Dimensões de sintomas obsessivo-compulsivos em pares de irmãos concordantes para o diagnóstico de Transtorno Obsessivo-Compulsivo (TOC) / Obsessive-compulsive dimensions in sibling pairs concordant for the Obsessive-Compulsive Disorder (OCD) diagnose

AUTOR(ES)
DATA DE PUBLICAÇÃO

2008

RESUMO

BACKGROUND: Obsessive-compulsive disorder (OCD) is a heterogeneous disorder of unknown etiology. Obsessive-compulsive symptoms (OCS) vary from one patient to another and even from time to time in the same patient. The heterogeneity of OCD reduces the chance of finding specific genes related to the disorder. Categorical and dimensional approaches have been used in many studies in attempts to identify more phenotypic homogeneous subgroups. Phenotypic studies of affected sib-pairs may help to characterize familial components of the OCD phenotype. The aim of this study is to determine whether sibling pairs affected with OCD are similar in age at onset of OCS, presence of tic disorders (TDs), and obsessive-compulsive symptom dimensions. METHODS: Forty OCD siblings (18 families) were evaluated by expert psychiatrists or psychologists. Families with two or more siblings affected with OCD were recruited from several specialized OCD clinics where at least one sibling was been treated. All of the clinics involved belonged to the Brazilian OCD Research Consortium (http://www.protoc.com.br/portal/ctoc/). The Yale Brown Obsessive- Compulsive Scale Checklist was used to assess OCS and the severity of OCD. The OCD diagnoses were made according to the DSM-IV. Age at onset was defined as the age that the patient, or a family member, remembered as the beginning of the OCS. The chi-square test was used to assess concordance of TD presence within sibling pairs based on the TD frequency reported in the literature (30%).Intraclass correlations were determined for the scores of all four evaluated factors and for the ages at onset of OCS. Four specific OCS factors were analyzed in the present study: aggressive, sexual, religious and somatic obsessions together with checking compulsions (Factor 1); symmetry, repeating, counting and ordering /arranging symptoms (Factor 2); contamination obsessions and cleaning compulsions (Factor 3); and hoarding symptoms (Factor 4). RESULTS: Among the siblings evaluated 52% were male, and the mean age at the time of interview was 29.65 ± 11.49 years. The mean age at onset of OCS was 11.83 ± 7.56 years. Age at onset of OCS correlated positively and significantly between the two members of each sibling pair (p=0.005). Fourteen patients (35%) were diagnosed with TDs. There was no concordance of the TD presence within the sibling pairs. When siblings were male, there was a significant sibling correlation in the contamination obsessions/cleaning compulsions dimension (ICC=0.74; p=0.002). Similarly, when both siblings were female, they were comparable in the hoarding obsessions/compulsions dimension (ICC=0.76; p=0.01). No other significant correlations were found. CONCLUSION: Familial factors seem to contribute to specific OCD phenotypic components such as age at onset of OCS and specific dimensions. The obvious influence of gender is as yet unexplained.

ASSUNTO(S)

obsessive-compulside disorder fenótipo transtoro obsessive-compulsivo relações fraternas sibling relations phenotype

ACESSO AO ARTIGO

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