Decision making performance in obsessive compulsive disorder

Background: Neuro-imaging studies in OCD report the orbitofrontal cortex to be functionally abnormal. As these areas are presumed to be involved in decision making, studying this behavior in OCD may provide further insight into the cognitive deficits accompanying the disorder. Methods: Performance of 27 drug-free OCD patients and 26 healthy volunteers was compared on the decision making task of Bechara et al. [Cognition, 50 (1994) 7–15]. Results: OCD patients and volunteers displayed comparable decision-making behavior. Within OCD patients, risk taking was independently related to both anxiety and OCD severity. Limitations: Results must be regarded as preliminary, due to the limited number of OCD patients included and the lack of a clinical control group. Conclusions: Although VMpfc function is not generally impaired, it seems to be involved in OCD; possibly in another way than could be measured with this task. Clinical relevance: Clarification of cognitive distortions underlying OCD may guide development of new strategies for cognitive-behavioral therapy.