Psychological Medicine

Original Article

The relationship between obsessive–compulsive disorder and anxiety and affective disorders: results from the Johns Hopkins OCD Family Study

G.  NESTADT  a1 c1, J.  SAMUELS  a1, M. A.  RIDDLE  a1, K.-Y.  LIANG  a1, O. J.  BIENVENU  a1, R.  HOEHN-SARIC  a1, M.  GRADOS  a1 and B.  CULLEN  a1
a1 Department of Psychiatry and Behavioral Sciences, School of Medicine and Department of Biostatistics, School of Hygiene and Public Health, The Johns Hopkins University, Baltimore, Maryland, USA


Objective. This study investigates the relationship of specific anxiety and affective disorders to obsessive–compulsive disorder (OCD) in a blind, controlled family study.

Method. Eighty case and 73 control probands, as well as 343 case and 300 control first-degree relatives of these probands, participated in the study. Subjects were examined by psychologists or psychiatrists using the Schedule for Affective Disorder and Schizophrenia-Lifetime Anxiety version (SADS-LA). Two experienced psychiatrists independently reviewed all clinical materials, and final diagnoses were made according to DSM-IV criteria, by consensus procedure.

Results. Except for bipolar disorder, all anxiety and affective disorders investigated were more frequent in case than control probands. Substance dependence disorders were not more frequent. Generalized anxiety disorder (GAD), panic disorder, agoraphobia, separation anxiety disorder (SAD) and recurrent major depression were more common in case than control relatives. These disorders occurred more frequently if the relative was diagnosed with OCD. Only GAD and agoraphobia were more frequent in case relatives independent of OCD.

Conclusion. GAD and agoraphobia share a common familial aetiology with OCD. The other anxiety and affective disorders, when comorbid with OCD, may emerge as a consequence of the OCD or as a more complex syndrome.

c1 Address for correspondence: Dr Gerald Nestadt, Mayer 4–181, 600 N Wolfe Street, Baltimore, Maryland 21287, USA.