Memory and executive functioning in obsessive-compulsive disorder: A selective review

Background: The neurocognitive deficits that underlie the unique features of obsessive-compulsive disorder (OCD) are not yet completely understood. This paper reviews the main neuropsychological findings in memory and executive functioning in this disorder, and examines a number of challenges facing this area of research. Method: A selective review of the neuropsychological literature on OCD was conducted using MEDLINE and drawing on literature known to the authors. Results: The neuropsychological profile of OCD appears to be one of primary executive dysfunction. Although memory functioning may be affected, these deficits appear secondary to an executive failure of organizational strategies during encoding. On tasks of executive functioning patients with OCD demonstrate increased response latencies, perseveration of responses, and difficulties utilizing feedback to adapt to change. Limitations: A statistical meta-analysis was not performed and only the cognitive domains of memory and executive functioning were examined. Conclusions: Given the prominence of chronic doubt and indecision in clinical settings, it is surprising that decision making as a cognitive construct as related to OCD has not received greater attention in the neuropsychological literature. On the basis of emerging literature we suggest that it is a potential area of dysfunction and one that warrants further investigation as it may assist in enhancing our understanding of the pathophysiology of OCD. (c) 2007 Elsevier B.V. All rights reserved.