{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T01:40:53Z","timestamp":1790905253617,"version":"4.1.0"},"reference-count":66,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,1,22]],"date-time":"2021-01-22T00:00:00Z","timestamp":1611273600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>In the last decade, decision-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. Here, we aimed to comprehensively review decision making under ambiguity, as measured by the Iowa Gambling Task (IGT), in OCD, using a meta-analytic approach. According to PRISMA Guidelines, we selected 26 studies for a systematic review and, amongst them, 16 studies were included in a meta-analysis, comprising a total of 846 OCD patients and 763 healthy controls (HC). Our results show that OCD patients perform significantly lower than HC at the IGT, pointing towards the direction of a decision making impairment. In particular, this deficit seems to emerge mainly in the last three blocks of the IGT. IGT scores in OCD patients under the age of 18 were still significantly lower than in HC. Finally, no difference emerged between medicated and unmedicated patients, since they both scored significantly lower at the IGT compared to HC. In conclusion, our results are in line with the hypothesis according to which decision making impairment might represent a potential endophenotype lying between the clinical manifestation of OCD and its neurobiological aetiology.<\/jats:p>","DOI":"10.3390\/brainsci11020143","type":"journal-article","created":{"date-parts":[[2021,1,22]],"date-time":"2021-01-22T11:13:53Z","timestamp":1611314033000},"page":"143","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Obsessive-Compulsive Disorder and Decision Making under Ambiguity: A Systematic Review with Meta-Analysis"],"prefix":"10.3390","volume":"11","author":[{"given":"Veronica","family":"Nistic\u00f2","sequence":"first","affiliation":[{"name":"Dipartimento di Scienze della Salute, Universit\u00e0 degli Studi di Milano, 20142 Milano, Italy"},{"name":"Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics, Universit\u00e0 degli Studi di Milano, 20142 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"De Angelis","sequence":"additional","affiliation":[{"name":"Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George\u2019s University of London, London SW17 0RE, UK"},{"name":"Department of Neuropsychiatry, St George\u2019s Hospital, South West London and St George\u2019s Mental Health NHS Trust, London SW17 0RE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Erro","sequence":"additional","affiliation":[{"name":"Dipartimento di Medicina, Chirurgia e Odontoiatria \u201cScuola Medica Salernitana\u201d, Universit\u00e0 di Salerno, 84018 Baronissi, Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedetta","family":"Demartini","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze della Salute, Universit\u00e0 degli Studi di Milano, 20142 Milano, Italy"},{"name":"Aldo Ravelli Research Center for Neurotechnology and Experimental Brain Therapeutics, Universit\u00e0 degli Studi di Milano, 20142 Milano, Italy"},{"name":"Unit\u00e0 di Psichiatria II, Presidio San Paolo, ASST Santi Paolo e Carlo, 20142 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Ricciardi","sequence":"additional","affiliation":[{"name":"Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George\u2019s University of London, London SW17 0RE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,1,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). 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