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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 University School of Medicine, Baltimore, MD, USA
J. F. Samuels
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
L. A. Wuyek
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School 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 University School of Medicine, Baltimore, MD, USA
M. A. Grados
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
B. A. Cullen
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
M. A. Riddle
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School 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 University School 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)
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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

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