impairment of decision-making in OCD might constitute a trait feature of the disorder itself and a potential endophenotype
ecision-making has been proposed to have a central role in obsessive-compulsive disorder (OCD) aetiology, since patients show pathological doubt and an apparent inability to make decisions
ur results would point towards the direction of a deficit in decision-making under risk, more than under ambiguity in OCD, in line with several studies included in our systematic review
pathological doubt (i.e., a lack of certitude or confidence in one’s memory, attention, intuition, and perceptions, such that it is difficult to trust one’s internal experiences [48,49]) is central in the clinical presentation of OCD
mpaired decision-making under ambiguity in OCD patients compared to HC as measured with the IGT
found that adolescents with OCD showed disorder-specific under-activation in ventral-medial-orbitofrontal cortex during advantageous choices;
Decision making, and thus the IGT, is strongly affected by one’s ability of response inhibition
In conclusion, our results show an impairment in decision making, in particular under risk, in OCD patients compared to HC. This finding suggests that the neuropsychological domain of decision making might represents a possible endophenotype accounting for OCD symptomatology.