Obsessive-compulsive disorder induced by psychostimulants, synthetic cathinones, or cocaine: a systematic review

The aim of the article is to conduct a systematic review of the literature in order to summarize the available data on the frequency of occurrence, clinical features, predictors of prognosis, and effective approaches to the treatment of obsessive-compulsive and related disorders associated with influence of cocaine (code 6C45.72 according to ICD-11), psychostimulants (6C46.73), and synthetic cathinones (6C47.72). The analysis of scientific publications in the eLibrary, CNKI, PubMed, and Scopus databases was performed with keyword search. In accordance with the PRISMA recommendations, 12 articles were selected and included in the analysis. No articles with data on synthetic cathinones have been found. It has been found that the misuse of amphetamine increases the risk of OCD by about 3 times, methamphetamine — by 4 times, cocaine — by 2.5 times. In the presence of additional comorbidity, this risk increases even more: in HIV infection — by 13 times, in the presence of induced psychoses in the anamnesis — by 12 times. The initial presence of OCD also increases the risk of developing addictions. Such mutual influence may be associated with the overlap of these disorders at genetic level (the relative contribution of these factors is estimated at 56–68 %), at neural circuits level (a decrease in the connectivity of the orbitofrontal cortex and in D2‑dopamine activity in the striatum are characteristic of both disorders), and at a behavioral level (both disorders are characterized by a decrease in cognitive flexibility in the model of probabilistic reversal learning). Comorbidity of OCD and addictions deteriorates the social functioning of patients, but increases the duration of remissions. To improve the effectiveness of the treatment of such conditions, combined treatment, aimed at both OCD and addiction, is required. The clinical picture of OCD induced by the use of the studied group of substances may differ in the greater severity of obsessions of contrast contents and compulsive counting. Socio-demographic predictors of the risk of its occurrence were not found.