The syndrome of the “obsessive-compulsory scientist”: a new mental disorder?

Introduction

In a recent opinion paper entitled “Nobelitis: a common disease among Nobel laureates?” published in Clinical Chemistry and Laboratory Medicine, Eleftherios P. Diamandis classified a novel human disorder, that he called “Nobelitis”, and which is nothing but unlikely that would affect most – if not all – Nobel Laureates [1]. In the present article, we have hence the presumption to classify another mental disorder, which is likely to be much more frequent than “Nobelitis”, since it is supposed to affect a huge number of scientists other than Nobel Laureates, also including the authors of this paper.

Obsessive-compulsive disorder (OCD) is the fourth most common mental disorder and is diagnosed nearly as often as the physiological ailments asthma and diabetes mellitus [2, 3]. It is also estimated that one in every 50 adults suffers from OCD in the US [2]. OCD is usually defined as an anxiety mental disorder characterized by involuntary intrusive thoughts and compulsive behaviors [4]. When the patients begins to acknowledge these intrusive thoughts, instead of dismissing them, which is voluntary, they develop a great degree of anxiety based on the doubt that something has happened or will happen, feeling compelled to voluntarily perform irrational, time-consuming, and sometimes distressing physical behaviors. Traditionally, obsessions are recurrent and persistent thoughts, impulses, or images that are experienced as intrusive and that cause marked anxiety or distress. The patient, having recognized that these obsessional thoughts, impulses, or images are a product of his or her own mind, and are not based on reality, attempts to ignore or suppress or neutralize them with some other thoughts or actions [4]. Compulsions are instead defined as repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly, which are aimed at preventing or reducing distress or avoiding some dreaded event or situation; however, these behaviors or mental acts are not actually connected to the issue, and/or are excessive [4].

Although several studies have placed the prevalence of OCD between 1.5% and 4% of the general population, the prevalence of clinically recognized OCD is much lower, suggesting that many individuals with the disorder may remain undiagnosed [2, 5]. Such a high prevalence inherently means that several unsuspected individuals might be affected. Basically, a workaholic is a person “who gradually becomes emotionally crippled and addicted to control and power in a compulsive drive to gain approval and success”, and work-addiction is a well-recognized and important cause of high rates of alcoholism, drug addiction, divorce and suicide in the medical profession, as warned by Olga Lechky on the pages of the Canadian Medical Association Journal more than 20 years ago [6]. Hence, the huge number of such persons plausibly includes several scientists who might more or less unconsciously express obsessive-compulsory (OC) activities in their routine activity.

The predisposing factors cannot be definitively established, but some are more likely than others. Scientists studying OCDs generally agree that both psychological and biological factors play a role in this pathology, although they may differentially emphasize the relative importance of these factors [2, 3]. Indeed, the OC scientist also carries a suggestive genotype [2, 3]. His personal history most likely involves several other compulsory activities earlier in life, including sports, gardening, collecting stamps and/or similar time-involved activities. OCD is however a sort of democratic syndrome, in that scientists of every medical specialty are affected, including those working on the bench and those at the bedside, and thus OCD does not distinguish between molecular biologists, biochemists, emergency physicians, surgeons, etc. Most likely, there is not a direct association with age, since OCD can develop early in the scientific career, although it may expand incrementally later in life, evidenced by the gradual increase in accumulated pages of the curriculum vitae. Both genders may both be affected, although males might tend to be more evidently affected, particularly if they have less involvement in other daily routines, such as raising children or performing housework. The ideal candidate to this OC syndrome has probably published more than 100 papers in scientific journals over the last 2-year period (i.e., nearly one every week or so), does not remember the birthday of his/her relatives and children, but remembers perfectly the number of his/her papers on PubMed, and his/her overall H-index, which is constantly (almost daily) updated. This person does not remember the number of his/her mobile phone, but knows exactly the impact factor of more than 1000 scientific journals.

Which are the predictable hallmarks of this compulsory disorder? The following is our personal experience. First and foremost, the ideal candidate to this syndrome wakes up early in the morning, typically before 6 AM, and ahead of all other conventional human activities (tooth brushing, drinking coffee), will compulsorily check any email received during the night, hoping that one or more of the papers submitted over the past weeks has been accepted for publication or, at least, has only received minor revisions. The worst way in which to start the day for this mentally diverged person is to discover one or more emails that contain notification of a paper rejected. Afterwards, his/her mood is irreversibly affected for the rest of the day, which is predicted to be no longer effective. The second predictable activity is to get onto PubMed, to check whether: 1) new (personal) papers has just been made available; 2) someone has published something on one of his/her major topic(s) of interest, so that this new idea can be made use of; and 3) a breaking discovery has been published, thus disclosing novel and unexpected scenarios for future research. Afterwards, the maniacal scientist quickly gets dressed, leaves the house, often forgetting to say goodbye to wife/husband/children, and after battling traffic or other commuters reaches his/her place of work. The rest of the working day is a continuous fight to find some valuable time to work on data and paper drafts among the thousands of other commitments. And, if he/she can find 10 min to apply to the latest paper, he/she resembles a lion, roaring to anybody who makes the unfortunate decision to visit at that very inopportune time.

Other typical symptoms appear when our scientist receives the severe criticisms of the referees for one of the recently submitted papers. Whether they are listed as minor or major revision, there is no doubt that the compulsive scientists will immediately start reworking the paper, and will not abandon this quest until the paper is ready to be resubmitted. Occasionally, someone might hear him/her verbalizing frustration using unrepeatable words targeted at the referees. But, following the completion of the paper’s revision, this person reaches a sort of mental orgasm, which is comparable to that experienced when a paper is accepted for publication. This is the best time of the day, that will be remembered alongside other hallmark moments such as the delivery of his/her first child.

The OC scientist never buys newspapers, but has on-line subscriptions to several scientific journals, that he/she regularly prints and reads in place of newspapers or comics, while eating or doing one or more of several other (unavoidable) physiological functions. The OC scientist is always abreast of the new technological developments, buying whatever technological device would permit him/her to stay in touch with his/her job 24 h a day. He/she was among the first to buy a smartphone and a tablet [7, 8], to overcome the anxiety of not being able to check emails for a few hours. The OC scientist displays overt excitement when the light of his/her smartphone turns to red, indicating that a new email has been received and is awaiting to be read, with the instinctive hope that an old paper resubmitted several times has finally been accepted for publication. Needless to say, he/she is amongst the first who has suffered from the well-known “blackberry syndrome” [3].

Should this scientist be unusually convinced by relatives and friends to abandon his/her compulsions for a few hours to watch television or movies, the first thought is always “How can I translate what I am watching into a paper?” Insomnia is also a hallmark of the OC scientist. Most of the night is spent finalizing papers, but the partner is already asleep and is either uncomplaining after years and years of such life or else has left the partnership some time ago. Alternatively, if the partner is finally able to convince the OC scientist to go to bed, he/she will pretend to sleep, but immediately arise to finish the work in progress as soon as the partner has fallen asleep. Although the OC scientist is mostly inoffensive, the progressive deterioration of several mental and biological functions might occur. Physical activity is often inexistent, or reduced to the minimum amount that might be compatible with the OC scientific activity. The household of the OC scientist is either in disarray, or maintained by the long-suffering partner. Bills often remain unpaid until threatened legal action, household plants died several weeks ago, and the fridge is desolately empty. Indeed, OCD is seemingly protective against obesity, and the OC scientist is frequently anorexic having forgotten to eat while drafting or revising the latest of his/her papers, and consuming a huge amount of calories from hyperexcitation when collecting new data for drafting the next paper. The renal function is still maintained, but the tendency to delay urination while writing papers may eventually adversely affect the kidneys. Social relationships are usually non-existent, or mostly limited to tolerant relatives. But, most likely, the very first, universally recognized pathognomonic symptom of the OC scientist is to write papers like this one, indeed.

The therapy

This remains the biggest hurdle for this OC syndrome, since there is no currently universal and effective therapy for this mental disorder [9]. Tricyclic antidepressants and benzodiazepines are unlikely to be effective [10], since the level of commitment with the OC scientific activity is so high to make ineffective any therapeutic level. Selective serotonin reuptake inhibitors (SSRIs), which are commonly used in other forms of OCDs along with atypical antipsychotics (risperidone, olanzapine, and quetiapine) [7, 11], might also be ineffective, since the OC scientist would forget to take them, still being busy analyzing data, drafting or revising manuscripts. Entering a social community is even worse, because he/she will find that there are other similar mentally deviated OC sufferers, who will contribute to worsen the syndrome and potentially make it even more chronic. While it has generally accepted that psychotherapy, in combination with psychotropic medication [9], is more effective than either option alone, this is a very risky option, because such disorders may in fact be contagious, so that there is a high chance that the psychotherapist will themselves become a OC scientist, so that rather than succeeding in curing the patient, they just spread the affliction. Therefore, more education in medical school about maintaining a balanced life and a healthy perspective is probably the only reasonable approach for preventing young scientists to transform into OC patients [6].

In conclusion, although we have no clue on how this condition is widespread among the scientific community, it would be very interesting to gather this information. We have a reasonable doubt that we might not be alone…

Conflict of interest statement

Authors’ conflict of interest disclosure: The authors stated that there are no conflicts of interest regarding the publication of this article.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.