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Epidemiology and Genetics of OCD: A Review and Discussion of Future Directions for Research

Published online by Cambridge University Press:  07 November 2014

Donald W. Black
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Abstract

The author reviews both the epidemiology and the genetics of obsessive-compulsive disorder (OCD). A relatively common disorder, OCD has an onset in late adolescence or early adulthood. Its gender distribution is nearly equal, although women are slightly more likely to develop the disorder. Usually chronic, OCD fluctuates depending on factors including the presence of depressed mood or stressful life events. OCD is associated with substantial psychiatric comorbidity, it affects quality of life, and it affects health care utilization. Many questions remain unanswered, such as whether its natural history has changed with the advent of effective therapies, and to what extent patients with OCD are disabled.

There are no adoption studies of OCD, but reports of twins suggest greater monozygotic than dizygotic concordance. Family study results are not entirely consistent, probably because of differences in study methods, but tend to show that OCD is familial. They also show a genetic relationship to subclinical OCD and Tourette's syndrome. Molecular genetic studies are just getting under way. Important issues remain to be answered, including defining the extent of an OCD spectrum of disorders, and determining what constitutes an OCD phenotype.

The author concludes by recommending that further studies on OCD involve samples from the general population rather than clinic- or hospital-based samples, which are inherently biased for severity.

The past 15 years have been exciting for psychiatric researchers interested in the epidemiology and genetics of OCD. Combined with ongoing development of effective pharmacologic and behavioral treatments, new research in these areas has affected how physicians think about OCD, as well as how we clinically manage patients. More work needs to be done, as many important questions about both the epidemiology and genetics of OCD remain unanswered.

Type
Feature Articles
Information
CNS Spectrums , Volume 1 , Issue 1: Special Academic Supplement: 2nd International OCD Conference , September 1996 , pp. 10 - 16
Copyright
Copyright © Cambridge University Press 1996

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References

1.Rudin, E. Ein beitrag zur frage der zwangskrankheit insbesondere ihrer hereditaren beziehungen. Arch Psychiatrische Nervenkrankheit. 1953;191:14–54.CrossRefGoogle Scholar
2.Myers, JK, Weissman, MM, Tischler, GL, et al. Six-month prevalence of psychiatric disorders in three communities. Arch Gen Psychiatry. 1984;41:949–958.CrossRefGoogle ScholarPubMed
3.Robins, LN, Helzer, JE, Weissman, MM, et al. Lifetime prevalence of specific psychiatric disorders in three sites. Arch Gen Psychiatry. 1984;41:958–967.CrossRefGoogle ScholarPubMed
4.Karno, M, Golding, JM, Sorenson, SB, et al. Epidemiology of obsessive-compulsive disorder in five U.S. communities. Arch Gen Psychiatry. 1988;45:1094–1099.CrossRefGoogle ScholarPubMed
5.Robins, LN, Helzer, JE, Croughan, J, et al. National Institute of Mental Health Diagnostic Interview Schedule: its history, characteristics, and validity. Arch Gen Psychiatry. 1981;381–389.Google Scholar
6.Bland, RC, Newman, SC, Orn, H. Lifetime prevalence of psychiatric disorders in Edmonton. Ada Psychiatr Scand. 1988;77(suppl 338):24–32.CrossRefGoogle Scholar
7.Bland, RC, Newman, SC, Orn, H. Prevalence of psychiatric disorders in Edmonton. Ada Psychiatr Scand. 1988;77(suppl 338):33–42.CrossRefGoogle Scholar
8.Canino, GJ, Bird, HR, Shrout, PE, et al. The prevalence of specific psychiatric disorders in Puerto Rico. Arch Gen Psychiatry. 1987;44:727–735.CrossRefGoogle ScholarPubMed
9.Well, JE, Bushnell, JA, Hornblow, AR, et al. Christchurch Psychiatric Epidemiology Study, I: methodology and lifetime prevalence for specific psychiatric disorders. Aust NZ J Psychiatry. 1989;23:315–326.CrossRefGoogle Scholar
10.Wittchen, HU, Essau, CA, VonZerssen, D, et al. Lifetime and 6-month prevalence of mental disorders in the Munich Follow-up Study. Eur Arch Psychiatry Clin Neurosci. 1992;241:247–258.CrossRefGoogle Scholar
11.Lee, CK, Kwak, YS, Yamamoto, J, et al. Psychiatric epidemiology in Korea. J Nerv Ment Dis. 1990;178:242–252.Google ScholarPubMed
12.Hwu, HG, Yek, EK, Chang, LY. Prevalence of psychiatric disorders in Taiwan defined by the Chinese Diagnostic Interview Schedule. Ada Psychiatr Scand. 1989;79:136–147.CrossRefGoogle ScholarPubMed
13.Goodwin, DH, Guze, SB, Robins, E. Follow-up studies in obsessional neurosis. Arch Gen Psychiatry. 1969;20:182–187.CrossRefGoogle ScholarPubMed
14.Rasmussen, SA, Eisen, JL. The epidemiology and clinical features of obsessive-compulsive disorder. Psychiatr din Am. 1992;15:743–758.Google ScholarPubMed
15.Rasmussen, SA, Eisen, JL. The epidemiology and differential diagnosis of obsessive-compulsive disorder. J Clin Psychiatry. 1992;53(suppl):4–10.Google ScholarPubMed
16.Rapoport, J. The Boy Who Couldn't Stop Washing. New York: Dutton; 1989.Google Scholar
17.Black, DW, Noyes, R, Pfohl, B, Goldstein, RB, Blum, N. Personality disorder in obsessive-compulsive volunteers, well comparison subjects, and their first-degree relatives. Am J Psychiatry. 1993;150:1226–1232.Google ScholarPubMed
18.Regier, DA, Narrow, WE, Rae, DS, et al. The de facto U.S. mental and addictive disorders service system. Arch Gen Psychiatry. 1993;50:85–94.CrossRefGoogle Scholar
19.Coryell, W. Obsessive-compulsive disorder and primary unipolar depression: comparisons of background, family history, course, and mortality. J Nerv Ment Dis. 1981;169:220–224.CrossRefGoogle ScholarPubMed
20.Jenike, MA, Baer, L, Ballantine, HT, et al. Cingulotomy for refractory obsessive-compulsive disorder: a long-term follow-up of 33 patients. Arch Gen Psychiatry. 1991;48:548–555.CrossRefGoogle ScholarPubMed
21.Black, A. The natural history of obsessional neurosis. In: Beech, HR, ed. Obsessional States. London: Methuen; 1974.Google Scholar
22.Leonard, HL, Swedo, SE, Lenane, MC, et al. A 2- to 7-year follow-up study on 54 obsessive-compulsive children and adolescents. Arch Gen Psychiatry. 1993;50:429–439.CrossRefGoogle ScholarPubMed
23.Orloff, L, Battle, MA, Baer, L, et al. Long-term follow-up of 85 patients with obsessive-compulsive disorder. Am J Psychiatry. 1994;151:441–442.Google ScholarPubMed
24.Helzer, JE, Robins, LN, McEvoy, LT. A comparison of clinical and diagnostic interview schedule diagnoses: physician re-examination of lay interview cases in general population. Arch Gen Psychiatry. 1985;42:657–666.Google Scholar
25.Weissman, MM, Bland, RC, Canino, GJ, et al. The cross natural epidemiology of obsessive-compulsive disorder. J Clin Psychiatry. 1994;55(3, suppl):5–10.Google Scholar
26.Kessler, RC, McConagle, KA, Zhao, S, et al. Lifetime and 12-month prevalence of DSM-IIIR psychiatric disorders in the United States—results from the National Comorbidity Study. Arch Gen Psychiatry. 1994;51:8–19.CrossRefGoogle Scholar
27.Pauls, DL, Alsobrook, JP, Goodman, W, et al. Family study of obsessive-compulsive disorder. Am J Psychiatry. 1995;142:76–84.Google Scholar
28.Baer, L, Jenike, MA, Black, DW, et al. Effect of axis ll diagnoses on treatment outcome with clomipramine in 55 patients with obsessive-compulsive disorder. Arch Gen Psychiatry. 1992;49:862–866.CrossRefGoogle Scholar
29.Lewis, A. Problems of obsessional illness. Proc R Soc Med. 1936;29:325–336.Google ScholarPubMed
30.Brown, FW. Heredity in the psychoneuroses. Proc R Soc Med. 1942;35:785–790.Google ScholarPubMed
31.Kringlen, E: Obsessional neurotics: a long-term followup. Br J Psychiatry. 1965;111:700–722.CrossRefGoogle Scholar
32.Lo, WH: A follow-up study of obsessional neurotics in Hong Kong Chinese. Br J Psychiatry. 1967;113:823–832.CrossRefGoogle ScholarPubMed
33.Rasmussen, SA, Tsuang, MT. DSM-III obsessive-compusive disorder: clinical characteristics and family history. Am J Psychiatry. 1986;143:317–322.Google Scholar
34.Lenane, MC, Sweedo, SE, Leonard, H, et al. Psychiatric disorders in first-degree relatives of children and adolescents with obsessive-compulsive disorder. J Am Acad Child Adolesc Psychiatry. 1990;29:407–412.CrossRefGoogle ScholarPubMed
35.Riddle, MA, Schaill, L, King, R, et al. Obsessive-compulsive disorder in children and adolescents: phenomenology and family history. J Am Acad Child Adolesc Psychiatry. 1990;29:766–772.CrossRefGoogle ScholarPubMed
36.Richter, MA, Swinson, RP, Joffe, RT. A family study of obses sive-compulsive disorder. Presented at the 144th Annual Meeting of the American Psychiatric Association; May 13, 1991; New Orleans.Google Scholar
37.Fyer, A, Mannuzza, S, Chapman, TF, et al. Familial transmission of obsessive-compulsive disorder. Abstracts of First International OCD Conference; March 12–13, 1993; Capri, Italy; p98.Google Scholar
38.Rosenberg, CM. Familial aspects of obsessional neurosis. Br J Psychiatry. 1967;113:405–413.CrossRefGoogle ScholarPubMed
39.Insel, TR, Hoover, C, Murphy, DL. Parents of patients with obsessive-compulsive disorder. Psychol Med. 1983;13:807–811.CrossRefGoogle ScholarPubMed
40.McKeon, P, Murray, R. Familial aspects of obsessive-compulsive neurosis. Br J Psychiatry. 1987;151:528–534.CrossRefGoogle ScholarPubMed
41.Bellodi, L, Sciuto, G, Diaferria, G, et al. Psychiatric disorders in families of patients with obsessive-compulsive disorder. Psychiatry Res. 1992;42:111–120.CrossRefGoogle ScholarPubMed
42.Black, DW, Noyes, R, Goldstein, RB, Blum, N. A family study of obsessive-compulsive disorder. Arch Gen Psychiatry. 1992;49:362–368.CrossRefGoogle ScholarPubMed
43.Sciuto, G, Pasquale, L, Bellodi, L. Obsessive-compulsive disorder and mood disorders: a family study. Am J Med Genet. 1995;60;475–479.CrossRefGoogle ScholarPubMed
44.Pauls, DL, Towbin, KE, Leckman, JF, et al. Gilles de la Tourette's syndrome and obsessive-compulsive disorder: evidence supporting a genetic relationship. Arch Gen Psychiatry. 1986;43:1180–1182.CrossRefGoogle ScholarPubMed
45.Rasmussen, SA. Genetic studies of obsessive-compulsive disorder. Ann Clin Psychiatry. 1993;5:241–248.CrossRefGoogle ScholarPubMed
46.Torgerson, S. Genetic factors in anxiety disorders. Arch Gen Psychiatry. 1983;40:1085–1089.CrossRefGoogle Scholar
47.Andrews, G, Stewart, G, Allen, R, Henderson, AS. The genetics of six neurotic disorders: a twin study. J Affect Disord. 1990;19:23–29.CrossRefGoogle ScholarPubMed
48.Rachman, SJ, Hodgson, RJ. Factors promoting and precipitating the disorder. In: Obsessions and Compulsions. Englewood Cliffs, NJ: Prentice Hall International, Inc; 1980;38–51.Google Scholar
49.Kendler, KS, Gruenberg, AM, Strauss, JS. An independent analysis of the Copenhagen sample of the Danish Adoption Study of Schizophrenia. Arch Gen Psychiatry. 1981;38:982–984.CrossRefGoogle ScholarPubMed
50.Richter, MA, Swinson, RP, Joffe, RT, et al. Family and genetic studies of OCD. Presented at the 148th Annual Meeting of the American Psychiatric Association; May 3, 1995; Miami.Google Scholar