Patients with obsessive-compulsive disorder (OCD) often display cognitions and/or behaviors that may well reflect the existence of "hyper-attachment" to different environmental elements, including their offspring, family members, divine entities, or even inanimate objects. Based on the fact that both OCD symptoms and physiologic interpersonal attachment mechanisms involve overlapping ventral fronto-limbic circuits, we hypothesized that there is a relationship between empathy, evaluated with the Interpersonal Reactivity Index (IRI), and OCD symptom dimensions. We evaluated 53 patients with OCD and 53 age- and sex-matched individuals from the community with the Structured Clinical Interview for the Diagnosis of DSM-IV axis I disorders, the Saving Inventory-Revised, the IRI (composed of four sub-scales), the Obsessive-Compulsive Inventory - Revised, the Beck Depression Inventory, and the Beck Anxiety Inventory. Patients with OCD displayed greater levels of affective empathy (i.e., empathic concern (p = 0.006) and personal discomfort (p < 0.001)) than community controls. In bivariate analyses, the severity of hoarding symptoms of patients with OCD correlated with empathic concern (r = 0.39; p < 0.001), fantasy (r = 0.36; p < 0.01), and personal discomfort (r = 0.39; p < 0.001). In partial correlation analyses adjusting for comorbid depression and anxiety, only the association between hoarding and fantasy remained robust (r = 0.41; p < 0.001). A model that included severity of hoarding, depression, and anxiety symptoms predicted 33% of the variance on the fantasy scale. Our findings suggest that hoarding is linked to specific aspects of interpersonal reactivity. Comorbid depression and anxiety, however, explain a large proportion of the empathic profile exhibited by patients with OCD. © 2008 Elsevier Ltd. All rights reserved.
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