Pauls D L, Alsobrook J P, Goodman W, Rasmussen S, Leckman J F
Department of Genetics, Yale University School of Medicine, New Haven, CT 06510.
Am J Psychiatry. 1995 Jan;152(1):76-84. doi: 10.1176/ajp.152.1.76.
The goal of this study was to determine 1) whether obsessive-compulsive disorder is familial, 2) whether there is a familial relationship between obsessive-compulsive disorder and Gilles de la Tourette's syndrome and chronic tics, and 3) whether different familial types of obsessive-compulsive disorder exist.
In this family study, all available first-degree relatives of 100 probands with obsessive-compulsive disorder were interviewed directly with structured interviews, and best-estimate diagnoses were assigned. In addition to the 466 first-degree relatives of the probands, 113 comparison subjects who were first-degree relatives of 33 psychiatrically unaffected subjects were studied with the same interviews.
The rates of obsessive-compulsive disorder and subthreshold obsessive-compulsive disorder were significantly greater among the relatives of the probands with obsessive-compulsive disorder (10.3% and 7.9%, respectively) than among the comparison subjects (1.9% and 2.0%, respectively). Furthermore, the rate of tics (Tourette's disorder and chronic tics) was also significantly greater among the relatives of the probands (4.6%) than among the comparison subjects (1.0%). The relatives of female probands with obsessive-compulsive disorder were more likely to have tics, and the relatives of probands with early onset were at higher risk for both obsessive-compulsive disorder and tics.
Obsessive-compulsive disorder is a heterogeneous condition. Some cases are familial and related to tic disorders, some cases are familial and unrelated to tics, and in other cases there appears to be no family history of either obsessive-compulsive disorder or tics.
本研究的目的是确定：1）强迫症是否具有家族性；2）强迫症与抽动秽语综合征及慢性抽动之间是否存在家族关系；3）是否存在不同的家族性强迫症类型。
在这项家族研究中，对100名强迫症先证者的所有在世一级亲属进行了直接的结构化访谈，并给出最佳估计诊断。除了先证者的466名一级亲属外，还对33名精神状态正常者的113名一级亲属作为对照对象进行了相同的访谈。
强迫症先证者亲属中强迫症及亚阈值强迫症的发生率（分别为10.3%和7.9%）显著高于对照对象（分别为1.9%和2.0%）。此外，先证者亲属中抽动（抽动秽语障碍和慢性抽动）的发生率（4.6%）也显著高于对照对象（1.0%）。患有强迫症的女性先证者的亲属更易出现抽动，发病早的先证者亲属患强迫症和抽动的风险更高。
强迫症是一种异质性疾病。一些病例具有家族性且与抽动障碍有关，一些病例具有家族性但与抽动无关，而在其他病例中，强迫症或抽动似乎均无家族病史。
