Mark A. Casteel wrote:
> Are any tipsters aware of recent research arguing that OCD may be more a
> form of a depressive disorder than an anxiety disorder? ...
> A student has tried to argue with me that his therapist believes that OCD
> is a depressive disorder (I should point out that this student is NOT being
> treated for OCD).
In general, there is an association between anxiety disorders and mood disorders,
especially major depression. I know I have read somewhere that some people think
that this association may reflect shared causes of the two sets of disorders but I
have seen no evidence other than the association itself to back up this
speculation. Dubovsky and Buzan (1999) offer the following possible noncausal
explanations for the association:
"Many kinds of distress in depressed patients can be grouped by patients as well
as independent raters under the rubric of _anxiety_..., and patients may describe
arousal and dysphoria as anxiety at one point and depression at another. Some
patients cannot tell the difference between anxiety and depression.... In other
patients, anxiety may reflect a separate disorder that occurs at a
higher-than-expected rate in depressed patients; this rate may be higher because
one disorder lowers the threshold for the expression of the other or because
susceptibility to one disorder is linked to susceptibility to the other....
"Anxiety and mood disorders may alternate with as well as accompany each other....
In some instances, the predominance of one or the other symptom may represent a
prodromal phase of a mood disorder in which both anxiety and depression are
important symptoms....
"In addition to their comorbidity, depression, mania, and anxiety as dimensions of
affective experience have complex overlap and interactions with each other.
Anxiety in depressed patients increases severity, chronicity, and impairment
associated with depression and makes depression more refractory to treatment." (p.
507).
With respect to OCD, in particular, Dubovsky and Buzan state that 33% of people
with OCD also can be diagnosed with major depression, whereas 11% of people with
major-depressive disorder experience at least some obsessions and/or compulsions.
Thus, it probably is not quite correct, based on these statistics, to state that
OCD is simply a form of major-depressive disorder. Nevertheless, they do suggest
some small to moderate association between the two.
Hollander, Simeon, and Gorman (1999) also stated that people with OCD sometimes
will experience major depression:
"Patients with OCD frequently have complicating depressions [actually, only 33%
according to the above] and these patients may be difficult to distinguish from
depressed patients who have complicating obsessive symptoms. Patients with
psychotic depression [approximately 10% of all people with major depression],
agitated depression, or premorbid obsessional features that occur before the
development of depression are particularly likely to develop obsessions.... In
addition, depressive ruminations, in contrast to pure obsessions, are often
focused on a past incident rather than on a current or future event and are rarely
resisted." (p. 606)
The last sentence points to a similarity between the thinking of depressed
patients and OCD patients that also is different in an important way. This
similarity may be an additional reason for the claim that OCD is a form of major
depression.
Jeff
P.S. Both references can be found in _The American Psychiatric Press Textbook of
Psychiatry_ (3rd ed.), edited by R. E. Hales, S. C. Yudofsky, and J. A. Talbott.
--
Jeffry P. Ricker, Ph.D. Office Phone: (480) 423-6213
9000 E. Chaparral Rd. FAX Number: (480) 423-6298
Psychology Department [EMAIL PROTECTED]
Scottsdale Community College
Scottsdale, AZ 85256-2626
"Science must begin with myths and with the criticism of myths"
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“No matter how cynical you become, it's never enough to keep up.”
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Listowner: Psychologists Educating Students to Think Skeptically (PESTS)
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