Genetic and phenotypic overlap of specific obsessive-compulsive and attention-deficit/hyperactive subtypes with Tourette syndrome.
Genetic and phenotypic overlap of specific obsessive-compulsive and attention-deficit/hyperactive subtypes with Tourette syndrome.
复制标题
DOI：
10.1017/s0033291717001672
复制
发表时间：
2018-01
影响因子：
6.9
通讯作者：
Mathews CA
中科院分区：
文献类型：
--
作者：
Hirschtritt ME;Darrow SM;Illmann C;Osiecki L;Grados M;Sandor P;Dion Y;King RA;Pauls D;Budman CL;Cath DC;Greenberg E;Lyon GJ;Yu D;McGrath LM;McMahon WM;Lee PC;Delucchi KL;Scharf JM;Mathews CA
图雷特综合征（TS）个体中强迫症（OCD）和注意力缺陷多动障碍（ADHD）的独特表型和遗传方面尚未得到很好的表征。在这里，我们研究症状模式和遗传性强迫症和多动症的TS家庭。强迫症和多动症的症状模式进行了检查，在TS患者及其家庭成员（N=3494）使用探索性因素分析（EFA）的强迫症和多动症症状分别，然后由潜在的类分析（LCA）的结果强迫症和多动症因子总分联合;遗传性和临床相关性的结果因素和类进行了评估。EFA产生了ADHD的2因素模型和OCD的8因素模型。注意力不集中和多动/冲动症状的两个ADHD因素都与TS、ADHD和强迫症有遗传关系。怀疑，污染，需要相同，迷信因素与强迫症，但没有ADHD或TS的遗传相关性;对称/精确性和害怕伤害与TS和强迫症，而囤积与ADHD和强迫症。相比之下，攻击性冲动与TS，OCD和ADHD遗传相关。LCA揭示了一个三级解决方案：少数强迫症/ADHD症状[LC 1]，强迫症和ADHD症状[LC 2]，以及对称性/精确性，囤积和ADHD症状[LC 3]。LC 2的精神病合并症发生率最高（所有疾病均≥50%）。对称性/精确性、攻击性冲动、害怕伤害和囤积显示了与TS、OCD和ADHD的复杂遗传关系，并且，不是OCD的特定亚型，而是超越了传统的诊断界限，可能代表了潜在的脆弱性（例如，失败的自上而下的认知控制）共同的所有三种疾病。
The unique phenotypic and genetic aspects of obsessive-compulsive (OCD) and attention-deficit/hyperactivity disorder (ADHD) among individuals with Tourette syndrome (TS) are not well characterized. Here, we examine symptom patterns and heritability of OCD and ADHD in TS families. OCD and ADHD symptom patterns were examined in TS patients and their family members (N=3494) using exploratory factor analyses (EFA) for OCD and ADHD symptoms separately, followed by latent class analyses (LCA) of the resulting OCD and ADHD factor sum scores jointly; heritability and clinical relevance of the resulting factors and classes were assessed. EFA yielded a 2-factor model for ADHD and an 8-factor model for OCD. Both ADHD factors (inattentive and hyperactive/impulsive symptoms) were genetically related to TS, ADHD, and OCD. The doubts, contamination, need for sameness, and superstitions factors were genetically related to OCD, but not ADHD or TS; symmetry/exactness and fear-of-harm were associated with TS and OCD while hoarding was associated with ADHD and OCD. In contrast, aggressive urges were genetically associated with TS, OCD, and ADHD. LCA revealed a three-class solution: few OCD/ADHD symptoms [LC1], OCD & ADHD symptoms [LC2], and symmetry/exactness, hoarding, and ADHD symptoms [LC3]. LC2 had the highest psychiatric comorbidity rates (≥50% for all disorders). Symmetry/exactness, aggressive urges, fear-of-harm, and hoarding show complex genetic relationships with TS, OCD, and ADHD, and, rather than being specific subtypes of OCD, transcend traditional diagnostic boundaries, perhaps representing an underlying vulnerability (e.g., failure of top-down cognitive control) common to all three disorders.