The study, published in the journal Psychological Medicine today, also demonstrated, for the first time, impaired goal-directed control and lack of the ability to think flexibly early in the development of OCD.
The findings have already been used to assist adolescents with OCD to obtain the help they needed at school to realise their potential – including helping one individual go on to university.
Dr Anna Conway Morris, child and adolescent psychiatrist at CPFT and one of the study’s authors, said: “This study has been very useful in assisting adolescents with OCD with the help they needed at school in terms of structuring the environment to ensure that there was a level playing field. This allowed them to receive the help they needed to realise their potential.
“One person with OCD was able to obtain good A Levels and to be accepted by a good university where she could get the support that she needed in order to do well in that environment.”
Thirty-six adolescents with OCD and 36 healthy young people completed learning and memory tasks. These computerised tests included recognition memory - remembering which of two objects they had seen before- and episodic memory - where in space they remember seeing an object. A subset of 30 participants in each group also carried out a task designed to assess the balance of goal-directed and habitual behavioural control.
The researchers found that adolescent patients with OCD had impairments in all learning and memory tasks. The study was led by Dr Julia Gottwald and Professor Barbara Sahakian from the Department of Psychiatry.
Experiencing learning and memory problems at school could affect self-esteem. Furthermore, some symptoms seen in people with OCD, such as compulsive checking, may result from them having reduced confidence in their memory ability. The stress of having difficulty in learning may also start a negative influence and promote inflexible habit learning.
Professor Barbara Sahakian, senior author and consultant psychologist at CPFT, said: “I was surprised and concerned to see such broad problems of learning and memory in these young people so early in the course of OCD. It will be important to follow this study up to examine these cognitive problems further and in particular to determine how they impact on clinical symptoms and school performance.”
Dr Julia Gottwald said: “While many studies have focused on adult OCD, we actually know very little about the condition in teenagers. Our study suggests that teens with OCD have problems with memory and the ability to flexibly adjust their actions when the environment changes.”
Future studies will examine in more detail the nature of these impairments and how they might affect clinical symptoms and school performance.
The research was funded by the Wellcome Trust and the Medical Research Council.
Reference
Gottwald, J, et al. Impaired cognitive plasticity and goal-directed control in adolescent obsessive-compulsive disorder. Psychological Medicine; 22 Jan 2018; DOI: 10.1017/S0033291717003464
OCD teens have learning and memory problems, research finds
22 January 2018
Teenagers with obsessive-compulsive disorder (OCD) have widespread learning and memory problems, research by Cambridgeshire and Peterborough NHS Foundation Trust and the University of Cambridge has found.