effect of behavior therapy on the neuropsychological function of patients with obsessive-compulsive disorder – memory function – *
Introduction: Recent neuropsychological studies have implicated abnormal cognitive dysfunction in visiospacial memory, attention and executive function in Obsessive-Compulsive Disorder（OCD）. There has been a controversy, however, regarding the relationship between repetitive checking behavior and memory function, and no concrete consensus has been reached concerning memory function in OCD. To elucidate the pathophisiology of OCD, we investigated changes in memory function of patients with OCD after substantial improvement of OC-symptoms brought about by behavior therapy. Subjects and methods: The subjects were all outpatients with OCD who significantly improved only after behavior therapy with or without previous sufficient pharmachotherapy（fluvoxamine 200 mg/day for at least eight weeks）. Diagnosis was done by SCID（structured clinical interview for DSM-ⅢR or Ⅳ）. The patients received 12 weekly 45-min. structured and manualized sessions of behavior therapy, mainly exposure and response prevention. Memory function was assessed with the Rey-Osterrieth Complex Figure Test（R-OCFT）and the Wechsler Memory Scale-Revised（WMS-R）. The assessments were performed before and after the behavior therapy by experienced clinical psychologists. The severity of O-C symptoms was assessed with the Yale-Brown Obsessive Compulsive Scale（YBOCS）by experienced psychiatrists. Results: After treatment, the mean percentage decrease on the Yale-Brown Obsessive Compulsive Scale was 58.26±13.28％（range:36.36％-78.13％）. After symptom improvement, significant increases were found in “copy condition”, “immediate recall”and“delayed recall”（40 minutes）for the R-OCFT. In addition,“delayed recall”, “verbal associate learning”, “logical memory”and“visual reproduction”for the WMS-R improved significantly. Discussion: The small number of subjects in this study dose not allow us to come to any concrete conclusion, but delayed recall function in OCD seems to improve after sufficient recovery brought about by behavior therapy. Further investigations, with larger numbers of subjects, on other memory-related factors, such as patients’beliefs regarding there own memory and other cognitive functions such as executive function and attention, and the relationship between these functions and functional neuroimaging could be promising. (Accepted on April 27，2006)
