OCD: obsessive–compulsive … disgust? The role of disgust in obsessive–compulsive disorder

OCD: obsessive–compulsive … disgust? The role of disgust in obsessive–compulsive disorder

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J Psychiatry Neurosci 2017;42(5):300-306

Tracy Bhikram, MSc; Elia Abi-Jaoude, MD; Paul Sandor, MD

Abstract

Recent research has identified the important role of disgust in the symptomatology of obsessive–compulsive disorder (OCD). Exaggerated and inappropriate disgust reactions may drive some of the symptoms of OCD, and in some cases, may even eclipse feelings of anxiety. This paper reviews behavioural and neuroimaging research that recognizes the prominent role of disgust in contributing to OCD symptoms, especially contamination-based symptoms. We discuss how elevated behavioural and biological markers of disgust reported in OCD populations support the need for alternative clinical treatment strategies and theoretical models of OCD.


Submitted April 24, 2016; Revised Jan. 16, 2017; Accepted Jan. 28, 2017; Early-released Apr. 4, 2017

Affiliations: From the Faculty of Medicine, University of Toronto (Bhikram, Abi-Jaoude, Sandor); the Tourette Syndrome Neurodevelopmental Clinic, Toronto Western Hospital (Bhikram, Abi-Jaoude, Sandor); the Department of Psychiatry, The Hospital for Sick Children (Abi-Jaoude); and the Division of Child Psychiatry, Department of Psychiatry, Youthdale Treatment Centres (Sandor), Toronto, Ont., Canada.

Competing interests: P. Sandor has received unrestricted funds from Purdue Pharma in support of a conference he organized outside the submitted work. No other competing interests declared.

Contributors: T. Bhikram designed the study and acquired and analyzed the data, which E. Abi-Jaoude and P. Sandor also analyzed. T. Bhikram wrote the article, which all authors reviewed and approved for publication.

DOI: 10.1503/jpn.160079

Correspondence to: T. Bhikram, University Health Network, Tourette Syndrome Neurodevelopmental Clinic, 399 Bathurst St, Toronto, ON M5T 2S8; tracy.bhikram@mail.utoronto.ca