Effects of comorbid obsessive-compulsive personality disorder on the behavioral inhibition/activation systems in patients with obsessive-compulsive disorder

Methods·A total of 247 patients with unmedicated OCD diagnosed in the Mental Health Center, Shanghai Jiao Tong University School of Medicine from 2014 to 2018 were included and divided into an OCD group (n=202), and an OCD+OCPD group (n=45), and 107 healthy controls were recruited as a comparison group. Yale-Brown Obsessive-Compulsion Scale (YBOCS), BIS/BAS Scale, Hamilton Depression Scale (HAMD), and Hamilton Anxiety Scale (HAMA) were used to assess psychopathological features. Gender differences among the three groups were analyzed using the χ² test. One-way analysis of variance (ANOVA) was used to compare differences in demographic characteristics, psychopathological features, and BIS/BAS scores, followed by the least significant difference (LSD) test for pairwise comparisons. Regression analysis was conducted to explore the relationships between psychopathological features and BIS/BAS scores.Results·There were no significant differences in gender, age, and years of education among the three groups. The scores of YBOCS (t=2.925, P=0.004), HAMD (t=2.130, P=0.034) and HAMA (t=2.568, P=0.011) in the OCD+OCPD group were significantly higher than those in the OCD group. There were statistically significant differences in BIS and BAS scores among the three groups (BIS: F=39.573, P<0.001; BAS: F=3.915, P=0.021). The results showed that for BIS, there were statistically significant differences in pairwise comparisons among the three groups (OCD+OCPD vs OCD: P=0.002; OCD+OCPD vs HC: P<0.001; OCD vs HC: P<0.001), and the scores were OCD+OCPD<OCD<HC from low to high. For BAS, the OCD group scored significantly higher than the OCD+OCPD and HC groups (OCD+OCPD vs OCD: P=0.018; OCD vs HC: P=0.043), but there was no significant difference between the OCD+OCPD and HC groups. Regression models of BIS and BAS were constructed for OCD patients with OCPD, and the results showed that the overall prediction effect of the model was significant for BIS total scores (F=2.599, P=0.013). Only the severity of OCPD symptoms can significantly predict BIS scores (t=-2.282, P=0.023). For BAS total scores, the overall prediction effect of the model was not significant (F=1.438, P=0.191).Conclusion·Comorbid OCPD may be an adverse factor for abnormal BIS and a protective factor for abnormal BAS in patients with OCD.Object·To explore the effects of comorbid obsessive-compulsive personality disorder (OCPD) on the behavioral inhibition system (BIS)/behavioral activation system (BAS) in patients with obsessive-compulsive disorder (OCD).