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Minerva Psichiatrica 2007 June;48(2):237-43

language: Italian

Understanding psychiatric disorders

Bellodi L.

Dipartimento di Psichiatria Ospedale San Raffaele Turro Milano


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This article focuses on decision making, an executive ability that plays a crucial role in many real-life situations, whereby individuals choose between pursuing strategies of action that involve only immediate reward and others based on long-term reward. Although the role of decision-making deficits in the evolution of various psychiatric disorders, in particular the so called obsessive-compulsive disorder (OCD) spectrum, requires further research, the collected findings have significant implications for understanding the clinical and behavioral heterogeneity that characterizes individuals with OCD. Current approaches to OCD spectrum have suggested that neurobiological abnormalities play a crucial role in the etiology and course of these psychiatric syndromes. In particular, a fronto-subcortical circuit, including the orbitofrontal cortex, basal ganglia and thalamus appears to be involved in the expression of pathological behaviours seen in these different disorders. Neuropsychological studies have also shown that patients with OCD and other related disorders show deficits in cognitive abilities that are strictly linked to the functioning of the frontal lobe and its related fronto-subcortical structures, such as executive functioning deficits and insufficient cognitive-behavioral flexibility.

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