Trastorno obsesivo-compulsivofunciones ejecutivas y variables relacionadas

Abstract

Different investigations have reported that neuropsychological deficits are one of the main characteristics of patients with Obsessive-compulsive disorder. Currently, some authors consider Cognitive flexibility, Response inhibition and Working memory as the main executive functions affected in this disorder, although the results are inconsistent. This may be due to limitations such as the lack of control of some variables that may be related, such as the severity of the disorder, age, type of medication consumed, subtypes depending on the symptoms and possible comorbidity with other diagnoses. The main objectives of this research were to analyze the differences in the executive functioning of patients with Obsessive-compulsive disorder versus a healthy group or non-clinical control, and to verify the influence on the results of the variables anxiety, depression, obsessive beliefs and level intelligence. The study sample (N = 69) was recruited from two contexts: clinical and community. The participants of the clinical group (n = 36) were patients aged 15 to 61 years diagnosed with Obsessive-compulsive disorder. The control group (n = 33) was made up of people between 18 and 62 years old, matched in number, age, sex and level of education attained. The evaluation was carried out through tests of cognitive flexibility, response inhibition and working memory. The evaluation instruments used were the Wisconsin Card Sorting Test, The Stroop Color and Word Test, Five Digits Test, a Go / NoGo Test, the Corsi Cube Test and Digits of the WAIS-IV. The instruments used to measure the variables that could be related to these constructs were the Beck Anxiety Inventory, the Beck Depression Inventory - II, The Obsessive Beliefs Spanish Inventory-Revised and the Reynolds Intellectual Screening Test. The results obtained showed a worse performance of the group with Obsessive-compulsive disorder in all the relevant variables of the tests that assess Cognitive flexibility, Response inhibition and visuospatial Working memory. There were no differences between groups in verbal Working memory. When the level of anxiety, depression and obsessive beliefs was controlled, the differences found in Response inhibition and Working memory decreased or disappeared. However, they did not alter the results in Cognitive flexibility. Regarding the level of intelligence, he was influential in the results of all executive functions, although to a lesser extent in Cognitive flexibility. In addition, different sociodemographic and clinical variables were shown within the clinical group in relation to executive functioning, such as educational level, employment status, comorbidity, taking of psychotropic drugs, assistance to psychological therapy and subtype of compulsion. The best executive performance was found in patients who presented higher education and those who were active in work, as well as in those who attended psychological treatment and those who did not suffer from comorbidity or consume psychotropic drugs. As for the subtypes of compulsions, patients with a predominance of repetition compulsions had more deficits in motor Response inhibition, being those characterized by the compulsory subtype of checking and cleaning / washing those who performed worse in Cognitive flexibility. The possible confused variables were hardly relevant in the results of the Cognitive flexibility tests, which can shed light on the specific difficulties in this function that we can find in patients with Obsessive-compulsive disorder. It is valued that the intervention focused on this executive function could improve the functioning and quality of life of patients with this disorder.