Is obsessive–compulsive disorder an anxiety disorder, and what, if any, are spectrum conditions? A family study perspective

Bienvenu, O. Joseph; Samuels, Jack; Wuyek, Lisa A.; Liang, Kung Yee; Wang, Y.; Grados, Marco A.; Cullen, Bernadette; Riddle, Mark A.; Greenberg, Benjamin D.; Rasmussen, Steven A.; Fyer, Abby J.; Pinto, Anthony; Rauch, Scott L.; Pauls, David L.; McCracken, James T.; Piacentini, John; Murphy, Dennis L.; Knowles, James A.; Nestadt, Gerald

doi:10.1017/s0033291711000742

Cited by 206 publications

(128 citation statements)

References 40 publications

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“…The strong association between trichotillomania and OCD is also supported by three earlier studies that reported higher prevalence of OCD in first-degree relatives of patients with trichotillomania (compared to the general population) either via collection of family history or direct interviewing of relatives (Lenane et al 1992;Schlosser et al 1994;King et al 1995). More recently, elevated grooming disorders including trichotillomania alone was also reported in OCD probands and their relatives compared to controls (Bienvenu et al 2012). …”

Section: Comorbiditysupporting

confidence: 60%

Behavioural addiction—A rising tide?

Chamberlain

Löchner

Stein

et al. 2016

European Neuropsychopharmacology

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The term 'addiction' was traditionally used in relation to centrally active substances, such as cocaine, alcohol, or nicotine. Addiction is not a unitary construct but rather incorporates a number of features, such as repetitive engagement in behaviours that are rewarding (at least initially), loss of control (spiralling engagement over time), persistence despite untoward functional consequences, and physical dependence (evidenced by withdrawal symptoms when intake of the substance diminishes). It has been suggested that certain psychiatric disorders characterized by maladaptive, repetitive behaviours share parallels with substance addiction and therefore represent 'behavioural addictions'. This perspective has influenced the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which now has a category 'Substance Related and Addictive Disorders', including gambling disorder. Could other disorders characterised by repetitive behaviours, besides gambling disorder, also be considered 'addictions'? Potential examples include kleptomania, compulsive sexual behaviour, 'Internet addiction', trichotillomania (hair pulling disorder), and skin-picking disorder. This paper seeks to define what is meant by 'behavioural addiction', and critically considers the evidence for and against this conceptualisation in respect of the above conditions, from perspectives of aetiology, phenomenology, co-morbidity, neurobiology, and treatment. Research in this area has important implications for future diagnostic classification systems, neurobiological models, and novel treatment directions.

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Section: Comorbiditysupporting

confidence: 60%

Behavioural addiction—A rising tide?

Chamberlain

Löchner

Stein

et al. 2016

European Neuropsychopharmacology

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“…Much debate has ensured regarding whether OCD should be considered an anxiety disorder, with overall mixed opinion based upon various categories of validators (Stein et al 2010). The limited data from extant genetic epidemiological studies suggest that OCD does share some familial (Bienvenu et al 2012) and genetic (Tambs et al 2009) risk factors with anxiety disorders, although OCD also shares risk with obsessive-compulsive spectrum disorders (Monzani et al 2014). No studies have included both of these groups to determine if these represent distinct genetic factors.…”

Section: Discussionmentioning

confidence: 99%

Direct, indirect and pleiotropic effects of candidate genes on internalizing disorder psychopathology

et al. 2015

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“…Family studies indicate that BDD is more common in firstdegree relatives of OCD probands than control probands, suggesting shared etiology (genetic and/or environmental) with OCD (36)(37)(38). Similarly, a twin study, which can tease apart genetic versus environmental influences, found that "dysmorphic concern" (a concept with similarities to BDD) has shared genetic vulnerability with other obsessive-compulsive and related disorders, including OCD; in addition, the study found BDD-specific genetic influences (heritability of 43%) (39).…”

Section: Genetic Factorsmentioning

confidence: 99%

Body Dysmorphic Disorder: Clinical Aspects and Relationship to Obsessive-Compulsive Disorder

Phillips¹

2015

FOC

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Body dysmorphic disorder (BDD) is an obsessive-compulsive and related disorder that is common and usually causes substantial distress and impairment in psychosocial functioning. BDD is associated with markedly poor quality of life and high rates of suicidal ideation and behavior. The first-line pharmacologic approach is a serotonin reuptake inhibitor, often at relatively high doses; serotonin reuptake inhibitors are also recommended for patients with delusional BDD beliefs. The firstline psychosocial treatment is manualized cognitive-behavioral therapy that is tailored to BDD's unique clinical features; it is not recommended that therapists simply apply cognitive-behavioral approaches for other disorders, such as obsessivecompulsive disorder (OCD). Because insight is so often absent or poor in BDD, motivational interviewing techniques are often needed to engage and retain patients in treatment. Cosmetic treatment (e.g., surgery or dermatologic treatment) is not recommended because it appears to only rarely improve BDD symptoms and can even make them worse. BDD has many similarities to OCD and is probably closely related to OCD, but the two disorders also have some important differences. From a clinical perspective, the most important differences are that BDD is characterized by poorer insight, more frequent comorbid major depressive disorder and substance use disorders, and more frequent suicidality. Although treatment approaches have similarities to those for OCD, effective cognitive-behavioral therapy for BDD meaningfully differs from that for OCD.

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Is obsessive–compulsive disorder an anxiety disorder, and what, if any, are spectrum conditions? A family study perspective

Abstract: On the basis of co-morbidity and familiality, OCD appears related both to anxiety disorders and to some conditions currently classified in other sections of DSM-IV.

Cited by 206 publications

References 40 publications

Behavioural addiction—A rising tide?

Behavioural addiction—A rising tide?

Direct, indirect and pleiotropic effects of candidate genes on internalizing disorder psychopathology

Body Dysmorphic Disorder: Clinical Aspects and Relationship to Obsessive-Compulsive Disorder

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