Classification of comorbidity in obsessive–compulsive disorder: A latent class analysis

Abstract

Objective Patients with OCD differ markedly from one another in both number and kind of comorbid disorders. In this study, we set out to identify and characterize homogeneous subgroups of OCD patients based on their comorbidity profile. Methods In a cohort of 419 adult subjects with OCD, the lifetime presence of fifteen comorbid disorders was assessed. Latent class analysis was used to identify comorbidity‐based subgroups. Groups were compared with regard to core clinical characteristics: familiality, childhood trauma, age at onset, illness severity, OCD symptom dimensions, personality characteristics, and course of illness. Results The study sample could be divided in a large group ( n = 311) with a low amount of comorbidity that could be further subdivided into two subgroups: OCD simplex ( n = 147) and OCD with lifetime major depressive disorder ( n = 186), and a group ( n = 108) with a high amount of comorbidity that could be further subdivided into a general anxiety‐related subgroup ( n = 49), an autism/social phobia‐related subgroup ( n = 27), and a psychosis/bipolar‐related subgroup ( n = 10). Membership of the high‐comorbid subgroup was associated with higher scores on childhood trauma, illness severity, and the aggression/checking symptom dimension and lower scores on several personality characteristics. Conclusion Grouping OCD patients based on their comorbidity profile might provide more homogeneous, and therefore, more suitable categories for future studies aimed at unraveling the etiological mechanisms underlying this debilitating disorder.

Knowledge and competency standards for specialized cognitive behavior therapy for adult obsessive-compulsive disorder

“…related to OCD and/or comorbid disorders may require crisis intervention followed by disorder-specific interventions (e.g., acute suicidality; life-threatening eating disorder; uncontrolled substance abuse, bipolar disorder, or psychotic disorders) (Veale et al 2009;Albert et al 2019;Dell'Osso et al 2020;Mawn et al 2020;Palombini et al 2020). Attempts to classify comorbidity in OCD to reduce heterogeneity require further research and replication (e.g., van Oudheusden et al 2020). Development of algorithms for treatment of comorbidity in OCD is beyond the scope of this paper.…”

Military Aspects of Malingering, Sexual and Reproductive Coercion: Report from Russia

“…Apparently, violence was the patient's obsessive behavior. Obsessions of aggression including intimate partner violence have been reported in studies on obsessive-compulsive disorder [16][17][18][19][20][21]. The patient trustworthily claimed that he regretted the violence but was unable to control himself.…”

The correlates of social phobia in OCD: Findings from a large clinical sample

“…The relevance of comorbidity in OCD has been related to various clinical correlates such as symptom severity, suicidality, and treatment response (Jakubovski et al, 2013; Torres et al, 2011, 2016). Increased comorbidity in OCD was also associated with a history of childhood trauma and with a chronic course of illness (van Oudheusden et al, 2020). Furthermore, comorbidity was a key predictor of impaired functioning and poor quality of life among patients with OCD (Huppert, Simpson, Nissenson, Liebowitz, & Foa, 2009).…”

“…Furthermore, comorbidity was a key predictor of impaired functioning and poor quality of life among patients with OCD (Huppert, Simpson, Nissenson, Liebowitz, & Foa, 2009). A different line of research suggested that the classification of OCD on the basis of the comorbidity profile might contribute to a better understanding of its aetiological and pathogenic mechanisms, thus facilitating personalized treatment approaches (Nestadt et al, 2003; van Oudheusden et al, 2020).…”

“…Using data from the Netherlands Obsessive Compulsive Disorder Association (NOCDA) study, we characterized various correlates of comorbid SP among OCD patients. Specifically, we examined clinical and vulnerability factors that previous research deemed as relevant to comorbidity in OCD, such as chronicity, illness severity, additional comorbidities, traumatic experiences, and life events (Assunção et al, 2012; Hofmeijer‐Sevink et al, 2013; van Oudheusden et al, 2020). In addition, we estimated the contribution of interpersonal factors (i.e., attachment style, perceived social support, and expressed emotion) to the comorbidity of SP in OCD.…”