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Further Evidence for Co-Segregation between Pediatric Obsessive Compulsive Disorder and Attention Deficit Hyperactivity Disorder: A Familial Risk Analysis

  • Daniel Geller
    Correspondence
    Address reprint requests to Daniel Geller, M.D., YAW 6A, Massachusetts General Hospital, Fruit Street, Boston, MA 02114
    Affiliations
    Pediatric Psychopharmacology Program, Center for Human Genetics, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts

    Department of Psychiatry, Center for Human Genetics, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts

    Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
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  • Carter Petty
    Affiliations
    Pediatric Psychopharmacology Program, Center for Human Genetics, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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  • Fe Vivas
    Affiliations
    Pediatric Psychopharmacology Program, Center for Human Genetics, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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  • Jessica Johnson
    Affiliations
    Pediatric Psychopharmacology Program, Center for Human Genetics, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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  • David Pauls
    Affiliations
    Department of Psychiatry, Center for Human Genetics, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts

    Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
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  • Joseph Biederman
    Affiliations
    Pediatric Psychopharmacology Program, Center for Human Genetics, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts

    Department of Psychiatry, Center for Human Genetics, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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      Background

      To examine the relationship between obsessive compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD) in children and adolescents using familial risk analysis.

      Methods

      We assessed for ADHD and OCD in the 1057 first-degree relatives of three groups of index children: those with OCD and ADHD, those with OCD but no ADHD and matched controls with neither disorder.

      Results

      The age-corrected risk for OCD was similarly elevated in families of OCD youth with (14.8%) and without ADHD (17.5%) (p = .78), and both groups had significantly higher rates of OCD compared with controls (.5%) (p < .001). In contrast, the risk for ADHD was significantly elevated only among relatives of youth who had ADHD (15.3%) compared with controls (4.6%) (p < .001). Relatives affected with ADHD also had a significantly elevated risk for OCD compared to relatives unaffected by ADHD (20% vs. 4.9%, hazard ratio 4.8) (p < .001) and the two disorders occurred together with higher than expected frequency in affected relatives of OCD+ADHD probands (p < . 001) suggesting co-segregation between these two disorders. There was no evidence of nonrandom mating between OCD- and ADHD-affected spouses.

      Conclusions

      These results extend previous findings regarding the familiality of both OCD and ADHD and provide further evidence of a familial relationship between ADHD and pediatric OCD which best fit the hypothesis of a unique familial subtype.

      Key Words

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