Abstract
Little is known about the factors influencing the stability of obsessive-compulsive behaviour (OCB) from childhood to adolescence. The current study aimed to investigate: (1) the stability of paediatric OCB over a 12-year period; (2) the extent to which genetic and environmental factors influence stability; and (3) the extent to which these influences are stable or dynamic across development. The sample included 14743 twins from a population-based study. Parental ratings of severity of OCB were collected at ages 4, 7, 9 and 16 years. OCB was found to be moderately stable over time. The genetic influence on OCB at each age was moderate, with significant effects also of non-shared environment. Genetic factors exerted a substantial influence on OCB persistence, explaining 59-80% of the stability over time. The results indicated genetic continuity, whereby genetic influences at each age continue to affect the expression of OCB at subsequent ages. However, we also found evidence for genetic attenuation in that genetic influences at one age decline in their influence over time, and genetic innovation whereby new genes 'come on line' at each age. Non-shared environment influenced stability of OCB to a lesser extent and effects were largely unique to each age and displayed negligible influences on OCB at later time points. OCB appears to be moderately stable across development, and stability is largely driven by genetic factors. However, the genetic effects are not entirely constant, but rather the genetic influence on OCB appears to be a developmentally dynamic process.
Highlights
Obsessive–compulsive disorder (OCD) affects 1–4% of children and adolescents (Flament et al 1988; Douglass et al 1995; Heyman et al 2001), and causes functional impairment in multiple domains (Piacentini et al 2003)
Multivariate analyses were conducted in order to address the second and third aims of the study, which were to establish the genetic and environmental influences on obsessive–compulsive behaviour (OCB) stability and to test the extent to which these influences remained stable or changed over time
The within-age and across-ages twin correlations were higher among MZ than DZ pairs, indicating genetic influences on the OCB phenotype within time and longitudinally
Summary
Obsessive–compulsive disorder (OCD) affects 1–4% of children and adolescents (Flament et al 1988; Douglass et al 1995; Heyman et al 2001), and causes functional impairment in multiple domains (Piacentini et al 2003). The only meta-analysis to date of long-term outcomes in paediatric OCD included 521 participants from 16 studies (Stewart et al 2004). A persistence rate of 41% for OCD and 60% for subclinical OCD symptoms was found over a mean follow-up period of 5.7 years. Most studies to date have been limited by small sample sizes and short follow-up periods, and they typically focus on clinical cohorts rather than community samples (Stewart et al 2004), and may reflect the long-term effects of treatment rather than the natural course of the disorder. Little is known about the factors influencing the stability of obsessive–compulsive behaviour (OCB) from childhood to adolescence. The current study aimed to investigate: (1) the stability of paediatric OCB over a 12-year period; (2) the extent to which genetic and environmental factors influence stability; and (3) the extent to which these influences are stable or dynamic across development
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