Neuropsychologie der Zwangserkrankung sto?rungsspezifische oder depressionsbedingte Defizite?

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Patients suffering from Obsessive Compulsive Disorder (OCD) show selective deficits both in the processing of complex visual information and concerning their executive functions. Patients with Major Depression (MD) were found to have, in parts, similar impairments. Other studies had suggested that concomitant depression is in large parts responsible for the functional impairments found in OCD patients concerning attention and executive functions. The aim of the present study was to identify those cognitive deficits in OCD patients which are a correlate specific to OCD, as opposed to MD patients. We also looked at the influence of the following factors on the cognitive functions of OCD patients: concomitant depression, severity of the disorder, age at onset, and the occurrence of OCD symptoms among immediate family. Forty OCD patients, 20 MD patients, and 40 healthy controls underwent several neuropsychological tests and were compared across seven cognitive domains. For the OCD sample, results of highly and slightly depressive OCD patients, according to BDI median split (medianBDI = 15.5) were compared, as were those of patients with and without a family history of the disorder. OCD patients showed impairments across all domains, not including Verbal Memory. The deficits in the domains Visual Organisation and Problem Solving / Working Memory were found to be specific correlates of obsessive-compulsive symptoms. MD patients had a deficit in Verbal Fluency similar to that of OCD patients, otherwise performance was unremarkable. Within the OCD group, we found a negative correlation between the current severity of obsessive thoughts and the domain Visual Organisation. Age at onset had a negative correlation with the domain Visual Motor Speed / Attentional Set Shifting. Neither concomitant depression nor a family history of OCD symptoms were found to influence cognitive performance. The study proved that the deficits of OCD patients concerning visual organisation and mental manipulation of complex, visually coded information are features specific to this disorder, in delimitation from mild forms of major depression. Furthermore, it became obvious that the light concomitant depression often found in OCD patients does not further impair their cognitive functions. Inhaltsverzeichnis vi Inhaltsverzeichnis Eidestattliche Erklärung.............................................................................................................................. ii Lebenslauf.................................................................................................................................................... iii Zusammenfassung ...................................................................................................................................... iv Abstract ......................................................................................................................................................... v Inhaltsverzeichnis........................................................................................................................................ vi Verzeichnis der Tabellen..........................................................................................................................viii Verzeichnis der Abbildungen..................................................................................................................... x 1 Einleitung............................................................................................................................................ 1 2 Theoretischer und empirischer Hintergrund................................................................................. 3 2.1 Neuropsychologische Leistungsdefizite bei Patienten mit Zwangserkrankung................ 3 2.1.1 Einfache Aufmerksamkeits- und Kurzzeitgedächtnisleistungen.................................... 3 2.1.2 Verbales und visuelles Langzeitgedächtnis........................................................................ 4 2.1.3 Elementare visuell-räumliche, räumlich-kognitive und visuo-konstruktive Leistungen