Acta Psychopathologica Open Access

Obsessive-Compulsive Symptoms in Dementia: A Systematic Review and Meta-Analysis of Prevalence and Treatment Approaches

Sara Muller^* Department of Clinical Psychology, University of Heidelberg, Germany
^*Correspondence: Sara Muller, Department of Clinical Psychology, University of Heidelberg, Germany, Email:

Received: 02-Sep-2024, Manuscript No. IPAP-24-21612 ; Editor assigned: 04-Sep-2024, Pre QC No. IPAP-24-21612 (PQ); Reviewed: 18-Sep-2024, QC No. IPAP-24-21612 ; Revised: 23-Sep-2024, Manuscript No. IPAP-24-21612 (R); Published: 30-Sep-2024, DOI: 10.36648/2469-6676-10.09.85

Introduction

Obsessive-compulsive Symptoms (OCS) in dementia have drawn increasing attention as the understanding of dementiarelated neuropsychiatric symptoms evolves. While cognitive impairments remain the hallmark of dementia, the prevalence of behavioural and psychological symptoms, including OCS, is significant but often under-recognized. Obsessive-compulsive symptoms encompass intrusive, unwanted thoughts (obsessions) and repetitive behaviours or mental acts performed to reduce anxiety or distress. In the context of dementia, these symptoms may manifest differently than in primary Obsessive- Compulsive Disorder (OCD), often complicating diagnosis and management. This review focuses on synthesizing available evidence on OCS in dementia, utilizing a systematic review with meta-analysis to understand the prevalence, characteristics, and potential treatment approaches for these symptoms. Dementia, particularly in its later stages, presents with a broad spectrum of neuropsychiatric symptoms, which can drastically impact the quality of life of both patients and caregivers. Neuropsychiatric symptoms in dementia include agitation, depression, anxiety, and psychosis; with obsessive-compulsive symptoms being a less frequently studied but important aspect. However, the evidence is limited and mixed, with some studies reporting only modest improvements.

Description

Given the overlap between cognitive and behavioural symptoms, OCS in dementia is often difficult to distinguish from other neuropsychiatric manifestations, making diagnosis a challenge. Furthermore, the clinical presentation of OCS in dementia may differ from that of younger individuals with primary OCD, who typically exhibit insight into their symptoms. In dementia, cognitive decline can obscure awareness, making compulsions appear more like stereotyped behaviours than goal-directed actions aimed at reducing anxiety. The systematic review and meta-analysis aimed to provide a clearer understanding of the prevalence of OCS across different types of dementia. Alzheimer’s Disease (AD), Frontotemporal Dementia (FTD), and other forms such as vascular dementia were examined. The data showed that OCS are prevalent in all major forms of dementia, though with some variation in frequency and severity depending on the type of dementia. Studies included in the meta-analysis suggested that OCS are more prevalent in frontal-temporal dementia compared to Alzheimer’s disease, possibly due to the greater involvement of the frontal lobes in FTD, which play a key role in behavioural regulation. The metaanalysis also highlighted the heterogeneity of study designs, which contributed to variability in reported prevalence rates.

Conclusion

In conclusion, obsessive-compulsive symptoms are a significant but often overlooked aspect of dementia. Their presence can complicate care and exacerbate the burden on caregivers. While the systematic review and meta-analysis shed light on the prevalence and characteristics of OCS across different types of dementia, there remain considerable gaps in our understanding of the neurobiological mechanisms and effective treatments for these symptoms. Future research should aim to clarify these mechanisms and develop more targeted interventions, both pharmacological and behavioural, to improve the management of OCS in dementia. A multi-disciplinary approach that includes medical professionals, caregivers, and mental health specialists is essential for addressing this complex aspect of dementia care.

Acknowledgement

None.

Conflict Of Interest

The author’s declared that they have no conflict of interest.