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Classification and Treatment of Obsessional Slowness

Published online by Cambridge University Press:  02 January 2018

David Veale*
Affiliation:
Grovelands Priory Hospital, The Bourne, Southgate, London N14 6RA Honorary Consultant Psychiatrist, Barnet and Edgware General Hospitals, London

Abstract

Obsessional slowness is regarded as an uncommon but severely disabling variant of obsessive-compulsive disorder. This paper examines the psychopathology, classification, pathophysiology and treatment of obsessional slowness. It argues that primary obsessional slowness does not require classification as a separate syndrome because it can be found to be secondary to recognised phenomena of obsessive-compulsive disorder or anankastic personality disorder. The treatment described in the literature is not thought to be successful in the long term, and controlled trials are required to evaluate new strategies and antidepressant medication.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1993 

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References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM-III-R). Washington, DC: APA.Google Scholar
Beck, A. T. & Freeman, A. (1990) Cognitive Therapy for Personality Disorders. New York: Guilford Press.Google Scholar
Bennun, I. (1980) Obsessional slowness: a replication and an extension. Behaviour Research and Therapy, 18, 595598.CrossRefGoogle Scholar
Bilsbury, C. & Morley, S. (1979) Obsessional slowness: a meticulous replication. Behaviour Research and Therapy, 17, 405408.CrossRefGoogle ScholarPubMed
British Medical Journal (1974) Editorial: obsessional slowness. British Medical Journal, ii, 685686.Google Scholar
Clark, D. A., Sugrim, L. & Bolton, D. (1982) Primary obsessional slowness: a nursing treatment programme and a 13 year old male adolescent. Behaviour Research and Therapy, 20, 289292.CrossRefGoogle Scholar
Comings, D. E. & Comings, B. G. (1986) Evidence for an X-linked modifier gene affecting the expression of Tourette syndrome and its relevance to the increased frequency of speech, cognitive, and behavioural disorders in males. Proceedings of the National Academy of Science USA, 83, 25512555.CrossRefGoogle Scholar
Denkla, M. B. (1988) Neurological examination. In Obsessive Compulsive Disorder in Children and Adolescents (ed. Rapoport, J.L.). Washington, DC: APA.Google Scholar
Gelder, M., Gath, D. & Mayou, R. (1983) Oxford Textbook of Psychiatry. Oxford: Oxford Medical.Google Scholar
Hamlin, C. L., Swayne, L. C. & Liebowitz, M. R. (1989) Striatal IMP-spect decrease in obsessive compulsive disorder, normalized by pharmacotherapy. Neuropsychiatry, Neuropsychology, and Behavioural Neurology, 2, 290300.Google Scholar
Hodgson, R. & Rachman, S. J. (1977) Obsessional compulsive complaints. Behaviour Research and Therapy, 15, 389395.CrossRefGoogle ScholarPubMed
Hollander, E., Schiffman, E., Cohen, B., et al (1990) Signs of central nervous system dysfunction in obsessive compulsive disorder. Archives of General Psychiatry, 47, 2732.CrossRefGoogle ScholarPubMed
Hymas, N., Lees, A., Bolton, D., et al (1991) The neurology of obsessional slowness. Brain, 114, 22032233.CrossRefGoogle ScholarPubMed
Khanna, S., Kaliaperumal, V. G. & Channabasavanna, S. M. (1990) Clusters of obsessive compulsive phenomena in obsessive compulsive disorder. British Journal of Psychiatry, 156, 5154.CrossRefGoogle ScholarPubMed
Laplane, D., Baulac, M., Widlocher, D., et al (1984) Pure psychic akinesia with bilateral lesions of basal ganglia. Journal of Neurology, Neurosurgery and Psychiatry, 47, 377385.CrossRefGoogle ScholarPubMed
Lees, A. J. (1989) The neuro-behavioural abnormalities in Parkinson's disease and their relationship to psychomotor retardation and obsessive compulsive disorder. Behavioural Neurology, 2, 111.CrossRefGoogle Scholar
Marks, I. M. (1987a) Fears, Phobias, and Rituals, New York: Oxford University Press.Google Scholar
Marks, I. M. (1987b) Psychological treatment: clinical issues. In Fears, Phobias and Rituals, p. 514. New York: Oxford University Press.Google Scholar
Marks, I. M. (1987c) Obsessive compulsive disorder. In Fears, Phobias and Rituals, pp. 429431. New York: Oxford University Press.Google Scholar
Mavissakalian, M., Turner, R. M. & Michelson, L. (1985) Future directions in the assessment and treatment of obsessive compulsive disorder. In Obsessive Compulsive Disorder - Psychological and Pharmacological Treatment (eds Mavissakalian, M., Turner, R. M. & Michelson, L.), p. 221. New York: Plenum Press.CrossRefGoogle Scholar
Morris, R. G., Downes, J. J., Sahakian, B. J., et al (1988) Planning and spatial working memory in Parkinson's disease. Journal of Neurology, Neurosurgery and Psychiatry, 51, 757766.CrossRefGoogle ScholarPubMed
O'Sullivan, G. & Marks, I. M. (1991) Long term outcome of phobic and obsessive-compulsive disorder after treatment. In Handbook of Anxiety Disorders, Vol. 4 The Treatment of Anxiety (eds Noyes, R., Roth, M. & Burrows, G. D.). Amsterdam: Elsevier Science Publishers.Google Scholar
Owen, A., Downes, J. J., Sahakian, B. J., et al (1990) Planning and spatial working memory following frontal lobe lesions in man. Neuropsychologia, 28, 10211034.CrossRefGoogle ScholarPubMed
Rachman, S. J. (1974) Primary obsessional slowness. Behaviour Research and Therapy, 12, 918.CrossRefGoogle ScholarPubMed
Rachman, S. J. & Hodgson, R. (1980) Obsessions and Compulsions. Englewood Cliffs, New Jersey: Prentice Hall.Google Scholar
Ratnasuriya, R. H., Marks, I. M., Forshaw, D. M., et al (1991) Obsessive slowness revisited. British Journal of Psychiatry, 159, 273274.CrossRefGoogle ScholarPubMed
Reed, G. F. (1985) Obsessional Experience and Compulsive Behaviour. Orlando, Florida: Academic Press.Google Scholar
Rogers, D. (1986) Bradyphrenia in Parkinsonism: a historical review. Psychological Medicine, 16, 257265.CrossRefGoogle ScholarPubMed
Salkovskis, P. M. & Kirk, J. W. (1989) Obsessional disorders. In Cognitive Behaviour Therapy for Psychiatric Problems (eds Hawton, K., Salkovskis, P. M., Kirk, J., et al), pp. 129168. Oxford: Oxford Medical.CrossRefGoogle Scholar
Sanavio, E. & Vidotto, G. (1985) The components of the Maudsley Obsessional Compulsive Questionnaire. Behaviour Research and Therapy, 6, 659662.CrossRefGoogle Scholar
Turner, R. M. & Beidel, D. C. (1988) Treating Obsessive Compulsive Disorder. New York: Pergamon Press.Google Scholar
Wise, S. P. & Rapoport, J. L. (1988) Obsessive compulsive disorder - is it basal ganglia dysfunction? In Obsessive Compulsive Disorder in Children and Adolescents (ed. Rapoport, J. L.), pp. 327344. Washington, DC: APA.Google Scholar
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