Hostname: page-component-8448b6f56d-mp689 Total loading time: 0 Render date: 2024-04-18T09:30:54.969Z Has data issue: false hasContentIssue false
  • English
  • Français

Is obsessive–compulsive disorder an anxiety disorder, and what, if any, are spectrum conditions? A family study perspective

Published online by Cambridge University Press:  13 May 2011

O. J. Bienvenu ,
J. F. Samuels ,
L. A. Wuyek ,
K.-Y. Liang ,
Y. Wang ,
M. A. Grados ,
B. A. Cullen ,
M. A. Riddle ,
B. D. Greenberg  and
S. A. Rasmussen
...Show all authors
O. J. Bienvenu*
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins UniversitySchool of Medicine, Baltimore, MD, USA
J. F. Samuels
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins UniversitySchool of Medicine, Baltimore, MD, USA
L. A. Wuyek
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins UniversitySchool of Medicine, Baltimore, MD, USA
K.-Y. Liang
Affiliation:
Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
Y. Wang
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins UniversitySchool of Medicine, Baltimore, MD, USA
M. A. Grados
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins UniversitySchool of Medicine, Baltimore, MD, USA
B. A. Cullen
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins UniversitySchool of Medicine, Baltimore, MD, USA
M. A. Riddle
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins UniversitySchool of Medicine, Baltimore, MD, USA
B. D. Greenberg
Affiliation:
Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA
S. A. Rasmussen
Affiliation:
Department of Psychiatry and Human Behavior, Brown Medical School, Providence, RI, USA
A. J. Fyer
Affiliation:
Columbia University College of Physicians and Surgeons, New York, NY, USA New York State Psychiatric Institute, New York, NY, USA
A. Pinto
Affiliation:
Columbia University College of Physicians and Surgeons, New York, NY, USA New York State Psychiatric Institute, New York, NY, USA
S. L. Rauch
Affiliation:
Massachusetts General Hospital, Boston, MA, USA Harvard Medical School, Department of Psychiatry, Boston, MA, USA
D. L. Pauls
Affiliation:
Massachusetts General Hospital, Boston, MA, USA Harvard Medical School, Department of Psychiatry, Boston, MA, USA
J. T. McCracken
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles School of Medicine, Los Angeles, CA, USA
J. Piacentini
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles School of Medicine, Los Angeles, CA, USA
D. L. Murphy
Affiliation:
Laboratory of Clinical Science, National Institute of Mental Health, Bethesda, MD, USA
J. A. Knowles
Affiliation:
Department of Psychiatry and Behavioral Sciences, Keck School of Medicine at the University of Southern California, Los Angeles, CA, USA
G. Nestadt
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins UniversitySchool of Medicine, Baltimore, MD, USA
*
*Address for correspondence: O. J. Bienvenu, M.D., Ph.D., Johns Hopkins University, Meyer 115, 600 N. Wolfe Street, Baltimore, MD 21287, USA. (Email: jbienven@jhmi.edu)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Experts have proposed removing obsessive–compulsive disorder (OCD) from the anxiety disorders section and grouping it with putatively related conditions in DSM-5. The current study uses co-morbidity and familiality data to inform these issues.

Method

Case family data from the OCD Collaborative Genetics Study (382 OCD-affected probands and 974 of their first-degree relatives) were compared with control family data from the Johns Hopkins OCD Family Study (73 non-OCD-affected probands and 233 of their first-degree relatives).

Results

Anxiety disorders (especially agoraphobia and generalized anxiety disorder), cluster C personality disorders (especially obsessive–compulsive and avoidant), tic disorders, somatoform disorders (hypochondriasis and body dysmorphic disorder), grooming disorders (especially trichotillomania and pathological skin picking) and mood disorders (especially unipolar depressive disorders) were more common in case than control probands; however, the prevalences of eating disorders (anorexia and bulimia nervosa), other impulse-control disorders (pathological gambling, pyromania, kleptomania) and substance dependence (alcohol or drug) did not differ between the groups. The same general pattern was evident in relatives of case versus control probands. Results in relatives did not differ markedly when adjusted for demographic variables and proband diagnosis of the same disorder, though the strength of associations was lower when adjusted for OCD in relatives. Nevertheless, several anxiety, depressive and putative OCD-related conditions remained significantly more common in case than control relatives when adjusting for all of these variables simultaneously.

Conclusions

On the basis of co-morbidity and familiality, OCD appears related both to anxiety disorders and to some conditions currently classified in other sections of DSM-IV.

Keywords

Anxiety disordersgenetic epidemiologyobsessive–compulsive disorderobsessive–compulsive personality disorderobsessive–compulsive spectrum
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 1 , January 2012 , pp. 1 - 13
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Barsky, AJ, Wyshak, G, Klerman, GL (1992). Psychiatric comorbidity in DSM-III-R hypochondriasis. Archives of General Psychiatry 49, 101–108.CrossRefGoogle ScholarPubMed
Biederman, J, Petty, C, Faraone, SV, Henin, A, Hirshfeld-Becker, D, Pollack, MH, de Figueiredo, S, Feeley, R, Rosenbaum, JF (2006). Effects of parental anxiety disorders in children at high risk for panic disorder: a controlled study. Journal of Affective Disorders 94, 191–197.CrossRefGoogle ScholarPubMed
Bienvenu, OJ, Samuels, JF, Riddle, MA, Hoehn-Saric, R, Liang, KY, Cullen, BA, Grados, MA, Nestadt, G (2000). The relationship of obsessive–compulsive disorder to possible spectrum disorders: results from a family study. Biological Psychiatry 48, 287–293.CrossRefGoogle ScholarPubMed
Bienvenu, OJ, Stein, MB (2003). Personality and anxiety disorders: a review. Journal of Personality Disorders 17, 139–151.CrossRefGoogle ScholarPubMed
Black, DW, Goldstein, RB, Noyes, R, Blum, N (1994). Compulsive behaviors and obsessive–compulsive disorder (OCD): lack of a relationship between OCD, eating disorders, and gambling. Comprehensive Psychiatry 35, 145–148.CrossRefGoogle Scholar
Black, DW, Noyes, R Jr., Goldstein, RB, Blum, N (1992). A family study of obsessive–compulsive disorder. Archives of General Psychiatry 49, 362–368.CrossRefGoogle ScholarPubMed
Black, DW, Noyes, R Jr., Pfohl, B, Goldstein, RB, Blum, N (1993). Personality disorder in obsessive–compulsive volunteers, well comparison subjects, and their first-degree relatives. American Journal of Psychiatry 150, 1226–1232.Google ScholarPubMed
Carter, AS, Pollock, RA, Suvak, MK, Pauls, DL (2004). Anxiety and major depression comorbidity in a family study of obsessive–compulsive disorder. Depression and Anxiety 20, 165–174.CrossRefGoogle Scholar
Cook, RJ, Sackett, DL (1995). The number needed to treat: a clinically useful measure of treatment effect. British Medical Journal 310, 452–454.CrossRefGoogle Scholar
Cullen, BA, Samuels, JF, Bienvenu, OJ, Grados, M, Hoehn-Saric, R, Hahn, J, Liang, K, Wellen, D, Dees, M, Riddle, M, Nestadt, G (2001). The relationship of pathologic skin picking to obsessive–compulsive disorder. Journal of Nervous and Mental Disease 189, 193–195.CrossRefGoogle ScholarPubMed
Dimsdale, JE, Creed, FH (2009). The proposed diagnosis of somatic symptom disorders in DSM-V to replace somatoform disorders in DSM-IV – a preliminary report. Journal of Psychosomatic Research 66, 473–476.CrossRefGoogle ScholarPubMed
do Rosario-Campos, MC, Leckman, JF, Curi, M, Quatrano, S, Katsovitch, L, Miguel, EC, Pauls, DL (2005). A family study of early-onset obsessive–compulsive disorder. American Journal of Medical Genetics, Part B, Neuropsychiatric Genetics 136, 92–97.CrossRefGoogle Scholar
First, M, Gibbon, M, Spitzer, R, Williams, G (1996). Users Guide for the SCID. Biometrics Research Division, New York State Psychiatric Institute: New York, NY.Google Scholar
Fyer, AJ, Lipsitz, JD, Mannuzza, S, Aronowitz, B, Chapman, TF (2005). A direct interview family study of obsessive–compulsive disorder: I. Psychological Medicine 35, 1611–1621.CrossRefGoogle ScholarPubMed
Goldstein, RB, Weissman, MM, Adams, PB, Horwath, E, Lish, JD, Charney, D, Woods, SW, Sobin, C, Wickramaratne, PJ (1994). Psychiatric disorders in relatives of probands with panic disorder and/or major depression. Archives of General Psychiatry 51, 383–394.CrossRefGoogle ScholarPubMed
Grabe, HJ, Ruhrmann, S, Ettelt, S, Buhtz, F, Hochrein, A, Schulze-Rauschenbach, S, Meyer, K, Kraft, S, Reck, C, Pukrop, R, Freyberger, HJ, Klosterkötter, J, Falkai, P, John, U, Maier, W, Wagner, M (2006). Familiality of obsessive–compulsive disorder in nonclinical and clinical subjects. American Journal of Psychiatry 163, 1986–1992.CrossRefGoogle ScholarPubMed
Grados, MA, Riddle, MA, Samuels, JF, Liang, KY, Hoehn-Saric, R, Bienvenu, OJ, Walkup, JT, Song, D, Nestadt, G (2001). The familial phenotype of obsessive–compulsive disorder in relation to tic disorders: the Hopkins OCD family study. Biological Psychiatry 50, 559–565.CrossRefGoogle ScholarPubMed
Hanna, GL, Himle, JA, Curtis, GC, Gillespie, BW (2005). A family study of obsessive–compulsive disorder with pediatric probands. American Journal of Medical Genetics, Part B, Neuropsychiatric Genetics 134, 13–19.CrossRefGoogle Scholar
Hettema, JM (2008). What is the genetic relationship between anxiety and depression? American Journal of Medical Genetics, Part C, Seminars in Medical Genetics 148C, 140–146.CrossRefGoogle ScholarPubMed
Hollander, E, Braun, A, Simeon, D (2008). Should OCD leave the anxiety disorders in DSM-V? The case for obsessive compulsive-related disorders. Depression and Anxiety 25, 317–329.CrossRefGoogle ScholarPubMed
Jaisoorya, TS, Reddy, YC, Srinath, S (2003). The relationship of obsessive–compulsive disorder to putative spectrum disorders: results from an Indian study. Comprehensive Psychiatry 44, 317–323.CrossRefGoogle ScholarPubMed
Kaufman, J, Birmaher, B, Brent, D, Rao, U, Flynn, C, Moreci, P, Williamson, D (1997). Schedule for Affective Disorders and Schizophrenia for School-Age Children – Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry 36, 1065–1069.Google ScholarPubMed
Kraemer, HC, Wilson, KA, Hayward, C (2006). Lifetime prevalence and pseudocomorbidity in psychiatric research. Archives of General Psychiatry 63, 604–608.CrossRefGoogle ScholarPubMed
Lenane, MC, Swedo, SE, Rapoport, JL, Leonard, H, Sceery, W, Guroff, JJ (1992). Rates of obsessive compulsive disorder in first degree relatives of patients with trichotillomania: a research note. Journal of Child Psychology and Psychiatry 33, 925–933.CrossRefGoogle ScholarPubMed
Lilenfeld, LR, Kaye, WH, Greeno, CG, Merikangas, KR, Plotnicov, K, Pollice, C, Rao, R, Strober, M, Bulik, CM, Nagy, L (1998). A controlled family study of anorexia nervosa and bulimia nervosa: psychiatric disorders in first-degree relatives and effects of proband comorbidity. Archives of General Psychiatry 55, 603–610.CrossRefGoogle ScholarPubMed
Mannuzza, S, Fyer, AJ, Endicott, J, Klein, DF (1985). Family Informant Schedule and Criteria. Anxiety Family Study Unit, New York State Psychiatric Institute: New York.Google Scholar
Mannuzza, S, Fyer, AJ, Klein, DF, Endicott, J (1986). Schedule for Affective Disorders and Schizophrenia – Lifetime version modified for the study of Anxiety disorders (SADS-LA): rationale and conceptual development. Journal of Psychiatric Research 20, 317–325.CrossRefGoogle Scholar
Nestadt, G, Samuels, J, Riddle, M, Bienvenu, OJ, Liang, KY, LaBuda, M, Walkup, J, Grados, M, Hoehn-Saric, R (2000). A family study of obsessive–compulsive disorder. Archives of General Psychiatry 57, 358–363.CrossRefGoogle ScholarPubMed
Nestadt, G, Samuels, J, Riddle, MA, Liang, KY, Bienvenu, OJ, Hoehn-Saric, R, Grados, M, Cullen, B (2001). The relationship between obsessive–compulsive disorder and anxiety and affective disorders: results from the Johns Hopkins OCD Family Study. Psychological Medicine 31, 481–487.CrossRefGoogle ScholarPubMed
Noyes, R Jr., Clarkson, C, Crowe, RR, Yates, WR, McChesney, CM (1987). A family study of generalized anxiety disorder. American Journal of Psychiatry 144, 1019–1024.Google ScholarPubMed
Noyes, R Jr., Holt, CS, Happel, RL, Kathol, RG, Yagla, SJ (1997). A family study of hypochondriasis. Journal of Nervous and Mental Disease 185, 223–232.CrossRefGoogle ScholarPubMed
Pauls, DL, Alsobrook, JP, Goodman, W, Rasmussen, S, Leckman, JF (1995). A family study of obsessive–compulsive disorder. American Journal of Psychiatry 152, 76–84.Google ScholarPubMed
Pauls, DL, Raymond, CL, Stevenson, JM, Leckman, JF (1991). A family study of Gilles de la Tourette syndrome. American Journal of Human Genetics 48, 154–163.Google ScholarPubMed
Pfohl, B, Blum, N, Zimmerman, M, Stangl, D (1989). Structured Interview for DSM-IIIR Personality – SIDP-R. University of Iowa College of Medicine: Iowa City, IA.Google Scholar
Phillips, KA, Stein, DJ, Rauch, S, Hollander, E, Fallon, B, Barsky, A, Fineberg, N, Mataix-Cols, D, Ferrão, YA, Saxena, S, Wilhelm, S, Kelly, MM, Clark, LA, Pinto, A, Bienvenu, OJ, Farrow, J, Leckman, J (2010). Should an obsessive–compulsive spectrum grouping of disorders be included in DSM-V? Depression and Anxiety 27, 528–555.CrossRefGoogle ScholarPubMed
Richter, MA, Summerfeldt, LJ, Antony, MM, Swinson, RP (2003). Obsessive–compulsive spectrum conditions in obsessive–compulsive disorder and other anxiety disorders. Depression and Anxiety 18, 118–127.CrossRefGoogle ScholarPubMed
Samuels, J, Nestadt, G, Bienvenu, OJ, Costa, PT, Riddle, MA, Liang, KY, Hoehn-Saric, R, Grados, MA, Cullen, BA (2000). Personality disorders and normal personality dimensions in obsessive–compulsive disorder. British Journal of Psychiatry 177, 457–462.CrossRefGoogle ScholarPubMed
Samuels, JF, Riddle, MA, Greenberg, BD, Fyer, AJ, McCracken, JT, Rauch, SL, Murphy, DL, Grados, MA, Pinto, A, Knowles, JA, Piacentini, J, Cannistraro, PA, Cullen, B, Bienvenu, OJ, Rasmussen, SA, Pauls, DL, Willour, VL, Shugart, YY, Liang, KY, Hoehn-Saric, R, Nestadt, G (2006). The OCD Collaborative Genetics Study: Methods and sample description. American Journal of Medical Genetics, Part B, Neuropsychiatric Genetics 141, 201–207.CrossRefGoogle Scholar
Schlosser, S, Black, DW, Blum, N, Goldstein, RB (1994). The demography, phenomenology, and family history of 22 persons with compulsive hair pulling. Annals of Clinical Psychiatry 6, 147–152.CrossRefGoogle ScholarPubMed
Stein, DJ, Fineberg, NA, Bienvenu, OJ, Denys, D, Lochner, C, Nestadt, G, Leckman, JF, Rauch, SL, Phillips, KA (2010). Should OCD be classified as an anxiety disorder in DSM-V? Depression and Anxiety 27, 495–506.CrossRefGoogle ScholarPubMed
Storch, EA, Abramowitz, J, Goodman, WK (2008). Where does obsessive–compulsive disorder belong in DSM-V? Depression and Anxiety 25, 336–347.CrossRefGoogle ScholarPubMed
Torres, AR, Del Porto, JA (1995). Comorbidity of obsessive–compulsive disorder and personality disorders: a Brazilian controlled study. Psychopathology 28, 322–329.CrossRefGoogle Scholar
van Grootheest, DS, Cath, DC, Beekman, AT, Boomsma, DI (2005). Twin studies on obsessive–compulsive disorder: a review. Twin Research and Human Genetics 8, 450–458.CrossRefGoogle ScholarPubMed