Posts tagged with "OCD"

Groundbreaking study: OCD sufferers face much higher risk of death

February 23, 2024

People with obsessive-compulsive disorder face a much higher risk of death—from natural and unnatural causes, according to a shocking new study out of Sweden, reports the New York Post.

OCD, which affects 2% to 3% of Americans, is characterized by recurring thoughts (obsessions) and repetitive behaviors such as excessive hand washing and arranging objects in a precise way (compulsions).

This new research is reported to be the largest-ever study of mortality in people with OCD. Researchers identified 61,378 Swedes with the condition and matched them with 613,780 people without OCD by sex, birth year, and county of residence.

They also studied 34,085 people with OCD and 47,874 of their siblings without it.

The groups were monitored for an average of eight years between January 1973 and December 2020. During the study period, 4,787 people with OCD and 30,619 people without it died.

Scientists determined that people with OCD had an 82% increased risk of death—after adjusting for factors such as birth year, sex, county, migrant status, education, and family income. Their findings were published in the BMJ journal.

Specifically, people with OCD face a 31% increased risk of natural death and a three-fold greater risk of dying of an unnatural cause.

The natural causes of death by increased risk are:

  • Respiratory system diseases (73%);
  • Mental and behavioral disorders (58%);
  • Genital and urinary system diseases (55%);
  • Endocrine, nutritional, and metabolic diseases (47%);
  • Circulatory system diseases (33%);
  • Nervous system disease (21%); and
  • Digestive system diseases (20%).

 However, people with OCD had a 10% reduced risk of death due to tumors.

Among the unnatural causes, researchers identified a nearly fivefold increased risk of suicide and a 92% greater risk of accidents.

Women with OCD had a higher relative risk of dying of unnatural causes than men with OCD, researchers said, noting that OCD is slightly more prevalent in women than in men.

It’s unclear what exactly causes OCD, but genetics and environmental factors such as pregnancy complications and childhood trauma have been studied. Psychotherapy and antidepressants are often used to treat the condition.

“Better surveillance, prevention, and early intervention strategies should be implemented to reduce the risk of fatal outcomes in people with OCD,” the researchers wrote in their findings.

The scientists are unsure if their findings apply to people outside of Sweden with different healthcare systems and medical practices.

Research contact: @nypost

Should you see a psychodermatologist?

June 17, 2021

Get ready for a new term in your skin-care lexicon: psychodermatology, Allure reports.

A relatively new medical specialization, psychodermatology primarily addresses skin concerns that could be linked stress and anxiety. Some of the doctors practicing it even have dual degrees in dermatology and psychiatry.

Overall, however, patients consult psychodermatologists to treat four kinds of psychopathologies: Depression, anxiety, obsessive behaviors, and delusions.

Obsessive behaviors can be seen in repetitive disorders such as  trichotillomania (the so-called “hair-pulling disorder”); while delusions would include parasitosis, which leads people to incorrectly believe that their skin is infested by parasites or insects.

But it’s the first two type —depression and anxiety—that may have more universal implications. While psychodermatology can be used to help address psoriasis, eczema, hyperhidrosis, and alopecia, the benefits can go beyond that to even more common worries like acne and age-related concerns, Allure reports.

That last one may come as a surprise, but according to Amy Wechsler, a dermatologist and psychiatrist in private practice in New York City, a reduction of stress boosts collagen production which can plump lines and wrinkles and help to icnrease cell turnover. “[You remember] what it feels like to go on vacation and people at work are like, ‘Wow, you look great?'” It’s proof, she insists, that in just seven days of tackling stress, she says, “you can see it on your skin.”

Currently, psychodermatology is considered a niche practice in the United States with established clinics devoted to it only found in seven U.S. cities (Rochester, New York; New York City; Tampa, Florida; Saginaw, Michigan; Madison, Wisconsin; Kansas City, KS; and San Francisco)according to the Association for Psychocutaneous Medicine of North America.

But lately, it’s also been popping up in newspaper articles and even inspiring new skin-care lines—like Loum, based on the ingredient neurophroline derived from wild indigo, which the brand claims reduces cortisol levels in the skin.

The practice includes the same familiar topicals and treatments that you’ll see at a traditional dermatology practice, but with the addition of other strategies as needed—among them:

  • Interpersonal therapy,
  • Cognitive behavior therapy (meant to address distorted thoughts that could be adding anxiety),
  • Hypnosis (which has some evidence that it could be beneficialfor certain skin conditions, including warts); and
  • Recommendations for sleep hygiene and mind-body practices like meditation and yoga.

If it’s appropriate, there may also be a psychological medication prescribed, such as serotonin reuptake inhibitors, if the patient exhibits symptoms of depression that could be a contributing factor to the state of their skin.

The effects can have far-reaching impacts on quality of life. “The mind is very tightly linked to the skin, particularly through the sensory nerves that reach the very superficial surface of the skin,” explains Francisco Tausk, dermatologist, past president of the APMA, and head of the Center for Integrated Dermatology.

“These nerves release into the skin small neuropeptides that have a very strong influence on cutaneous physiology and how the skin behaves in health and disease.” Some of these neuropeptides: cortisol, adrenaline, and substance P.

Wechsler takes the example of cortisol, which when chronically raised, can cause a host of problems including inflammation and collagen breakdown. What that can lead to: “Premature aging, acne, eczema, psoriasis—you name it. The skin barrier doesn’t work well, so you get more sensitive to allergens.” In other words, she says, “All sorts of bad stuff happens.”

According to Allure, psychodermatology appointments, just like separate appointments in either field, are highly individualized—depending greatly on the doctor’s practices and the patient’s needs. For example, Wechsler prefers to send her patients to outside specialists when psychological medications are needed, and instead focuses her own practice largely on active listening therapies. Other practices offer additional psychology-based strategies within the practice itself.

Regardless, you’ll still walk away with a regimen. It just may be a little longer and touch on more disciplines than you might be used to discussing with your derm. And that may include more in-office work and even homework, like doing yoga a couple of times a week.

Finally, dealing with elevated cortisol levels on your skin may get easier as interest increases and experts and brands find ways to address it. Loum founder Kat Bryce sees potential for us all to benefit as the United States wakes up to the link between mental health and our complexions. After developing her line, she and her partners are believers. “Now we see the fundamental impact of stress on skin, we hope more developments will come in this space as the need is enormous and the opportunity for effective solutions vast,” she says.

Research contact: @Allure_magazine

Do you have an addictive personality, or just a healthy enthusiasm?

February 24, 2020

Some people cannot stop tweeting; others stream endless episodes of a favorite TV series, drink gallons of coffee each week; bet on competitive sports;  cover themselves with tattoos, jockey for position on video games, or visit tanning salons. While they may not be taking opioids, they still might be “addicted.”

But is there such a thing as an addictive personality? The informal answer is yes, according to the American Addiction Centers—one of the largest networks of rehab facilities nationwide.

Indeed, the rehabilitation experts describe “addictive personality” as an informal term that links particular personality traits to a higher risk of addiction or other problematic behaviors—such as drug abuse, cigarette smoking, gambling, or even constant social media use—according to a report by MindyBodyGreen 

“The term is used colloquially to refer to people who have tendencies that appear to lead to addiction-like behaviors,” says George Koob, Ph.D., director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

“Addictive personality” is a term often used in association with alcoholism, but you can also feel addicted to other things, like certain activities, people, foods, or physical objects. According to J. Wesley Boyd, M.D., Ph.D., an associate professor of psychiatry at Harvard Medical School’s Center for Bioethics, behaviors like gambling, frequent social media use, or even video gaming can also be addictive.

“For people who are addicted to these behaviors—and even those who just derive intense enjoyment from them—engaging in these behaviors can result in the release of dopamine, a neurotransmitter that is the final common pathway of basically every drug of abuse,” Dr. Boyd told MindyBodyGreen.

He also notes that you can even be addicted to another person in a dating relationship because of this neurochemical response. That said, an unhealthy addiction is very different from healthy enthusiasm.

“Being addicted to something means it has taken over your life and that you are sacrificing important things in your life in service of the addiction,” says Boyd. Koob describes addiction similarly as “being stuck in a cycle in which a person binges on a substance, feels discomfort when the substance wears off, and is preoccupied with procuring and using the substance again.” (And again, this doesn’t apply only to physical substances—it can also be behaviors or experiences.)

On the flip side, “enthusiasm means that you might love something and even that you might look forward to it much of the time, but you are not and will not compromise basic important elements in your life,” Boyd says. 

Some experts believe that the term “addicted” is used too loosely to explain behaviors that are closer to enthusiasm, so Boyd uses exercise as an example of this distinction: An enthusiastic exerciser will look forward to workouts but probably won’t work out when they’re sick, he says. An exercise “addict,” on the other hand, might continue exercising even when they have the flu, despite adverse outcomes. 

“There are definitely individuals who are prone to become addicted in various ways,” Boyd says, noting that addiction is often a combination of both genetics and the environment. “Some of this is based on personal history, but much of it is determined by having a family history of addiction.”

According to MindBodyGreen, people who are at a higher-than-average risk for addiction may have some of the following markers:

  • A close family member with an addiction. Boyd says individuals born to parents who have an addiction are more likely to become addicted themselves, and lots of research backs this up. Overall, it appears that genetic heritability affects addiction by between 40% and 70%—but Koob is careful to note that this genetic component comes from many different pathways, and the likelihood of developing an addiction is due to both the environment and your genetics.
  • An OCD diagnosis. Several other disorders, including obsessive-compulsive disorder, are more likely to co-occur with addiction.
  • Impulsive tendencies and trouble self-regulating. A study about video game addiction found that impulsive people might be more prone to developing an addiction.
  • Low self-esteem. For certain people, low self-esteem also appears to be associated with a higher risk for developing an addiction, according to the study about video gamers.
  • ADHD. A sibling study conducted in 1997 found certain people with ADHD may be more likely to develop substance use disorders, and more recent studies have found that ADHD and substance use disorders tend to co-occur in the same patients.
  • Social anxiety. People who feel lonely and anxious during social events are more likely to develop problematic internet use tendencies, according to a 2007 study. This may be because scrolling the internet can feel soothing in the moment, which helps to reduce overall feelings of anxiety or discomfort.
  • A traumatic history. Koob says people who have a history of abuse or trauma may be more likely to initiate substance abuse in order to reduce their discomfort.

Again, Koob is careful to note, “While there are tendencies that increase the risk of a substance use disorder, they don’t comprise a specific personality type, such as an addictive personality.”

Research contact: @mindbodygreen


More than just a pretty face: ‘Snapchat dysmorphia’

August 9, 2018

Selfies are the “feature films” we take of ourselves. If we are happy with the original shot, that’s fine. But many of us have taken to “erasing” any imperfections—by using apps and filters such as Facetune to smooth out skin; and to give our eyes, nose, and lips a little tweak. We might even use Snapchat to produce an idealized version of our visage (as well as to add rainbows or puppy ears).

It’s all in good fun, right? Not so much. In fact, according to a study published on August 2 by the Journal of the American Medical Association (JAMA) Network, the demand for a certain type of plastic surgery has increased, due to a new disorder dubbed “Snapchat dysmorphia.”

The study—conducted by researchers at Boston University School of Medicine’s Department of Dermatology—notes a growing trend: People are bringing in their own selfies to plastic surgeons, usually edited with a smartphone application, and asking to look more like these glorified photos.

The phenomenon is causing widespread concern among experts, who are worried about its negative effect on people’s self-esteem and its potential to trigger body dysmorphic disorder, a mental illness classified on the obsessive-compulsive spectrum, The Washington Post reported on August 8.

“This is an alarming trend because those filtered selfies often present an unattainable look and are blurring the line of reality and fantasy for these patients,” the research has found.

The condition is a mental disorder that causes people to be “extremely preoccupied with a perceived flaw in appearance that to others can’t be seen or appears minor,” according to the Mayo Clinic. People who have body dysmorphic disorder tend to obsess over their appearance and body image—often checking the mirror, grooming or seeking reassurance for many hours a day, the clinic said. Treatments include cognitive behavioral therapy and medication

Neelam Vashi, M.D. ,an assistant professor of Dermatology at the school and one of the article’s authors, told the Post in an interview that Snapchat dysmorphia is a result of people now being able to edit away any imperfections with ease.

“It’s remarkable,” said Vashi, who is also a board-certified dermatologist. “What used to lie in the hands of … celebrities … people who were innately beautiful made to look more beautiful … now it’s in the hands of anyone.”

On Snapchat, for example, the picture messaging application features upward of 20 filters that users can toggle through by simply swiping across their phone screens. Aside from adding flower crowns or puppy ears, filters can give a person freckles, longer eyelashes, wider eyes and flawless skin, among other augmentations. Facebook, Instagram and Twitter also allow people to edit their photos in the application before uploading.

Other applications such as Facetune take things a step further. For $3.99, users have access to a host of editing tools such as teeth whitening and making a person’s forehead, nose or waist smaller. While people most often use filters or editing software for minor fixes such as clearing blemishes or plumping lips, Vashi said traditional cosmetic procedures largely can’t reproduce the “instant fix” people see in their edited photos.

Based on findings of an annual survey conducted by the  American Academy of Facial Plastic and Reconstructive Surgery, selfies continue to be a driving force behind why people wish to get plastic surgery done. In 2017, the survey found that 55% of surgeons reported seeing patients who requested surgery to look better in selfies—a 13% increase from the previous year’s results.

Vashi told the Post that it is unlikely that people will change their behavior in the near future. “It sounds like people are still going to do it because they like it. They like the way they look,” she said. “I’m just one small person in a big world, I can’t change everything, but I can make people aware and recognize and know that it’s not the real world. It’s like living in a fantasy.”

Research contact: @NeelamVashi