Funciones ejecutivas en el trastorno obsesivo-compulsivo y trastorno dismórfico corporal (Dismorfia muscular)

Resumen

Some research suggests that at the core of Obsessive-Compulsive Disorder and Body Dysmorphic Disorder lies a neuropsychological deficit. Cognitive flexibility, response inhibition, and working memory are some of the affected functions. However, the results have not been conclusive, making it necessary to analyze variables that may be related, such as the severity of the disorder, patient age, type of medication consumed, comorbidity with other possible disorders, etc. The general objective of this study has been to analyze the differences in cognitive flexibility, response inhibition, and working memory among three groups: two clinical groups, Obsessive-Compulsive Disorder and Body Dysmorphic Disorder (Muscular Dysmorphia), and a healthy control group. Additionally, influential clinical and sociodemographic variables in the performance of these functions were compared within each group. The study sample (N=91) was recruited from both clinical and community settings. The OCD group (N=35) consisted of participants aged 15 to 61 years, the Muscular Dysmorphia group (N=24) included patients aged 18 to 54 years, and the healthy control group (N=32) consisted of participants aged 18 to 56 years, matched in number, age, gender, and level of education attained. Multiple tests were used for evaluation. Neuropsychological measures included the Wisconsin Card Sorting Test, the Stroop Test, the Go/NoGo Task, the Digits Subtest from the Wechsler Adult Intelligence Scale, and the Corsi Block-Tapping Test. A specific research protocol was used for sociodemographic measures, which collected variables such as age, gender, marital status, level of education, employment status, family history, disorder history, comorbidity, treatments used, and physical illnesses. Clinical measures included the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), Obsessive-Compulsive Inventory-Revised (ICO-R), and Body Image Dissatisfaction Assessment (IMAGEN). The results in cognitive flexibility showed poorer performance in the clinical groups compared to the healthy control group, with anxiety and depression influencing the OCD and Muscular Dysmorphia groups, leading to worse results. Certain sociodemographic variables influenced OCD and Muscular Dysmorphia (such as age, gender, and employment status). The clinical variable influencing performance in the tests was the Duration of Disorder for the Muscular Dysmorphia group. It was found that higher scores on the BDI led to longer task completion times for the Muscular Dysmorphia group, and higher uncertainty led to worse results in cognitive flexibility. As for response inhibition, both clinical groups showed poorer results in the relevant variables. There was a marginal influence of anxiety and depression in the clinical groups, indicating low performance. Some sociodemographic (such as age, gender, level of education, and employment status) and clinical variables (duration of the disorder) influenced the clinical groups. Lastly, the clinical groups showed poorer performance in visuospatial working memory. Anxiety and depression influenced the results, along with some sociodemographic and clinical variables. Significant correlations were observed between anxiety, depression, uncertainty, and working memory. In conclusion, introducing a specific executive function package into therapeutic interventions for OCD and Muscular Dysmorphia would improve patient responses and their quality of life.