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Psychol Med ; 39(9): 1491-501, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19046474

RESUMO

BACKGROUND: Obsessive-compulsive disorder (OCD) is probably an etiologically heterogeneous condition. Many patients manifest other psychiatric syndromes. This study investigated the relationship between OCD and co-morbid conditions to identify subtypes. METHOD: Seven hundred and six individuals with OCD were assessed in the OCD Collaborative Genetics Study (OCGS). Multi-level latent class analysis was conducted based on the presence of eight co-morbid psychiatric conditions [generalized anxiety disorder (GAD), major depression, panic disorder (PD), separation anxiety disorder (SAD), tics, mania, somatization disorders (Som) and grooming disorders (GrD)]. The relationship of the derived classes to specific clinical characteristics was investigated. RESULTS: Two and three classes of OCD syndromes emerge from the analyses. The two-class solution describes lesser and greater co-morbidity classes and the more descriptive three-class solution is characterized by: (1) an OCD simplex class, in which major depressive disorder (MDD) is the most frequent additional disorder; (2) an OCD co-morbid tic-related class, in which tics are prominent and affective syndromes are considerably rarer; and (3) an OCD co-morbid affective-related class in which PD and affective syndromes are highly represented. The OCD co-morbid tic-related class is predominantly male and characterized by high conscientiousness. The OCD co-morbid affective-related class is predominantly female, has a young age at onset, obsessive-compulsive personality disorder (OCPD) features, high scores on the 'taboo' factor of OCD symptoms, and low conscientiousness. CONCLUSIONS: OCD can be classified into three classes based on co-morbidity. Membership within a class is differentially associated with other clinical characteristics. These classes, if replicated, should have important implications for research and clinical endeavors.


Assuntos
Transtornos Mentais/classificação , Transtorno Obsessivo-Compulsivo/classificação , Adulto , Fatores Etários , Idade de Início , Comorbidade , Estudos Transversais , Transtorno Depressivo Maior/classificação , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/genética , Transtorno Depressivo Maior/psicologia , Feminino , Predisposição Genética para Doença/genética , Humanos , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/genética , Transtornos Mentais/psicologia , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/genética , Transtorno Obsessivo-Compulsivo/psicologia , Determinação da Personalidade/estatística & dados numéricos , Transtornos da Personalidade/classificação , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/genética , Transtornos da Personalidade/psicologia , Psicometria , Fatores Sexuais , Transtornos de Tique/classificação , Transtornos de Tique/diagnóstico , Transtornos de Tique/genética , Transtornos de Tique/psicologia
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