Comparison of Cognitive Functions in Patients with Autogenous and Reactive Obsessive-Compulsive Disorder.

Introduction

Obsessive-compulsive disorder (OCD) is clinically heterogeneous, and the neurocognitive characteristics of autogenous and reactive obsessional presentations remain insufficiently understood. This study compared neurocognitive performance and exploratory clinical-cognitive associations in strictly classified autogenous and reactive OCD presentations.

Methods

This cross-sectional study included 67 outpatients with OCD classified as having reactive (n = 35) or autogenous (n = 32) presentations based on clinical evaluation and the Yale-Brown Obsessive Compulsive Scale Symptom Checklist. Patients with mixed presentations were excluded. Executive functioning, attentional control, cognitive flexibility, and verbal learning and memory were assessed using the Wisconsin Card Sorting Test, Stroop Test, and Rey Auditory Verbal Learning Test. Depressive symptoms were assessed using the Beck Depression Inventory.

Results

The groups were comparable in age, age at OCD onset, illness duration, and overall OCD symptom severity, whereas depressive symptom scores were higher in the autogenous group. Neuropsychological performance was broadly comparable between groups. The autogenous group showed better RAVLT-6 performance, reflecting recall after interference, with a nominally significant unadjusted group difference. This difference remained significant in an exploratory ANCOVA adjusting for depressive symptoms, education, and age at OCD onset, although it did not survive false-discovery-rate correction. Exploratory within-group correlations were observed; however, formal Fisher's r-to-z comparisons revealed no significant differences between groups.

Conclusions

Strictly classified autogenous and reactive OCD presentations showed broadly similar neuropsychological profiles, with a preliminary group difference in recall after interference. Within-group correlations should be interpreted as exploratory and hypothesis-generating rather than as evidence of presentation-specific clinical-cognitive mechanisms. Replication in larger samples is warranted.