry , in press.
8 +
Pauls D, Leckman J, Towbin K, et al:  Tourette's syndrome and obsessive compulsive disorder . Arch Gen Psychiatry 1986;;43:1180-1182.
9 +
Freeman J, Aron A, Collard D:  The emotional correlates of Sydenham's chorea . Pediatrics 1965;;35:42-49.
10 +
Swedo SE, Rapoport JL, Cheslow DL, et al:  Increased incidence of obsessive compulsive symptoms in patients with Sydenham's chorea . Am J Psychiatry , in press.
11 +
Von Economo C: Encephalitis Lethargica, Its Sequellae and Treatment , Newman KO (trans). New York, Oxford University Press Inc, 1931;.
12 +
Kettl P, Marks I:  Neurological factors in obsessive compulsive disorder: Two case reports and a review of the literature . Br J Psychiatry 1986;;149:315-319.
13 +
Baxter L, Phelps M, Mazziotta J, et al:  Local cerebral glucose metabolic rates in obsessive compulsive disorder . Arch Gen Psychiatry 1987;;44: 211-218.
14 +
Baxter L, Schwartz JM, Mazziotta J, et al:  Cerebral glucose metabolic rates in non-depressed obsessive-compulsives . Am J Psychiatry 1988 , in press.
15 +
Swedo S, Schapiro M, Grady C, et al:  Cerebral glucose metabolism in childhood onset obsessive compulsive disorder . Arch Gen Psychiatry , in press.
16 +
Bartlett J, Bridges P, Kelly D:  Contemporary indications for psycho-surgery . Br J Psychiatry 1981;;138:507-511.
17 +
Veasey LG, Wiedmeier SE, Orsmond GE, et al:  Resurgence of acute rheumatic fever in the intermountain area of the United States . N Engl J Med 1987;;316:421-427.
18 +
Rachman SJ, Hodgson RJ: Obsessions and Compulsions . Englewood Cliffs, NJ, Prentice-Hall International Inc, 1980;.
19 +
Flament M, Rapoport J, Berg C, et al:  Clomipramine treatment of childhood obsessive-compulsive disorder: A double-blind controlled study . Arch Gen Psychiatry 1985;;42:977-983.
20 +
Leonard H, Rapoport J:  Pharmacotherapy of childhood obsessive compulsive disorder . Psychiatr Clin North Am , in press.
21 +
Leonard H, Swedo S, Rapoport J, et al:  Treatment of childhood obsessive compulsive disorder with clomipramine and desmethylimipramine: A double-blind crossover comparison . Psychopharmacol Bull 1988;;24:93-95.
22 +
Zohar J, Insel T, Xohar-Kadouch R, et al:  Serotonergic responsivity in obsessive compulsive disorder . Arch Gen Psychiatry 1988;;45:167-172.
23 +
 Food and Drug Administration Office of Health Affairs: Clomipramine 'treatment IND' approved . JAMA 1988;;260:315.
24 +
Lewis A:  Problems of obsessional illness . Proc R Soc Med 1936;;29:325-336.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Young FE, Norris JA, Levitt JA, et al:  The FDA's new procedures for the use of investigational drugs in treatment . JAMA 1988;;259:2267-2270.
2 +
Swedo S, Rapoport J:  Phenomenology and differential diagnosis of obsessive compulsive disorder , in Rapoport J (ed): Obsessive Compulsive Disorder in Children and Adolescents Washington, DC, American Psychiatric Press Inc, in press.
3 +
Rapoport J: The Boy Who Couldn't Stop Washing . New York, EP Dutton, in press.
4 +
Black A:  The natural history of obsessional neurosis , in Hoch PH, Zubin J (eds): Obsessional States . New York, Methuen & Co Ltd, 1974;, pp 19-54.
5 +
Robins L, Helzer J, Weissman M, et al:  Lifetime prevalence of specific psychiatric disorders . Arch Gen Psychiatry 1984;;41:449-458.
6 +
Karno M, Golding J, Sorenson S, et al:  The epidemiology of obsessive compulsive disorder in five US communities . Arch Gen Psychiatry , in press.
7 +
Flament M, Whitaker A, Rapoport J:  Obsessive compulsive disorder in adolescence: An epidemiologic study . J Child Psychol Psychiatry , in press.
8 +
Pauls D, Leckman J, Towbin K, et al:  Tourette's syndrome and obsessive compulsive disorder . Arch Gen Psychiatry 1986;;43:1180-1182.
9 +
Freeman J, Aron A, Collard D:  The emotional correlates of Sydenham's chorea . Pediatrics 1965;;35:42-49.
10 +
Swedo SE, Rapoport JL, Cheslow DL, et al:  Increased incidence of obsessive compulsive symptoms in patients with Sydenham's chorea . Am J Psychiatry , in press.
11 +
Von Economo C: Encephalitis Lethargica, Its Sequellae and Treatment , Newman KO (trans). New York, Oxford University Press Inc, 1931;.
12 +
Kettl P, Marks I:  Neurological factors in obsessive compulsive disorder: Two case reports and a review of the literature . Br J Psychiatry 1986;;149:315-319.
13 +
Baxter L, Phelps M, Mazziotta J, et al:  Local cerebral glucose metabolic rates in obsessive compulsive disorder . Arch Gen Psychiatry 1987;;44: 211-218.
14 +
Baxter L, Schwartz JM, Mazziotta J, et al:  Cerebral glucose metabolic rates in non-depressed obsessive-compulsives . Am J Psychiatry 1988 , in press.
15 +
Swedo S, Schapiro M, Grady C, et al:  Cerebral glucose metabolism in childhood onset obsessive compulsive disorder . Arch Gen Psychiatry , in press.
16 +
Bartlett J, Bridges P, Kelly D:  Contemporary indications for psycho-surgery . Br J Psychiatry 1981;;138:507-511.
17 +
Veasey LG, Wiedmeier SE, Orsmond GE, et al:  Resurgence of acute rheumatic fever in the intermountain area of the United States . N Engl J Med 1987;;316:421-427.
18 +
Rachman SJ, Hodgson RJ: Obsessions and Compulsions . Englewood Cliffs, NJ, Prentice-Hall International Inc, 1980;.
19 +
Flament M, Rapoport J, Berg C, et al:  Clomipramine treatment of childhood obsessive-compulsive disorder: A double-blind controlled study . Arch Gen Psychiatry 1985;;42:977-983.
20 +
Leonard H, Rapoport J:  Pharmacotherapy of childhood obsessive compulsive disorder . Psychiatr Clin North Am , in press.
21 +
Leonard H, Swedo S, Rapoport J, et al:  Treatment of childhood obsessive compulsive disorder with clomipramine and desmethylimipramine: A double-blind crossover comparison . Psychopharmacol Bull 1988;;24:93-95.
22 +
Zohar J, Insel T, Xohar-Kadouch R, et al:  Serotonergic responsivity in obsessive compulsive disorder . Arch Gen Psychiatry 1988;;45:167-172.
23 +
 Food and Drug Administration Office of Health Affairs: Clomipramine 'treatment IND' approved . JAMA 1988;;260:315.
24 +
Lewis A:  Problems of obsessional illness . Proc R Soc Med 1936;;29:325-336.

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