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Objective: Obsessions are categorized into two subtypes, autogenous obsessions and reactive obsessions, which are different in terms of identifiability of their evoking stimuli, subjective experiences, contents, and subsequent cognitive processes. Autogenous obsessions include sexual, aggressive, and immoral thoughts or impulses. Reactive obsessions include thoughts about contamination, mistake, accident, asymmetry. OCD of the autogenous subtype was associated with impaired inhibitory control on the visual go/no-go task. In the study comparing cognitive functions in autogenous obsessions and reactive obsessions, no differences were found. This study aimed to compare decision-making, executive functions and impulsivity of OCD patients with autogenous obsessions and reactive obsessions.
Methods: Fourteen autogenous OCD patients and 25 reactive OCD patients completed psychometric cognitive tests and psychiatric rating scales. Decision-making and impulsivity were evaluated respectively with Iowa Gambling Task and Barratt Impulsivity Scale. Executive functions included Stroop Task and Tower of London (ToL) test. OCD severity was assessed with Yale Brown Obsessive Compulsive Scale (YBOCS)
Results: The mean age of patients was 32.2. Mann Whitney U test indicated that there were no differences between autogenous and reactive OCD patients in decision-making, impulsivity and executive functions. Pearson correlation revealed positive relationship between YBOCS score and impulsivity (p=0.001). There was a negative relationship between decision-making scores and maximum moves in LoT and Stroop scores (p<0.01). In the regression analysis, 27.7% of the variance of YBOCS scores were explained with impulsivity.
Conclusion: The results suggest that OCD exhibits features of impulsivity. Due to the limited number of patients in the current study, any future research with a greater sample size will be helpful to explore decision-making and executive functions in OCD.