Obsessive Slowness: Uncovering a Little-Known Symptom of OCD

Obsessive Slowness: Uncovering a Little-Known Symptom of OCD

A study conducted by IDOR has identified clinical predispositions to the problem, which can cause people to spend hours on simple tasks. 

When we talk about obsessive-compulsive disorder (OCD), we immediately imagine someone extremely meticulous about the organization of objects or highly concerned about cleanliness. But have you ever heard of obsessive slowness? A new study has delved into this lesser-known symptom of OCD, aiming to differentiate it from other features of the obsessive-compulsive spectrum and identify predictors for its development. 

Published in the International Journal of Psychiatry in Clinical Practice, this research was led by the D’Or Institute for Research and Education (IDOR), with collaboration from the Federal University of Rio de Janeiro (UFRJ), Federal University of São Paulo (Unifesp), University of São Paulo (USP), Federal University of Health Sciences of Porto Alegre (UFCSPA), and Monash University in Australia. 

According to the World Health Organization (WHO), up to 2% of the population is affected by OCD. The most common symptoms are related to intrusive thoughts about contamination, symmetry, religion, and behaviors like hoarding. However, these symptoms represent only a part of the OCD spectrum, with “obsessive slowness” being one of the lesser-known components. But what does it involve? 

Imagine having to wake up four hours earlier for work just because you can’t complete your morning routine of showering and brushing your teeth quicker than that. For some individuals, a simple daily routine can take up to 10 hours due to this issue, which often involves moments of paralysis and immobility that disrupt everyday tasks. This can lead to persistent career and relationship challenges, and symptoms typically begin to develop in adolescence and early adulthood. 

Given the limited scientific literature on this debilitating condition, the study’s authors delved into data from over a hundred individuals with obsessive slowness, aiming to differentiate the clinical and demographic characteristics of this group. They considered factors like gender, marital status, and comorbidities with other mental disorders or OCD symptoms. 

Dr. Leonardo Fontenelle, the study’s coordinator, who is a researcher at IDOR and a professor at UFRJ, explains the distinction between procrastination and obsessive slowness. “Procrastination is a more nonspecific symptom observed in individuals with symptoms of anxiety or depression, characterized by fear or a lack of enthusiasm. In contrast, obsessive slowness arises from meticulousness and a need for precision, sometimes without an accompanying sense of fear.” 

The research was based on data from over 1,000 OCD patients evaluated by the Brazilian Consortium for Research on Obsessive-Compulsive Spectrum Disorders. The data was collected between 2003 and 2009, and Dr. Fontenelle was also part of the committee. The study drew from this extensive dataset, comparing information from 189 participants with obsessive slowness and another 478 OCD patients without the symptoms. 

The study’s findings challenged previous assumptions about obsessive slowness. For instance, obsessive slowness was previously believed to be more prevalent in men, but the current research showed a higher occurrence among women, raising questions about gender predisposition to this symptom. 

Marital status emerged as a significant predictor; the research indicated that single individuals with OCD had a 54% higher chance of developing obsessive slowness, an aspect even more relevant than unemployment rates or the education level among patients.  

The majority of participants with obsessive slowness were unemployed, but this wasn’t a defining demographic feature for the problem, as a smaller proportion managed to maintain their jobs even in full-time positions. 

Although some demographic factors were relevant, clinical aspects played a more prominent role in the predisposition to obsessive slowness. Participants with this trait displayed symptoms across all major dimensions of OCD, with symmetry and contamination symptoms being more common. Interestingly, those with tics (involuntary, repetitive movements or vocalizations) had a 71% chance of experiencing obsessive slowness. Other OCD symptoms such as hoarding and thoughts of aggression also increased the likelihood of developing obsessive slowness within the obsessive-compulsive spectrum. 

An intriguing finding was that anxiety and depression disorders didn’t appear to directly contribute to the development of obsessive slowness in OCD, suggesting that treatments focused on anxiety reduction might not be effective for this specific issue.  

Patients who reported postnatal complications showed a stronger statistical relation with the development of slowness, although the authors emphasized the need for further investigation before definitively establishing an association. The study also pointed out that the lack of a precise, quantifiable duration of slowness for diagnosing patients means there might be varying degrees of the problem, requiring further investigation in the future. 

Since the data relied on individual perceptions, the authors acknowledge potential limitations due to subjectivity. Nevertheless, the study’s significance is indisputable, as it represents the most extensive descriptive analysis conducted on obsessive slowness, offering promising evidence that individuals with this symptom can be distinguished within the obsessive-compulsive spectrum. 

For clinical practitioners, knowing that marital status, tics, and other OCD symptoms can be risk factors for the development of obsessive slowness is highly relevant for directing their patients’ therapy. But perhaps the most significant impact of research like this is the visibility it brings to the problem, as many people may live with and suffer from the condition every day without realizing that they can achieve improvements in their quality of life through proper treatment. 

Cognitive-behavioral therapy (CBT) and OCD Treatment 

Cognitive-behavioral therapy (CBT) is a prominent approach in clinical psychology, supported by strong scientific evidence. CBT focuses on understanding and reshaping thoughts that influence behavior, making it highly effective for patients with anxiety, depression, and especially OCD. 

Approximately 70% of OCD patients experience improvements after CBT, with half of them successfully overcoming the disorder, even when previous medication-based treatments were ineffective. 

At IDOR’s Psychology undergraduate program, students gain exposure to various psychological approaches, preparing them for a diverse future in the field. Moreover, they benefit from close proximity to IDOR’s scientific research, ensuring the continuous evolution of their knowledge. 

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