Comparison of clinical characteristics of familial and sporadic obsessive-compulsive disorder

Abstract

BackgroundObsessive-compulsive disorder (OCD) is a heterogeneous condition with evidence of familiality in a considerable proportion of patients. A classification into familial and sporadic forms has been proposed to explain the heterogeneity. The current study aims to compare the demographic, clinical and comorbidity patterns of patients with and without a family history of OCD in first-degree relatives. Method802 consecutive patients who consulted a specialty OCD Clinic at a tertiary care psychiatric hospital in India were evaluated with the Mini-International Neuropsychiatric Interview, the Yale-Brown Obsessive–Compulsive Scale, and the Clinical Global Impression Scale. Family history was assessed by interviewing patients and at least one first-degree relative. ResultsFamily history of OCD was seen in 152 patients (19%). Family history was associated with juvenile onset (Χ2=19.472, p<0.001), obsessions of contamination (Χ2=6.658, p=0.01), hoarding (Χ2=4.062, p=0.032), need for symmetry (Χ2=3.95, p=0.047), washing compulsion (Χ2=7.923, p=0.005), ordering compulsions (Χ2=6.808, p=0.009), repeating compulsions (Χ2=4.950, p=0.026) and compulsions by proxy (Χ2=7.963, p=0.005). Family history was also associated with greater severity of OCD (t=−2.31, p=0.022) and compulsions (t=−3.09, p=0.002) and longer duration of illness at presentation (t=−2.93, p=0.004). ConclusionOur findings suggest that familial OCD may have distinctive clinical features. Studying familial forms of OCD may offer unique insight in to understanding the genetic basis of OCD.