Onset of obsessive-compulsive disorder: premorbid conditions and prodromal phase

This article focuses on the clinical onset of obsessive-compulsive disorder (OCD), specifically addressing the age of onset, gradual and acute onset, and whether there are some types of premorbid conditions or a prodromal phase that predispose individuals to the onset of OCD. Clinical and epidemiological studies have come to different conclusions regarding age at onset as well as regarding differences between the sexes. Data gleaned from research to date have demonstrated a relationship between OCD and obsessive-compulsive personality disorder (OCPD), although OCPD does not appear to be the more prevalent personality disorder among patients with OCD. Preliminary research has suggested that Axis I disorders may predispose individuals to OCD onset; however, the significance of this relationship remains to be clarified. Evidence of the association between OCD and subthreshold obsessive-compulsive syndrome suggests that these disorders lie on a continuum of severity, with some cases developing OCD while others do not.     

Three years after Tunisia: thoughts and perspectives on the rights to freedom of assembly and association from United Nations Special Rapporteur Maina Kiai

Roughly three years after the creation of his mandate, United Nations Special Rapporteur Maina Kiai reflects on the global state of assembly and association rights. Although the mandate was created against the backdrop of shrinking space for civil society, a massive and growing global protest movement has grabbed most of the headlines since 2011. Kiai argues that the mandate has made a measurable impact – it has helped raise awareness of repressive NGO laws, provided technical assistance to governments to strengthen assembly and association rights and developed soft law. But perhaps, the most important work of the mandate has been its contribution to a better understanding of just how important the rights to freedom of peaceful assembly and association are. Assembly and association rights are a powerful tool to promote dialog, pluralism, broadmindedness, tolerance and civic participation; they satisfy people's fundamental desire to take control of their own destinies. And if anything, the past few years have taught us that the worst turmoil comes when this desire is suppressed. When people are denied something so fundamental, rage inevitably follows. When people have no outlet for that rage, it can ultimately manifest itself as something much more chaotic than a street protest.     

The role of recent life events in the onset of obsessive-compulsive disorder

Although many investigations into the onset of obsessive-compulsive disorder (OCD) suggest the occurrence of potential life events as triggering factors, such an association has not been well studied to date. The purpose of the present paper is to review the literature on OCD onset in order to determine whether OCD is triggered by recent life events, what specific events may serve as triggers, and the clinical and research implications of these factors. Overall, the available studies do not consistently support the theory that OCD is triggered by specific antecedent life events. However, there is a body of evidence to support the theory that the specific life events of pregnancy and birth of a child can trigger OCD. This apparent association has led to the investigation of certain neurohormonal factors, including changes in estrogen or oxytocin levels, that may be of etiopathogenetic significance in OCD. Confirming such associations may allow clinicians to provide more targeted preventive and therapeutic interventions.     

Personality disorders in patients with burning mouth syndrome

Burning Mouth Syndrome (BMS) presents high rates of comorbid Axis I disorders while no controlled studies have addressed the question of Axis II comorbidities. The aim of the present study was to examine DSM-IV (APA, 1994) Axis II comorbidity in BMS patients and to control for the specificity of this association. Seventy BMS patients were compared to a nonpsychiatric population sample and to patients with other Somatoform Disorders for the presence of personality disorders (assessed with the Structured Clinical Interview for DSM-IV Axis II Personality Disorders [SCID-II; First, Gibbon, Spitzer, & Williams, 1997). Prevalence rates were compared using the Pearson's chi square test. At least one personality disorder (PD) was found in 85.7%, 24.3%, and 88.6% of subjects in the three groups, respectively. When examining PD subgroups, significant differences emerged even between the BMS and the somatoform disorder group, with BMS patients showing more Cluster A and fewer Cluster B PDs. Our results suggest that BMS is associated with a specific pattern of Axis II comorbidity.     

Faith, Premarital Sex and Relationships: Are Church Messages in Accordance with the Perceived Realities of the Youth? A Qualitative Study in KwaZulu–Natal, South Africa

Since religious messages on life style have a strong impact in South Africa, it is important to assess how they relate to the situation for young people at risk of HIV infection. Nine focus group discussions were conducted with youth (n = 62), aged 13–20 years, from the Roman Catholic Church, the Lutheran Church, and the Assemblies of God. Young people were ambivalent toward sexual contacts since these generally were expected to be part of a relationship even though the church condemns premarital sex. Girls perceived the moral norms to concern them more than the boys for whom sexual needs were more accepted. These moral barriers lead to lack of information about protection and may increase the risk of HIV. The realities young people facing should be a major concern for the faith communities.