Background
Identification of familial, more homogenous characteristics of obsessive–compulsive
disorder (OCD) may help to define relevant subtypes and increase the power of genetic
and neurobiological studies of OCD. While factor-analytic studies have found consistent,
clinically meaningful OCD symptom dimensions, there have been only limited attempts
to evaluate the familiality and potential genetic basis of such dimensions.
Methods
Four hundred eighteen sibling pairs with OCD were evaluated using the Structured Clinical
Interview for DSM-IV and the Yale–Brown Obsessive Compulsive Scale (YBOCS) Symptom
Checklist and Severity scales.
Results
After controlling for sex, age, and age of onset, robust sib–sib intraclass correlations
were found for two of the four YBOCS factors: Factor IV (hoarding obsessions and compulsions
(p = .001) and Factor I (aggressive, sexual, and religious obsessions, and checking
compulsions; p = .002). Smaller, but still significant, familiality was found for
Factor III (contamination/cleaning; p = .02) and Factor II (symmetry/ordering/arranging;
p = .04). Limiting the sample to female subjects more than doubled the familiality
estimates for Factor II (p = .003). Among potentially relevant comorbid conditions
for genetic studies, bipolar I/II and major depressive disorder were strongly associated
with Factor I (p < .001), whereas ADHD, alcohol dependence, and bulimia were associated
with Factor II (p < .01).
Conclusions
Factor-analyzed OCD symptom dimensions in sibling pairs with OCD are familial with
some gender-dependence, exhibit relatively specific relationships to comorbid psychiatric
disorders and thus may be useful as refined phenotypes for molecular genetic studies
of OCD.
Key Words
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References
- Symptom presentation and outcome of cognitive-behavioral therapy for obsessive–compulsive disorder.J Consult Clin Psychol. 2003; 71: 1049-1057
- Segregation analysis of obsessive–compulsive disorder using symptom-based factor scores.Am J Med Genet. 1999; 88: 669-675
- Symptoms of schizophrenia.Arch Gen Psychiatry. 1995; 52: 341-351
- Obsessive–compulsive severity spectrum in the community: Prevalence, comorbidity, and course.Eur Arch Psychiatry Clin Neurosci. 2004; 254: 156-164
- Diagnostic and statistical manual of mental disorders. 4th ed. Author, Washington, DC1994
- Factor analysis of symptom subtypes of obsessive compulsive disorder and their relation to personality and tic disorders.J Clin Psychiatry. 1994; 55: 18-23
- Hoarding and treatment response in 38 nondepressed subjects with obsessive-compulsive disorder.J Clin Psychiatry. 1998; 59: 420-425
- Twin and family studies of anxiety, phobic, and obsessive disorders.in: Klein D.F. Rabkin J.G. Anxiety: New Research and Changing Concepts. Raven Press, New York1981: 117-136
- A factor analysis of the signs and symptoms of mania.Arch Gen Psychiatry. 1998; 55: 27-32
- Exploratory factor analysis of obsessive–compulsive patients and association with 5-HTTLPR polymorphism.Am J Med Genet. 2002; 114: 347-353
- Genetic and environmental influences on obsessional traits and symptoms.Psychol Med. 1984; 14: 791-800
- Pitfalls in factor analytic techniques.Am J Psychiatry. 2004; 161: 579-580
- Use of factor analysis to detect potential phenotypes in obsessive–compulsive disorder.Psychiatry Res. 2004; 128: 273-280
- Psychopathology and attrition in the epidemiologic catchment area surveys.Am J Epidemiol. 1992; 135: 1051-1059
- Linkage analysis of ordinal traits for pedigree data.Proc Natl Acad Sci U S A. 2004; 101: 16739-16744
- Statistical Methods for Research Workers. Oliver and Boyd, Edinburgh1925
- The Yale–Brown Obsessive Compulsive Scale.Arch Gen Psychiatry. 1989; 46: 1006-1011
- A family study of obsessive–compulsive disorder with pediatric probands.Am J Med Genet B Neuropsychiatr Genet. 2005; 134: 13-19
- Discovering endophenotypes for major depression.Neuropsychopharmacology. 2004; 29: 1765-1781
- Factor analysis of obsessive–compulsive disorder YBOCS-SC symptoms and association with 5-HTTLPR SERT polymorphism.Am J Med Genet. 2006; 141: 403-408
- Obsessive–compulsive disorder symptom dimensions show specific relationships to psychiatric comorbidity.Psychiatry Research. 2005; 135: 121-132
- Depressive symptoms during childhood and adult obesity: The Zurich Cohort Study.Mol Psychiatry. 2005; 10: 842-850
- Obsessive and compulsive symptoms in a general population sample of female twins.Am J Med Genet. 2000; 96: 791-796
- The epidemiology of obsessive–compulsive disorder in five US communities.Arch Gen Psychiatry. 1988; 45: 1094-1099
- Checkers and washers: Valid subtypes of obsessive compulsive disorder.Psychopathology. 1992; 25: 283-288
- Familiality of symptom dimensions in depression.Arch Gen Psychiatry. 2004; 61: 468-474
- Diagnostic interview assessed neuropsychiatric disorder comorbidity in 334 individuals with obsessive-compulsive disorder.Depress Anxiety. 2004; 19: 163-173
- The hoarding dimension of OCD: Psychological comorbidity and the five-factor personality model.Behav Res Ther. 2005 (Dec 28 [Epub ahead of print])
- Symptoms of obsessive–compulsive disorder.Am J Psychiatry. 1997; 154: 911-917
- Obsessive–compulsive symptom dimensions in affected sibling pairs diagnosed with Gilles de la Tourette syndrome.Am J Med Genet. 2003; 116B: 60-68
- Generalized estimating equations for correlated binary data: Using the odds ratio as a measure of association.Biometrika. 1991; 78: 153-160
- SAS System for Mixed Models. SAS Institute, Cary, NC1996
- Family Informant Schedule and Criteria. Anxiety Family Study Unit, New York State Psychiatric Institute, New York1985
- Schedule for Affective Disorders and Schizophrenia—Lifetime Version modified for the study of anxiety disorders (SADS-LA): Rationale and conceptual development.J Psychiatr Res. 1986; 20: 317-325
- Obsessive–compulsive symptom dimensions as predictors of compliance with and response to behaviour therapy: Results from a controlled trial.Psychother Psychosom. 2002; 71: 255-262
- Use of factor-analyzed symptom dimensions to predict outcome with serotonin reuptake inhibitors and placebo in the treatment of obsessive-compulsive disorder.Am J Psychiatry. 1999; 156: 1409-1416
- A multidimensional model of obsessive–compulsive disorder.Am J Psychiatry. 2005; 162: 228-238
- Distinct neural correlates of washing, checking, and hoarding symptom dimensions in obsessive-compulsive disorder.Arch Gen Psychiatry. 2004; 61: 564-576
- Obsessive–compulsive disorder phenotypes: implications for genetic studies.Mol Psychiatry. 2005; 10: 258-275
- The Global Burden of Disease. Harvard University Press, Boston1996
- The identification of OCD-related subgroups based on comorbidity.Biol Psychiatry. 2003; 53: 914-920
- Complex segregation analysis provides compelling evidence for a major gene underlying obsessive–compulsive disorder and for heterogeneity by sex.Am J Hum Genet. 2000; 67: 1611-1616
- A family study of obsessive–compulsive disorder.Arch Gen Psychiatry. 2000; 57: 358-363
- SPSS and SAS programs for determining the number of components using parallel analysis and velicer’s MAP test.Behav Res Methods Instrum Comput. 2000; 32: 396-402
- A family study of obsessive–compulsive disorder.Am J Psychiatry. 1995; 152: 76-84
- The epidemiology and clinical features of obsessive compulsive disorder.Psychiatr Clin North Am. 1992; 15: 743-758
- Neural correlates of factor-analyzed OCD symptom dimensions: A PET study.CNS Spectr. 1998; 3: 37-43
- The Dimensional Yale–Brown Obsessive–Compulsive Scale (DY-BOCS): An instrument for assessing obsessive–compulsive symptom dimensions.Mol Psychiatry. 2006; 11: 1-10
- The OCD Collaborative Genetics Study: Methods and sample description.Am J Med Genet B Neuropsychiatr Genet. 2006; 141: 201-207
- Cerebral glucose metabolism in obsessive–compulsive hoarding.Am J Psychiatry. 2004; 161: 1038-1048
- Phenotypic characteristics of obsessive–compulsive disorder ascertained in adulthood.J Psychiatr Res. 1999; 33: 265-273
- The Structured Clinical Interview for DSM-III-R (SCID).Arch Gen Psychiatry. 1992; 49: 624-629
- Symptom structure in obsessive-compulsive disorder: A confirmatory factor-analytic study.Behav Res Ther. 1999; 37: 297-311
- The cross national epidemiology of obsessive compulsive disorder.J Clin Psychiatry. 1994; 55: 5-10
- Familiality of symptom dimensions in schizophrenia.Schizophr Res. 2001; 47: 223-232
- Genomewide scan of hoarding in sib pairs in which both sibs have Gilles de la Tourette syndrome.Am J Hum Genet. 2002; 70: 896-904
Article info
Publication history
Published online: October 10, 2006
Accepted:
May 23,
2006
Received in revised form:
May 17,
2006
Received:
February 27,
2006
Identification
Copyright
© 2007 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.