Neuropsychological Findings in Obsessive-Compulsive Disorder and its Potential Implications for Treatment

Neuropsychological studies have shed light on several important aspects of obsessive-compulsive disorder (OCD). Along with neuroimaging and information processing approaches, it has contributed to delineate some of the most instigating pathophysiological models of OCD and to strengthen its diagnostic validity. Lately, neuropsychological studies have also emerged as a potentially relevant research area for therapeutics. In this review, we described the nature of the executive dysfunctions associated with OCD and theorized how they may account for the characteristic memory and visuoconstructive/visuospatial impairments found in patients suffering from this disorder. We also examined the concepts of implicit memory, meta-memory, memory for actions, memory bias, reality monitoring, and the multiple ways these functions may be altered in patients with OCD. The role of cognitive dysfunctions as potential predictors of treatment response to either pharmacological approaches (e.g. serotonin reuptake inhibitors) or to cognitive-behavior therapies (i.e. exposure and response prevention) in patients with OCD was also discussed. Finally, we argued that cognition might be an area of particular vulnerability to the negative effects of the anti-obsessional drugs and of the neuroanatomically-based approaches (neurosurgery and deep-brain stimulation).