Is familial obsessive-compulsive disorder different from sporadic obsessive-compulsive disorder? A comparison of clinical characteristics, comorbidity and treatment response.

BACKGROUND

Familial and sporadic subtypes of obsessive-compulsive disorder (OCD) have been proposed, but have not been well studied. The aim of the study was to compare the clinical characteristics, comorbidity and treatment response of familial OCD with sporadic OCD.

SAMPLING AND METHODS

We reviewed the clinical records of 84 familial OCD patients and 80 randomly selected sporadic OCD patients from a specialty OCD clinic in India. All the subjects had been evaluated using the specially devised topical OCD evaluation proforma, the Yale-Brown Obsessive Compulsive Scale and the Clinical Global Impression scale. A diagnosis of OCD was made according to the DSM-IV criteria.

RESULTS

Familial OCD was associated with earlier age at onset, a greater duration of untreated illness and more compulsions, particularly ordering and cognitive types. It was also associated with greater comorbidity, especially depression and other anxiety disorders, and treatment non-response. The sporadic group had more sexual obsessions and predominant obsession subtypes of OCD. In regression analysis, ordering compulsions, cognitive compulsions, absence of sexual obsessions, lifetime comorbidity of major depression and anxiety disorders and a greater duration of untreated illness predicted familial OCD.

CONCLUSIONS

Our findings support the observation that familial OCD could be phenotypically different from sporadic forms of OCD and therefore a putative subtype of OCD.