Yue Sun, Xuedi Zhang, Wenxin Tang, Qianqian Li, Jun Yan, Si Mi, Zhanjiang Li, Bin Li, Guiyun Xu, Congwen Yang, Maorong Hu, Zhenqing Zhang, Yanbin Jia, Zhen Tang, Xiaoping Wang, Jun Ma, Changhong Wang, Wei Liu, Na Liu
SP may represent a clinically meaningful dimension of OCD psychopathology, within which SP subtypes operate as a heterogeneous set of experiences rather than a uniform construct, differentially shaping symptom connectivity. Anxiety serves as a critical bridge between SP and OC symptoms, while SP severity functions as a symptom network intensifier rather than a structural reorganizer. Future studies should explore whether precision interventions targeting anxiety and sensory-channel-specific pathways may improve treatment outcomes for refractory OCD with SP. Trial Registration: Chinese Clinical Trial Registry: ChiCTR2100051536.
BACKGROUND: Sensory phenomena (SP) affect 60%-80% of obsessive-compulsive (OC) disorder (OCD) patients, demonstrate dimension-specific symptom associations, yet their mechanistic role in OCD's network architecture remains unexamined.
METHODS: In this cross-sectional study, 1350 clinician-diagnosed OCD patients from the China OCD Cohort (COCC) underwent standardized assessments using the University of São Paulo SP Scale (USP-SPS), Yale-Brown OC Scale (Y-BOCS), OC Inventory-Revised (OCI-R), and Beck Depression Inventory-II/Beck Anxiety Inventory (BDI-II/BAI). Network analysis was utilized to identify core/bridge symptoms and test network differences across early/late-onset and SP-severity subgroups.
RESULTS: SP-positive OCD patients (n = 850) demonstrated earlier disease onset (p < 0.001), more severe compulsions (p = 0.010), and greater depression than SP-negative patients (n = 500). Network analysis in the SP-positive cohort identified SP symptoms as central network drivers, though with considerable heterogeneity across subtypes: muscle-joint/bone sensation (strength = 3.41) and sound "just-right" (strength = 2.73) exhibited the highest centrality, while other SP subtypes showed more modest or selective connectivity. Anxiety was the primary bridge symptom (bridge strength = 1.60), with the strongest cross-domain link between "look 'just-right'" and "ordering." The network architecture remained stable across subgroups, though elevated SP severity significantly increased global connectivity (S = 5.343, p = 0.002) without altering topology.
CONCLUSION: SP may represent a clinically meaningful dimension of OCD psychopathology, within which SP subtypes operate as a heterogeneous set of experiences rather than a uniform construct, differentially shaping symptom connectivity. Anxiety serves as a critical bridge between SP and OC symptoms, while SP severity functions as a symptom network intensifier rather than a structural reorganizer. Future studies should explore whether precision interventions targeting anxiety and sensory-channel-specific pathways may improve treatment outcomes for refractory OCD with SP. Trial Registration: Chinese Clinical Trial Registry: ChiCTR2100051536.