Is obsessive-compulsive disorder an anxiety disorder, and what, if any, are spectrum conditions? A family study perspective
Is obsessive-compulsive disorder an anxiety disorder, and what, if any, are spectrum conditions? A family study perspective
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DOI：
10.1017/s0033291711000742
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发表时间：
2012-01-01
影响因子：
6.9
通讯作者：
Nestadt, G.
中科院分区：
文献类型：
--
作者：
Bienvenu, O. J.;Samuels, J. F.;Nestadt, G.
背景资料。专家建议将强迫症(OCD)从焦虑症部分删除，并将其与DSM-5中假定的相关条件分组。目前的研究使用共同发病率和熟悉度数据来告知这些问题。将来自强迫症合作遗传学研究的病例家系数据(382名强迫症先证者及其一级亲属)与来自约翰霍普金斯强迫症家族研究的对照家系数据(73名非强迫症先证者及其一级亲属233人)进行比较。焦虑症(特别是广场恐怖症和广泛性焦虑症)、C类人格障碍(特别是强迫症和回避性)、抽动障碍、躯体形式障碍(疑病症和躯体变形障碍)、梳理障碍(特别是脱毛症和病理性皮肤挑剔)和情绪障碍(特别是单相抑郁障碍)在病例组中比对照先证者更常见；然而，进食障碍(厌食症和神经性暴食症)、其他冲动控制障碍(病理性赌博、嗜酒癖、盗窃症)和物质依赖(酒精或毒品)的患病率在两组之间没有差异。同样的一般模式在病例先证者和对照先证者的亲属中也很明显。在对人口统计学变量和同一疾病的先证者诊断进行调整后，亲属中的结果没有明显差异，尽管在亲属中调整强迫症时，关联强度较低。然而，当同时调整所有这些变量时，病例组中几种焦虑、抑郁和推测与强迫症相关的疾病仍然明显比对照亲属更常见。根据共同发病率和熟悉度，强迫症似乎既与焦虑症有关，也与目前在DSM-IV其他部分分类的一些疾病有关。
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.