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Comparing two basic subtypes in OCD across three large community samples: a pure compulsive versus a mixed obsessive-compulsive subtype

Rodgers, Stephanie ; Ajdacic-Gross, Vladeta ; Kawohl, Wolfram ; Müller, Mario ; Rössler, Wulf ; Hengartner, Michael ; Castelao, Enrique ; Vandeleur, Caroline ; Angst, Jules ; Preisig, Martin

In: European Archives of Psychiatry and Clinical Neuroscience, 2015, vol. 265, no. 8, p. 719-734

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    Titre
    • Comparing two basic subtypes in OCD across three large community samples: a pure compulsive versus a mixed obsessive-compulsive subtype
    Auteur
    • Rodgers, Stephanie. Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 1930, 8021, Zurich, Switzerland
    • Ajdacic-Gross, Vladeta. Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 1930, 8021, Zurich, Switzerland
    • Kawohl, Wolfram. Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 1930, 8021, Zurich, Switzerland
    • Müller, Mario. Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 1930, 8021, Zurich, Switzerland
    • Rössler, Wulf. Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 1930, 8021, Zurich, Switzerland
    • Hengartner, Michael. Department of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
    • Castelao, Enrique. Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
    • Vandeleur, Caroline. Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
    • Angst, Jules. Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 1930, 8021, Zurich, Switzerland
    • Preisig, Martin. Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • European Archives of Psychiatry and Clinical Neuroscience, 2015, vol. 265, no. 8, p. 719-734. Springer Berlin Heidelberg
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:331416
    Summary
    Due to its heterogeneous phenomenology, obsessive-compulsive disorder (OCD) has been subtyped. However, these subtypes are not mutually exclusive. This study presents an alternative subtyping approach by deriving non-overlapping OCD subtypes. A pure compulsive and a mixed obsessive-compulsive subtype (including subjects manifesting obsessions with/without compulsions) were analyzed with respect to a broad pattern of psychosocial risk factors and comorbid syndromes/diagnoses in three representative Swiss community samples: the Zurich Study (n=591), the ZInEP sample (n=1500), and the PsyCoLaus sample (n=3720). A selection of comorbidities was examined in a pooled database. Odds ratios were derived from logistic regressions and, in the analysis of pooled data, multilevel models. The pure compulsive subtype showed a lower age of onset and was characterized by few associations with psychosocial risk factors. The higher social popularity of the pure compulsive subjects and their families was remarkable. Comorbidities within the pure compulsive subtype were mainly restricted to phobias. In contrast, the mixed obsessive-compulsive subtype had a higher prevalence and was associated with various childhood adversities, more familial burden, and numerous comorbid disorders, including disorders characterized by high impulsivity. The current comparison study across three representative community surveys presented two basic, distinct OCD subtypes associated with differing psychosocial impairment. Such highly specific subtypes offer the opportunity to learn about pathophysiological mechanisms specifically involved in OCD.