Obsessive-Compulsive Disorder: An Exploration of Some Unresolved Clinical Issues

1990 ◽  
Vol 24 (4) ◽  
pp. 480-485 ◽  
Author(s):  
R. Julian Hafner ◽  
Robyn J. Miller
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Support Group ◽  
Psychiatric Treatment ◽  
Age At Onset ◽  
Community Support ◽  
Study Data ◽  
Significant Excess ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Australian Community

The study data were obtained from a questionnaire survey of a South Australian community support group for obsessive-compulsive disorder (OCD). The response rate was 47%, yielding 81 questionnaire sets completed by members who, on the basis of their questionnaire responses, were judged to meet DSM-Ill-R criteria for OCD. The clinical and demographic characteristics of the respondents were very similar to those of previously reported clinical populations. Mean age at onset of OCD was 18 years and mean duration 17 years; 55% of respondents rated their current OCD as extremely or very severe. Seventy-seven percent had received psychiatric treatment (mean 55 occasions) and 47% had attended clinical psychologists or professional counsellors (mean 20 occasions). Those who reported prominent fears of losing control of motor behaviours had received a significant excess of outpatient and inpatient psychiatric treatment. Most respondents reported the presence of all 4 identified components of OCD, of which the obsession/rumination component was central. Levels of OCD correlated strongly with levels of overall psychopathology, and fertility rates were significantly reduced in those patients who reported the most symptoms.

scholarly journals Obsessive–compulsive disorder: subclassification based on co-morbidity

2008 ◽  
Vol 39 (9) ◽  
pp. 1491-1501 ◽  
Author(s):  
G. Nestadt ◽  
C. Z. Di ◽  
M. A. Riddle ◽  
M. A. Grados ◽  
B. D. Greenberg ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Obsessive Compulsive Disorder ◽  
Clinical Characteristics ◽  
Latent Class ◽  
Age At Onset ◽  
Separation Anxiety Disorder ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Co Morbidity ◽  
The Relationship

BackgroundObsessive–compulsive disorder (OCD) is probably an etiologically heterogeneous condition. Many patients manifest other psychiatric syndromes. This study investigated the relationship between OCD and co-morbid conditions to identify subtypes.MethodSeven hundred and six individuals with OCD were assessed in the OCD Collaborative Genetics Study (OCGS). Multi-level latent class analysis was conducted based on the presence of eight co-morbid psychiatric conditions [generalized anxiety disorder (GAD), major depression, panic disorder (PD), separation anxiety disorder (SAD), tics, mania, somatization disorders (Som) and grooming disorders (GrD)]. The relationship of the derived classes to specific clinical characteristics was investigated.ResultsTwo and three classes of OCD syndromes emerge from the analyses. The two-class solution describes lesser and greater co-morbidity classes and the more descriptive three-class solution is characterized by: (1) an OCD simplex class, in which major depressive disorder (MDD) is the most frequent additional disorder; (2) an OCD co-morbid tic-related class, in which tics are prominent and affective syndromes are considerably rarer; and (3) an OCD co-morbid affective-related class in which PD and affective syndromes are highly represented. The OCD co-morbid tic-related class is predominantly male and characterized by high conscientiousness. The OCD co-morbid affective-related class is predominantly female, has a young age at onset, obsessive–compulsive personality disorder (OCPD) features, high scores on the ‘taboo’ factor of OCD symptoms, and low conscientiousness.ConclusionsOCD can be classified into three classes based on co-morbidity. Membership within a class is differentially associated with other clinical characteristics. These classes, if replicated, should have important implications for research and clinical endeavors.

Admixture analysis of age at onset in obsessive–compulsive disorder

2005 ◽  
Vol 35 (2) ◽  
pp. 237-243 ◽  
Author(s):  
RICHARD DELORME ◽  
JEAN-LOUIS GOLMARD ◽  
NADIA CHABANE ◽  
BRUNO MILLET ◽  
MARIE-ODILE KREBS ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Late Onset ◽  
Age At Onset ◽  
Admixture Analysis ◽  
Obsessive Compulsive ◽  
General Anxiety Disorder ◽  
General Anxiety ◽  
Compulsive Disorder ◽  
History Of ◽  
Best Fitting

Background. Age at onset (AAO) has been useful to explore the clinical, neurobiological and genetic heterogeneity of obsessive–compulsive disorder (OCD). However, none of the various thresholds of AAO used in previous studies have been validated, and it remains an unproven notion that AAO is a marker for different subtypes of OCD. If AAO is a clinical indicator of different biological subtypes, then subgroups based on distinct AAOs should have separate normal distributions as well as different clinical characteristics.Method. Admixture analysis was used to determine the best-fitting model for the observed AAO of 161 OCD patients.Results. The observed distribution of AAO in OCD is a mixture of two Gaussian distributions with mean ages of 11·1±4·1 and 23·5±11·1 years. The first distribution, defined by early-onset OCD, had increased frequency of Tourette's syndrome and increased family history of OCD. The second distribution, defined by late-onset OCD, showed elevated prevalence of general anxiety disorder and major depressive disorder.Conclusions. These results, based on a statistically validated AAO cut-off and those of previous studies on AAO in OCD, suggest that AAO is a crucial phenotypic characteristic in understanding the genetic basis of this disorder.

The epidemiology of obsessive-compulsive disorder in an Italian population

1992 ◽  
Vol 7 (2) ◽  
pp. 53-59 ◽  
Author(s):  
P Ronchi ◽  
M Abbruzzese ◽  
S Erzegovesi ◽  
G Diaferia ◽  
G Sciuto ◽  
...  
Keyword(s):  
Family History ◽  
Obsessive Compulsive Disorder ◽  
Age At Onset ◽  
Epidemiological Data ◽  
Italian Population ◽  
Obsessive Compulsive ◽  
Axis Ii ◽  
Compulsive Disorder ◽  
Axis I ◽  
The Relationship

SummaryThis study presents the clinical and demographic characteristics of a sample of 131 patients, who met DSM III-R criteria for obsessive-compulsive disorder (OCD). Our aim was to compare our epidemiological data with non-European research, and to investigate the relationship between OCD symptoms and other clinical features, ie other Axis I concomitant disturbances, personality disorders (Axis II) and family history. Furthermore, we evaluated the age at onset distribution according to sex, family history and presence/absence of a comorbid diagnosis of mood disorder, by means of survival analysis.

Early Onset Obsessive-Compulsive Disorder With and Without Tics

CNS Spectrums ◽  
2009 ◽  
Vol 14 (7) ◽  
pp. 362-370 ◽  
Author(s):  
Maria Alice de Mathis ◽  
Juliana B. Diniz ◽  
Roseli G. Shavitt ◽  
Albina R. Torres ◽  
Ygor A. Ferrão ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Early Onset ◽  
Age Of Onset ◽  
Age At Onset ◽  
Clinical Manifestations ◽  
Tic Disorders ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Diagnostic And Statistical Manual ◽  
History Of

ABSTRACTIntroduction: Research suggests that obsessive-compulsive disorder (OCD) is not a unitary entity, but rather a highly heterogeneous condition, with complex and variable clinical manifestations.Objective: The aims of this study were to compare clinical and demographic characteristics of OCD patients with early and late age of onset of obsessive-compulsive symptoms (OCS); and to compare the same features in early onset OCD with and without tics. The independent impact of age at onset and presence of tics on comorbidity patterns was investigated.Methods: Three hundred and thirty consecutive outpatients meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for OCD were evaluated: 160 patients belonged to the “early onset” group (EOG): before 11 years of age, 75 patients hadResults: The EOG had a predominance of males, higher frequency of family history of OCS, higher mean scores on the “aggression/violence” and “miscellaneous” dimensions, and higher mean global DY-BOCS scores. Patients with EOG without tic disorders presented higher mean global DY-BOCS scores and higher mean scores in the “contamination/cleaning” dimension.Conclusion: The current results disentangle some of the clinical overlap between early onset OCD with and without tics.

Treatment–response by age at onset in obsessive–compulsive disorder

2004 ◽  
Vol 83 (2-3) ◽  
pp. 283-284 ◽  
Author(s):  
Leonardo F. Fontenelle ◽  
Maria Conceição do Rosário-Campos ◽  
Mauro V. Mendlowicz ◽  
Ygor Arzeno Ferrão ◽  
Marcio Versiani ◽  
...  
Keyword(s):  
Treatment Response ◽  
Obsessive Compulsive Disorder ◽  
Age At Onset ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

scholarly journals Brain white matter integrity and association with age at onset in pediatric obsessive-compulsive disorder

2014 ◽  
Vol 4 (1) ◽  
Author(s):  
Isabelle M Rosso ◽  
Elizabeth A Olson ◽  
Jennifer C Britton ◽  
S Evelyn Stewart ◽  
George Papadimitriou ◽  
...  
Keyword(s):  
White Matter ◽  
Obsessive Compulsive Disorder ◽  
Age At Onset ◽  
White Matter Integrity ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Brain White Matter

scholarly journals Association analysis between a VNTR intron 8 polymorphism of the dopamine transporter gene (SLC6A3) and obsessive- compulsive disorder in a Brazilian sample

2007 ◽  
Vol 65 (4a) ◽  
pp. 936-941 ◽  
Author(s):  
Karen Miguita ◽  
Quirino Cordeiro ◽  
Jacqueline Siqueira-Roberto ◽  
Roseli Gedanke Shavitt ◽  
José Carlos Ramos Castillo ◽  
...  
Keyword(s):  
Dopamine Transporter ◽  
Obsessive Compulsive Disorder ◽  
Age At Onset ◽  
Tic Disorders ◽  
Transporter Gene ◽  
Obsessive Compulsive ◽  
Dopamine Transporter Gene ◽  
Brazilian Sample ◽  
Compulsive Disorder ◽  
Co Morbidity

Family, twin and segregation analysis have provided evidences that genetic factors are implicated in the susceptibility for obsessive-compulsive disorder (OCD). Several lines of research suggest that the dopaminergic system may be involved in the pathophysiology of OCD. Thus, the aim of the present study was to investigate a possible association between a polymorphism located in intron 8 of the dopamine transporter gene (SLC6A3) and OCD in a Brazilian sample composed by 208 patients and 865 healthy controls. No statistically differences were observed in allelic and genotype distributions between cases and controls. No association was also observed when the sample was divided according to specific phenotypic features such as gender, presence of tic disorders co-morbidity and age at onset of obsessive-compulsive symptoms (OCS). Our results suggest that the intron 8 VNTR of the SLC6A3 investigated in this study is not related to the susceptibility for OCD in our Brazilian sample.

Gender-related clinical differences in obsessive-compulsive disorder

1999 ◽  
Vol 14 (8) ◽  
pp. 434-441 ◽  
Author(s):  
F. Bogetto ◽  
S. Venturello ◽  
U. Albert ◽  
G. Maina ◽  
L. Ravizza
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Clinical Features ◽  
Age At Onset ◽  
Obsessive Compulsive ◽  
Course Of Illness ◽  
Compulsive Disorder ◽  
History Of ◽  
Axis I ◽  
Dsm Iv ◽  
Chronic Course

SummaryThe purpose of the present study was to investigate the gender-related differences of clinical features in a sample of obsessive-compulsive (OCD) patients. One hundred and sixty outpatients with a principal diagnosis of obsessive-compulsive disorder (DSM-IV, Y-BOCS = 16) were admitted. Patients were evaluated with a semi-structured interview covering the following areas: socio-demographic data, Axis I diagnoses (DSM-IV), OCD clinical features (age at onset of OC symptoms and disorder, type of onset, life events and type of course). For statistical analysis the sample was subdivided in two groups according to gender. We found an earlier age at onset of OC symptoms and disorder in males; an insidious onset and a chronic course of illness were also observed in that group of patients. Females more frequently showed an acute onset of OCD and an episodic course of illness; they also reported more frequently a stressful event in the year preceding OCD onset. A history of anxiety disorders with onset preceding OCD and hypomanic episodes occurring after OCD onset was significantly more common among males, while females showed more frequently a history of eating disorders. We found three gender-related features of OCD: males show an earlier age at onset with a lower impact of precipitant events in triggering the disorder; OCD seems to occur in a relative high proportion of males who already have phobias and/or tic disorders; and a surfeit of chronic course of the illness in males in comparison with females.

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