The authors have not supplied their declaration of competing interest.

Data from electronic health records of adult Latino/a primary care patients (n = 29,887 person-years) were used to identify rates of SUD treatment in primary and specialty care. Treatment characteristics and receipt of adequate care were compared by gender and immigrant status.

Tobacco was the most frequently treated substance followed by alcohol and other drugs. Forty-six percent of SUD patients had a comorbid psychiatric condition. Treatment rates ranged from 2.52% (female non-immigrants) to 8.38% (male immigrants). Women had lower treatment rates than men, but male and female immigrants had significantly higher treatment rates than their non-immigrant counterparts. Receipt of minimally adequate outpatient care varied significantly by gender and immigrant status (female non-immigrants 12.5%, immigrants 28.57%; male non-immigrants 13.46%, immigrants 17.09%) in unadjusted and adjusted analyses.

Results indicate overall low prevalence of SUD treatment in the healthcare system. Low rates of minimally adequate care evidence the challenge of delivering integrated behavioral healthcare for Latinos with SUD. Results also demonstrate gender and immigrant status disparities in an unexpected direction, with immigrant women receiving the highest rates of adequate care.

The authors have not supplied their declaration of competing interest.

We aimed to review the distribution of diagnoses in children and adolescents evaluated by a child psychiatrist, in refugee camps in Diyarbakır, Cizre and Silopi province of Turkey.

Sociodemographic data, psychiatric complaints and distribution of psychiatric diagnoses of 38 children and adolescents living in refugee camps in Diyarbakır, Cizre and Silopi were evaluated. Psychiatric diagnoses were made according to DSM-5 criteria but some diagnoses as conversion disorder were also mentioned even tough they were not included in DSM-5.

The sample consisted of 22 female and 16 male children and adolescents. The mean age was 12.1 ± 4.5 and the range was 2–18 years. The mean duration of residency in the camp was 23.2 ± 3.9 days. The most common symptom was sleep problems. The most frequently seen psychiatric disorder was depressive disorder (36.8%) and at least two comorbidities were detected in 50% of children and adolescents. This diagnosis was followed by conversion disorder (28.9%), adjustment disorder (21.8%), acute stress disorder (18.4%), enuresis nocturna (18.4%), post-traumatic stress disorder (10.5%), separation anxiety disorder (10.5%), somatization disorder (7.8%), selective mutism (2.5%) and night terror (2.5%) respectively.

The study revealed that in refugee children and adolescents, starting from the early days of the migration period, various psychiatric symptoms and disorders might be seen. Therefore, it is essential to integrate psychosocial support units into the aid and support programs for refugees and quite important to observe and treat children in terms of psychiatric disorders, starting from the early days of the migration period.

The authors have not supplied their declaration of competing interest.

According to the Guiding Principles on Internal Displacement, internally displaced persons are persons who have been forced or obliged to leave their homes, in particular as a result of extreme situations, and who have not crossed an state border. As of May 21, 2015 UNHCR has information about 1,299,800 IDPs.

To study clinical features of neurotic disorders in IDPs.

We have a complex psychopathological and psychodiagnostic research 97 IDPs in volunteer center, located at the central train station in Kharkiv.

In total, 75.9% of IDPs observed have violations of adaptation: long-term depressive reaction (F 43.21) and predominant disturbance of other emotions (F 43.23). The men reactive alarm indicators (average – 37.7 ± 3.0), were higher than trait anxiety (average – 32.6 ± 2.9). On the contrary, women figures trait anxiety (average – 38.6 ± 2.9) were higher than reactive anxiety (average – 34.7 ± 3.0). Severity of depressive symptoms also slightly prevailed in women. The mean score on the Hamilton scale for men was 17.0 ± 2.3 points, women – 18.0 ± 2.3 points. Test results on a scale of quality of life showed no significant differences between men and women. We have developed a medical and psychological support system to correct the neurotic disorders in IDPs.

The majority of people who left the ATO zone have emotional disorders of different severity and require a further correction in the specialized medical institutions.

The authors have not supplied their declaration of competing interest.

A significant cortical thinning has been repeatedly observed in adult-onset first-episode schizophrenia patients compared to healthy controls, mostly in medial and inferior prefrontal cortices. However, it is yet unclear whether all these replicated alterations are related to any particular clinical feature.

This study aimed to investigate differences of cortical thickness in a sample of first-episode, drug-naive psychotic patients and age- and gender-matched healthy controls and explore clinical correlates of these parameters regarding negative symptoms.

High-resolution T1-weighted images were acquired from 23 antipsychotic-naive, first-episode psychotic patients and 26 age-matched healthy comparison subjects. Clinical features were measured with the negative subscale of the Positive and Negative Syndrome Scale (PANSS) at baseline and after a 2-month follow-up period.

No differences were found regarding age or gender when comparing patients and controls. We found a significant cortical thinning in the left medial orbitofrontal cortex and in the right lateral orbitofrontal cortex in patients compared to healthy age- and gender-matched controls. Regarding clinical performance, no correlation was found at baseline between left medial orbitofrontal nor right lateral ortitofrontal cortical thickness and scores of the negative subscale of the PANSS. However, at the 2-month evaluation clinical performances were significantly associated to the left medial orbitofrontal cortical thickness values.

Cortical thickness alterations in prefontal cortex appear to be present at disease onset and these alterations may relate to clinical outcome. However, our findings must be considered just as exploratory. Larger longitudinal studies may help characterize, replicate and consolidate these findings.

The authors have not supplied their declaration of competing interest.

The intuitive association between cognitive dysfunction in late onset depression (LOD) and the aberrant functional activity in the brain's default-mode network (DMN) has prompted interest in exploring the role of the DMN in LOD. The altered pattern of resting state voxel-mirrored homotopic connectivity (VMHC) in cognitive processes is not yet well understood in LOD.

The study was designed to examine the implicit coupling between the alteration of interhemispheric functional coordination and cognitive impairment in LOD. Thirty-one LOD patients and 37 matched healthy controls (HC) underwent neuropsychological tests and functional magnetic resonance imaging (fMRI) in this study.

Compared to HC group, attenuated VMHC in superior frontal gyrus, superior temporal gyrus, posterior cerebellar lobe, postcentral and precentral gyrus was observed in LOD. Neuro-behavioral relevancy approach revealed that the imbalanced interhemispheric functional coordination in bilateral cerebellum was positively correlated with the performance of trail making test in LOD (r = 0.367, P = 0.040).

Altered linkage pattern of intrinsic homotopic connectivity and cognition was firstly investigated in LOD, and it would provide a novel clue to reveal the neural substrates underlying the cognitive dysfunction in LOD.

The authors have not supplied their declaration of competing interest.

Neuroimaging studies of attention-deficit/hyperactivity disorder (ADHD) have revealed structural deviations of the corpus callosum in children and adolescents. However, little is known about the link between callosal morphology and symptoms of inattention or hyperactivity in adulthood, especially later in life.

We aimed to further expand this understudied field by analyzing a large population-based sample of 280 adults (150 males, 130 females) in their late sixties and early seventies.

We applied a well-validated approach capturing the thickness of the corpus callosum with a high regional specificity at 100 equidistant points. In addition to correlating point-wise callosal thickness with ADHD symptom measures within the whole sample, we tested for sex interactions.

There were significant sex interactions with respect to measures of inattention and hyperactivity, with follow-up analyses revealing significant negative correlations in males (see Fig. 1 – Top). In contrast, there were positive correlations with respect to hyperactivity only in females (see Fig. 1 – Bottom).

A thinner corpus callosum may be associated with fewer fibers or less myelination. Thus, the negative correlations, as observed in males, suggest an impaired inter-hemispheric communication necessary to sustain motor control and attention, which may contribute to symptoms of hyperactivity, impulsivity and/or inattention. The functional relevance and underlying mechanisms of the positive correlations, as detected in females, remain to be resolved.

The authors have not supplied their declaration of competing interest.

Increasing body of evidence suggest that patients with schizophrenia (SCZ) present dysfunction of the gamma band oscillations (GBO) during cognitive tasks. The current study aimed to explore the GBO activity in SCZ during a Sternberg task.

Twenty-eight chronic stabilized SCZ and 18 healthy controls (HC), were recruited. Ongoing EEG was recorded during the execution of the Sternberg task. Continuous EEG data were band-pass filtered (1–100 Hz) and corrected for eye blink and muscle artefacts by ICA. For each subject, the event-related-spectral-perturbation (ERSP) and the inter-trial-coherence (ITC) were computed at the Pz channel only for those stimulus-locked segments containing correct responses. GBO wavelet analysis was performed with two different increasing cycle ranges (3 to 5.8 and 12 to 22.6; frequency range: 30–90 Hz), to obtain the best information about temporal and frequency dynamics. Student's t test (with multiple comparisons FDR correction) was used to compare the groups.

During the manteinance phase (4000 to 4600 ms after the stimulus onset), SCZ presented a significant increase, respect to HC, in low GBO activity (range: 30-50 Hz;). In the other phases of the Sternberg task (encoding, probe presentation and response periods), no significant difference in GBO was observed between SCZ and HC.

These findings are in line with the evidence that GBO dysfunction in SCZ is present during selective phases of the working memory task. Future studies have to clarify the role of GBO dysfunction on the cognitive performance and the clinical utility of selective GBO modulation during cognitive rehabilitation.

The authors have not supplied their declaration of competing interest.

Taste perception is a complex phenomenon modulated by different factors, such as taste receptors and memory brain circuits. The palatability of the food, that activates the central reward pathways, also plays an important role in taste perception. It means that taste is able to influence the choice of food and then eating behaviour.

It is well known that people with anorexia nervosa (AN) have a lower sensitivity to reward stimuli and recent studies suggested that altered function of taste neural circuitry may contribute to restricted eating in AN.

The aim of this study was to evaluate, in patients suffering from AN, the activation of brain areas involved in taste perception and in central reward mechanisms to both pleasant and aversive taste stimuli and to correlate gustatory neurocircuitry activity with eating behaviours, temperament measures and/or sensitivity to reward and to punishment.

Fifteen underweight female AN patients and sixteen normal-weight healthy women underwent a functional MRI to measure brain areas activation to repeated stimuli of a pleasant taste (sucrose solution), alternated with an aversive taste (bitter solution), and water taste.

Compared to healthy controls, patients with AN showed a significantly reduced activation of left insula and left dorsolateral prefrontal cortex to sweet stimulus and reduced activation of right parietal cortex to bitter stimulus.

These results, if confirmed in future studies, may improve our knowledge about the pathophysiological mechanisms of AN.

The authors have not supplied their declaration of competing interest.

Brain amyloid-β protein (Aβ) deposition is a key pathology of Alzheimer's disease (AD). Cholinergic degeneration, including reductions in α7 nicotinic acetylcholine receptors (α7-nAChR), is also known as a pathophysiology of AD. Recent imaging studies have shown cognitively normal subjects with Aβ depositions, indicating a missing link between Aβ deposition and cognitive decline.

To clarify relationships among the Aβ burden, α7-nAChR availability, and cognitive declines in AD.

To measure brain Aβ deposition and α7-nAChR availability in the same patients with AD using positron emission tomography (PET).

Twenty AD patients and age-matched 20 healthy adults were studied. The α7-nAChR availability and Aβ deposition were evaluated using PET with [11C]MeQAA and [11C]PIB, respectively. Levels of specific binding were estimated by a simplified reference tissue method (BPND) for [11C]MeQAA and a tissue ratio method (SUVR) for using [11C]PIB. The values were compared with clinical measures of various cognitive functions using regions of interest (ROIs)-based and statistical parametric mapping (SPM) analyses.

[11C]MeQAA BPND levels were extensively lower in the cholinergic projection regions of AD. There was a significant negative correlation between [11C]PIB SUVR and [11C]MeQAA BPND in the nucleus basalis of Mynert (NBM). The NBM [11C]PIB SUVR was negatively correlated with the [11C]MeQAA BPND level in the anterior and posterior cingulate cortices, whereas the relation within the same region showed weak correlation. Also we found significant correlation between cognitive decline and [11C]MeQAA BPND levels in the NBM.

Aβ deposition-linked α7-nAChR dysfunction may account for cognitive decline in AD.

The authors have not supplied their declaration of competing interest.

The thought of greater loss of brain tissue in Deficit Syndrome (DS) i.e. subgroup of schizophrenia with enduring primary negative symptoms defined by Carpenter et al.; this has not been verified by recent studies.

Accumulated researches suggest that enlargement in Lateral Ventricles (LV) is related with current negative symptoms and poor prognosis. However, this has not been validated in DS.

Our aim is to study the association between the enduring negative symptoms and LV changes schizophrenia. We included both deficit and non-deficit patients for comparison with controls.

Forty-five patients (18 DS, 27 non-DS) and 37 healthy controls were recruited, evaluated for positive and negative symptoms, depression and extrapyramidal symptoms. Structural magnetic resonance imaging was performed. LV was assessed by MANCOVA (gender, age total brain volume as confounding factors) in 3-dimensional (3D) shape analyses. Correlations between clinical and imaging data were analyzed by Pearson correlation coefficient; P > 0.05 being significant.

LV of patients was found to be greater than controls, especially in regions adjacent to parietal and temporal regions but no significant difference between subgroups was detected. Enlargement in right LV by corpus callosum adjacency was found in DS. There was no correlation between negative symptoms and LV volume.

The idea of greater amount of LV enlargement in patients with predominant negative symptoms could not be observed in 3D analyses. New pathophysiological theories are needed for the explanation of negative symptoms, loss of functioning and poor prognosis rather than only commenting about tissue decrease/loss.

The authors have not supplied their declaration of competing interest.

Spectroscopy is a diagnostic method using MRI, to analysis tissue in vivo noninvasively. There are several studies with magnetic resonance spectroscopy (MRS) in patients with psychiatric disorders, especially schizophrenia and Alzheimer's type dementia, in their different developmental stage. Sometimes spectroscopy may allow brain metabolic changes to be observed before the onset of alterations in brain parenchyma. We do not know any documented case of spectroscopy performed on a psychiatry-targeted manner on our hospital. It is a noninvasive technique without added cost to the MRI and is available in our hospital. It seems interesting for us to combine two specialties like radiology and psychiatry in the field of a neuroimaging Project.

Our goal is try to establish a radiological anatomical correlate to brain molecular levels. It's a transverse and longitudinal prospective observational study in which subjects will be submitted to various psychiatric assessments by conducting a radiological examination that is the MRI and MRS to determine the regional metabolic pattern in the subjects explored.

Informed consent to all patients, aged more than 18 years, selected according inclusion/exclusion criteria that meet ethical principles. Patients are selected within the public health network of Sacyl Health Care System, Zamora Hospital, Spain.

Schizophrenia increased creatinine, choline and glutamate. NAA decrease in untreated patients and increased the same in patients with treatment Alzheimer: < increased NAA (N-acetyl aspartate) and increased MI (myo-inositol), their relationship has a high negative predictive value, ie if it is negative (the peaks are not increased) is discarded Alzheimer's disease. Early Dx/screening? Treatment?

The authors have not supplied their declaration of competing interest.

Although male and female patients with major depression (MDD) differ in psychopathology and other illness characteristics, a potentially confounding effect of gender has not been systematically controlled or investigated in most of the previous neuroimaging studies.

We investigated activation patterns during processing of ambiguous stimuli in MDD by functional MRI.

We aimed at examining potential activation differences between male and female patients.

A matching task was employed in which two stimuli with varying degrees of perceptual uncertainty had to be compared with respect to their sameness. Eighteen patients meeting DSM-IV criteria of MDD and eighteen healthy control subjects participated in this study.

Whereas on the level of behavioral performance no significant group differences could be detected we found distinct disorder- and gender-related differences in the brain activation. Patients activated significantly stronger in superior parietal, prefrontal and cingulate regions. Gender specific analyses revealed that the hyperactivity in the patient group was mainly attributable to hyperactivity in the male patients who activated significantly stronger than the female patients in an extensive fronto-temporo-limbic network, which partly overlapped with the network we found when comparing patients and healthy controls.

Our results indicate that male patients seem to be reliant on a significantly stronger metabolism in task-relevant regions to maintain an equal level of performance.

The present results provide evidence for gender-related differences in the functional organization of the brain in patients with MDD. Gender differences should be taken into consideration when investigating the neural correlates of MDD.

The authors have not supplied their declaration of competing interest.

Schizophrenia is characterized by poor social interaction contributing to poor functional outcome. Particularly nonverbal communication is disturbed. Neural correlates of impaired gesturing are currently unclear. We thus tested functional correlates of gesturing in schizophrenia patients and healthy controls.

We tested 22 patients and 25 controls with an event-related fMRI (instructed delay) paradigm to dissociate brain activation during planning and execution of meaningful (e.g. use scissors) and meaningless novel gestures. Preprocessing included realignment, coregistration, normalization and spatial smoothing. We used a two stage mixed effects model for statistical analysis. Conditions were contrasted against a linguistic control within and between groups. We correlated psychopathological characteristics with beta estimates of brain areas with between group effects.

During planning and execution of both gesture subtypes both groups activated brain areas of the ventral and dorsal stream. However patients’ activity was less prominent and more left lateralized. During planning patients showed additional activity in bilateral temporal poles, amygdala and hippocampus associated with the level of delusions. Furthermore patients had increased dorsomedial prefrontal cortex and precuneus activity when planning meaningless gestures.

During the planning of meaningless gestures we detected aberrant activation of limbic structures in patients typically implicated in delusion formation, which also correlated with current severity of delusions. Moreover, planning of meaningless gestures relied on areas relevant for strategic control and attention. These results argue for a pathologic search for meaning in neutral gestures and increased control effort during planning of meaningless gestures in schizophrenia.

The authors have not supplied their declaration of competing interest.

To study the neural substrates of insight in OCD by comparing patients with good insight, patients with poor insight and matched healthy controls using functional MRI.

Subjects were recruited from among patients attending OCD clinic, adult psychiatry services and psychiatry ward inpatients of National Institute of Mental Health And Neurosciences (NIMHANS), Bangalore. They were further divided into ‘good insight’ (n = 30) and ‘poor insight’ (n = 14) using Brown's assessment of belief's scale. Control subjects (n = 30) were recruited from consenting volunteers. 3 T MRI was used, mental rotation task was paradigm used for fMRI and analysis was done by SPM 8.

Poor insight patients and Ggood insight patients comparison revealed differential activation in Left superior/Medial frontal gyrus (corresponding to the DLPFC). A negative correlation between BABS score and activation of right inferior parietal lobule. Mental Rotation task behavioural data results: OCD patients as a group had significantly lower accuracy compared to healthy controls. Poor insight group had significantly decreased accuracy ratio compared to Good insight group and healthy controls. A negative correlation was noted between BABS score and accuracy ratio, indicating that poorer the insight, greater the errors during the active task.

Insight has been important prognostic factor in OCD. Poor insight patients had specific deficits in left medial frontal gyrus and right inferior parietal lobule as compared to good insight patients and healthy controls. Together, these indicate that insight has a strong neurobiological underpinning in OCD.

The authors have not supplied their declaration of competing interest.

Obsessive thoughts can be categorized into two subtypes, autogenous obsessions and reactive obsessions. Although it has been investigated that each subtype associates with different maladaptive coping strategies, no studies have yet empirically compared the effectiveness of adaptive coping strategies on autogenous and reactive obsessions.

It is hypothesized that acceptance, which is a core therapeutic principle of acceptance-based cognitive therapy (ACT), is more effective on autogenous obsessions, whereas response suppression as a principle of exposure and response prevention (ERP) has a stronger effect on reactive obsessions.

To compare the effectiveness of two coping strategies (acceptance and response suppression) on autogenous and reactive obsessions.

A total of 164 undergraduate students completed questionnaires for obsessional thoughts and coping strategies. According to the most distressing thought, sixty subjects (n = 30 with autogenous obsession, n = 30 with reactive obsession) were randomly assigned to two groups differing in treatment conditions. Individual psychoeducation and practice were performed for four different groups (2 obsessional subtypes × 2 coping strategies).

Repeated measure ANOVA demonstrated that the autogenous obsessional group showed greater distress reduction after acceptance treatment than response suppression treatment, although its effect was not statistically significant. However, the reactive obsessional group did not show the interaction effect between distress reduction and the two coping strategies.

The results suggest that coping strategies have differential effects on distress reduction of obsessional subtypes. Different therapeutic approaches may need to be offered to individuals with autogenous and reactive obsessions.

The authors have not supplied their declaration of competing interest.

OCD could be a very disabling condition, implying severe impairment of social and occupational functioning and decreased quality of life. OCD is treated with a combination of psychopharmacological treatments and cognitive-behavioural therapy. Clomipramine was the first anti-obsessive drug, and was followed by selective serotonin re-uptake inhibitors (SSRIs), both modulating serotoninergic transmission. Low dose atypical anti-psychotic are sometimes used to potentiate serotoninergic agents. Growing evidence based on animal models and on neuroimaging shows that glutamatergic transmission could play an important role in the aetiology of OCD. Therefore, glutamate modulators such as N-methyl-D-aspartate (NMDA) receptor antagonists became the focus of the search of novel treatments for OCD. One of this drugs, memantine, already approved for Alzheimer disease treatment, was used off-label the first time ten years ago in resistant case of OCD with positive results. Besides some further successful case reports, there are a single-blind case control study and a couple of randomized, double-blind, placebo-controlled trials showing improvement of OCD symptoms with memantine adjuvant pharmacotherapy.

To describe a case report of off-label treatment of a severe resistant case of OCD with memantine, after 15 weeks of treatment.

Literature review and case description. Before beginning treatment with memantine, the patient made a psychological assessement (baseline) with a battery of tests (MINI Plus, Y-BOCS, QPP-15, WDQ, ECPAD, OP2, OAS2, MPS-H&F, MPS-F, HEXACO-PI-R, MOCI, BDI-II). This battery will be repeated after 15 weeks of treatment, to evaluate symptom improvement.

To be announced after 15 weeks of treatment course.

The authors have not supplied their declaration of competing interest.

Despite the potential theoretical and clinical relevance of psychopathological dimensions in Obsessive-Compulsive Disorder (OCD), few studies to date have investigated their possible association with obsession subtypes.

We aimed to examine whether, in OCD patients, anger and other psychopathological dimensions are associated with specific obsession subtypes.

We consecutively recruited 57 first-visit DSM-V OCD patients (females = 66.7%; age range = 18–63 years) at the Psychiatric Outpatient Clinic of our University Hospital. These patients were affected by severe OCD, as shown by a median (1st quartile–3rd quartile) Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score of 27.0 (23.0–32.5). We used the point-biserial coefficient (rpbi) to measure the correlation between psychopathological dimensions, as assessed with the Scale for the Rapid Assessment of Psychopathology (SVARAD), and obsession subtypes, as evaluated with the Y-BOCS.

We found significant correlations (P-values < 0.05) between: anger/aggressiveness dimension and aggressive, contamination, and sexual obsessions; apprehension/fear dimension and contamination, religious, and somatic obsessions; sadness/demoralization dimension and contamination and somatic obsessions; obsessiveness/iterativity dimension and all obsession subtypes; impulsivity dimension and aggressive and sexual obsessions; somatic concern/somatization dimension and contamination and somatic obsessions. We also found, by using the Mann-Whitney U-test, that OCD patients with comorbid Obsessive-Compulsive Personality Disorder–but not Schizotypal or Histrionic ones–showed higher levels (P < 0.05) of obsessiveness/iterativity and anger/aggressiveness than OCD patients without the personality disorder.

Anger and other psychopathological dimensions seem to be linked with specific obsession subtypes in OCD patients, suggesting an association between these dimensions and OCD.

The authors have not supplied their declaration of competing interest.

The author has not supplied his/her declaration of competing interest.

Comorbid Cluster C Personality Disorders (PDs) are the most prevalent PDs in Obsessive-Compulsive Disorder (OCD). Investigating clinical correlates associated to OCD with Cluster C PDs may allow identifying tailored treatment strategies.

The current study examined whether OCD with comorbid cluster C PDs is associated to more severe OCD symptoms, anxiety and depression relative to OCD with comorbid cluster B PDs or OCD alone.

Two hundred thirty-nine patients with OCD were included (mean age = 35.64, SD = 11.08, 51% females). Seventeen percent had a comorbid Cluster C PD, 8% had a comorbid Cluster B PD, and 75% had OCD alone. The Structured Clinical Interview for Axis II Disorders, Yale-Brown Obsessive Compulsive Scale, Beck Anxiety Inventory, Beck Depression Inventory-II were administered.

Patients with comorbid Cluster C PDs reported more severe depression and anxiety than those with comorbid Cluster B PDs (F = 10.48, P < 0.001) or with OCD alone (F = 9.10, P < 0.001). Patients with comorbid Cluster C PDs had more severe OCD symptoms than those with OCD alone but not than those with comorbid Cluster B PDs (F = 3.12, P < 0.05).

OCD with Cluster C PDs could be a subtype with more severe anxiety and depression. These findings could be explained with the fact that Cluster C PDs are characterized by behaviours, which can be seen as maladaptive attempts to cope with anxiety and depression. Tailored treatment strategies for OCD with comorbid Cluster C PDs are discussed to target co-occurring anxiety and depression.

The authors have not supplied their declaration of competing interest.