title: Obsessive-compulsive disorder. Familial-developmental history, symptomatology, comorbidity and course with special reference to gender-related differences.
abstract: BACKGROUND
  Demographic data, family history, psychopathological features, comorbidity and course of obsessive-compulsive disorder (OCD) are investigated and data generated to support the possible existence of two subgroups with gender-related differences of a broader nature.
  
  
  METHODS
  Two hundred and sixty-three OCD patients, consecutive admissions to the Institute of Psychiatry, University of Pisa over a period of 5 years, not excluding those with comorbid Axis I and Axis II conditions, were studied. Patients were evaluated with a specifically designed semi-structured OCD interview.
  
  
  RESULTS
  We found a significantly greater history of perinatal trauma in men who also had an earlier onset, greater likelihood of never having been married and a higher frequency of such symptoms as sexual, exactness and symmetry obsessions and odd rituals; by contrast, women suffered a later onset of the disorder, were more likely to be married, had higher rates of associated panic attacks after the onset of OCD and a higher frequency of aggressive obsessions at the onset of their illness, and were less frequently associated with bipolar disorders.
  
  
  CONCLUSIONS
  Pathophysiological mechanisms in OCD seem to differ by gender. Perinatal trauma might predispose to earlier onset in men, whereas in women there is a close association between OCD and panic disorder.
authors.affiliation: Istituto di Psichiatria, Università di Pisa, Italia.
authors.forename: P
authors.initials: P
authors.lastname: Lensi
authors.forename: G B
authors.initials: GB
authors.lastname: Cassano
authors.forename: G
authors.initials: G
authors.lastname: Correddu
authors.forename: S
authors.initials: S
authors.lastname: Ravagli
authors.forename: J L
authors.initials: JL
authors.lastname: Kunovac
authors.forename: H S
authors.initials: HS
authors.lastname: Akiskal
mesh_terms: D000328:Adult; D016241:Child of Impaired Parents / Q000523:psychology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000145:classification / Q000175:diagnosis* / Q000235:genetics / Q000523:psychology; D010553:Personality Development; D012307:Risk Factors; D012737:Sex Factors