Further development of YBOCS dimensions in the OCD Collaborative Genetics Study: Symptoms vs. categories

Abstract

Despite progress in identifying homogeneous subphenotypes of obsessive compulsive disorder (OCD) through factor analysis of the Yale-Brown Obsessive Compulsive Scale Symptom Checklist (YBOCS-SC), prior solutions have been limited by a reliance on presupposed symptom categories rather than discrete symptoms. Furthermore, there have been only limited attempts to evaluate the © 2007 Elsevier Ireland Ltd. All rights reserved. *Corresponding author: Anthony Pinto, Ph.D., Butler Hospital, 345 Blackstone Blvd., Providence, RI 02906 USA; tel: 1-401-455-6299; fax: 1-401-455-6442; e-mail: Anthony_Pinto@brown.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript familiality of OCD symptom dimensions. The purpose of this study was to extend prior work by this collaborative group in category-based dimensions by conducting the first-ever exploratory dichotomous factor analysis using individual OCD symptoms, comparing these results to a refined category-level solution, and testing the familiality of derived factors. Participants were 485 adults in the six-site OCD Collaborative Genetics Study, diagnosed with lifetime OCD using semi-structured interviews. YBOCS-SC data were factor analyzed at both the individual item and symptom category levels. Factor score intraclass correlations were calculated using a subsample of 145 independent affected sib pairs. The item-and category-level factor analyses yielded nearly identical 5-factor solutions. While significant sib-sib associations were found for 4 of the 5 factors, Hoarding and Taboo Thoughts were the most robustly familial (r ICC ≥ 0.2). This report presents considerable converging evidence for a 5-factor structural model of OCD symptoms, including separate factor analyses employing individual symptoms and symptom categories, as well as sibling concordance.The results support investigation of this multidimensional model in OCD genetic linkage studies.

Sapap3 and pathological grooming in humans: Results from the OCD collaborative genetics study

“…Persons with GDs and OCD had significantly earlier ages at onset of OCD symptoms (median 6 years in persons with GD, median 8 without, Mann-Whitney P < 0.0005). GDs were not strongly or specifically related to particular OCD symptom dimensions derived from a factor analysis of Yale-Brown ObsessiveCompulsive Scale Symptom Checklist items [Pinto et al, 2008]. Using polychoric correlations, we found that the five OCD symptom dimensions (symmetry/ordering, taboo thoughts, hoarding, doubt/checking, and contamination/ cleaning) related more strongly to each other than to grooming disorders ( Table I).…”

Randomized Controlled Crossover Trial of Ketamine in Obsessive-Compulsive Disorder: Proof-of-Concept

“…Specifically, those receiving ketamine had lower mean estimated baseline OCD-VAS score at mid-infusion (by À 4.52 points, SE ¼ 1.23, po0.005), 230 min (by 3.84 points, SE ¼ 1.59, po0.05), and 7 days (by À 3.67 points, SE ¼ 1.36, po0.05) post infusion, each with large effect size (Cohen's d40.8), Abbreviations: A, Asian; AA, African American; C, Caucasian; EX/RP, cognitive behavior therapy with exposure and response prevention; F, female; H, Hispanic; HDRS, Hamilton Depression Rating Scale; M, male; MDD, major depressive disorder; OCD, obsessive-compulsive disorder; SAD, social anxiety disorder; SP, specific phobia; SRI, serotonin reuptake inhibitor; Y-BOCS, Yale-Brown Obsessive-Compulsive Scale. Symptom dimensions were based on a five-factor model (Pinto et al, 2008;Schooler et al, 2008) and listed in order of clinical severity for each subject: Cln (contamination/cleaning); Dbt (doubt/checking); Hrd (hoarding); Sym (symmetry/ordering); Tab (taboo thoughts (aggressive, sexual, and religious obsessions)). Y-BOCS was rated at baseline before infusion (pre) and 1-week post-infusion (post).…”

Investigation of Cortical Glutamate–Glutamine and γ-Aminobutyric Acid in Obsessive–Compulsive Disorder by Proton Magnetic Resonance Spectroscopy

“…OCD and depressive severity were assessed by trained clinician raters using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS; Goodman et al, 1989a, b) and the 17-item Hamilton Depression Rating Scale (HAM-D; Hamilton, 1960). The Y-BOCS checklist provided scores for each OCD patient along five symptom dimensions (contamination and cleaning, taboo thoughts, doubt and checking, symmetry and ordering, and hoarding), using the approach recommended by Pinto et al (2007Pinto et al ( , 2008Pinto et al ( , 2009). …”