Executive functions in obsessive–compulsive disorder: state or trait deficits?

Objective: Despite the neuropsychology literature providing reliable evidence of impaired executive functions in obsessive–compulsive disorder (OCD), to date it has not been determined whether these deficits are trait‐related (independent of symptomatology) or state‐dependent (dependent on symptomatology). The current research examines the executive functions in OCD in a comprehensive manner and, for the first time, assesses the stability of these deficits over the developmental course of the disorder. Method: Using a cross‐sectional design, Study 1 examined the executive functions (set shifting, inhibition, planning, verbal fluency and working memory) in 60 subjects (20 actively Symptomatic OCD, 20 Remitted OCD and 20 Panic Disorder). Using a longitudinal design, Study 2 reassessed a subsample of OCD subjects (participants in Study 1) once they reached remitted status. Results: Study 1 found that the OCD groups exhibited deficits in set shifting and inhibition relative to Panic Disorder controls; however, no deficits were observed in planning, verbal fluency or working memory. There were no differences found between the Symptomatic and Remitted OCD groups on any of the executive function measures. Study 2 found that the identified executive function deficits in individuals were stable over time and remained unchanged despite symptom remittance. Conclusion: Current results confirm the presence of specific executive function deficits in OCD, and indicate that these deficits are trait‐like in nature.