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单卵双生子和多卵双生子强迫症先证者的临床特征。

Clinical characteristics of probands with obsessive-compulsive disorder from simplex and multiplex families.

机构信息

Department & Institute of Psychiatry, Faculdade de Medicina, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo (SP), Brazil.

Child Study Center and Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.

出版信息

Psychiatry Res. 2024 Jan;331:115627. doi: 10.1016/j.psychres.2023.115627. Epub 2023 Nov 30.

Abstract

Genetic and non-genetic factors contribute to obsessive-compulsive disorder (OCD), with strong evidence of familial clustering. Genomic studies in psychiatry have used the concepts of families that are "simplex" (one affected) versus "multiplex" (multiple affected). Our study compares demographic and clinical data from OCD probands in simplex and multiplex families to uncover potential differences. We analyzed 994 OCD probands (501 multiplex, 493 simplex) from the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders (C-TOC). Clinicians administered the Structured Clinical Interview for DSM-IV (SCID-IV) to diagnose, Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) to assess severity, and Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS) to assess symptom dimensionality. Demographics, clinical history, and family data were collected. Compared to simplex probands, multiplex probands had earlier onset, higher sexual/religious and hoarding dimensions severity, increased comorbidity with other obsessive-compulsive-related disorders (OCRD), and higher family history of psychiatric disorders. These comparisons provide the first insights into demographic and clinical differences between Latin American simplex and multiplex families with OCD. Distinct clinical patterns may suggest diverse genetic and environmental influences. Further research is needed to clarify these differences, which have implications for symptom monitoring and management.

摘要

遗传和非遗传因素导致强迫症 (OCD),且有强烈的家族聚集证据。精神病学的基因组研究使用了“单病例家族”(一个受影响)与“多病例家族”(多个受影响)的概念。我们的研究比较了单病例和多病例家族中强迫症先证者的人口统计学和临床数据,以揭示潜在的差异。我们分析了来自巴西强迫症谱系障碍研究联合会 (C-TOC) 的 994 名强迫症先证者(501 名多病例,493 名单病例)。临床医生使用 DSM-IV 结构临床访谈 (SCID-IV) 进行诊断,耶鲁-布朗强迫症量表 (Y-BOCS) 评估严重程度,维度耶鲁-布朗强迫症量表 (DY-BOCS) 评估症状维度。收集了人口统计学、临床病史和家族数据。与单病例先证者相比,多病例先证者的发病年龄更早,性/宗教和囤积维度的严重程度更高,与其他强迫症相关障碍 (OCRD) 的共病率更高,以及家族精神障碍史更高。这些比较首次深入了解了拉丁美洲单病例和多病例家族中强迫症的人口统计学和临床差异。不同的临床模式可能表明存在不同的遗传和环境影响。需要进一步研究来阐明这些差异,这对症状监测和管理具有重要意义。

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