title: Gender in obsessive-compulsive disorder: clinical and genetic findings.
abstract: BACKGROUND
  There is increasing recognition that obsessive-compulsive disorder (OCD) is not a homogeneous entity. It has been suggested that gender may contribute to the clinical and biological heterogeneity of OCD.
  
  
  METHODS
  Two hundred and twenty patients (n=220; 107 male, 113 female) with DSM-IV OCD (age: 36.40+/-13.46) underwent structured interviews. A subset of Caucasian subjects (n=178), including subjects from the genetically homogeneous Afrikaner population (n=81), and of matched control subjects (n=161), was genotyped for polymorphisms in genes involved in monoamine function. Clinical and genetic data were statistically analyzed across gender.
  
  
  RESULTS
  Compared with females, males with OCD (1) had an earlier age of onset, and a trend toward having more tics and worse outcome, (2) had somewhat differing patterns of OCD symptomatology and axis I comorbidity, and (3) in the Caucasian group, were more likely to have the high activity T allele of the EcoRV variant of the monoamine oxidase A (MAO-A) gene compared to controls, and (4) in the Afrikaner subgroup, were more frequently homozygous for the C allele at the G861C variant of the 5HT(1D beta) gene than controls. Females with OCD (1) reported more sexual abuse during childhood than males, (2) often noted changes in obsessive-compulsive symptoms in the premenstrual/menstrual period as well as during/shortly after pregnancy, and with menopause, and (3) in the Caucasian subgroup, were more frequently homozygous for the low activity C allele of the EcoRV variant of the MAO-A gene compared to controls, with this allele also more frequent in female patients than controls.
  
  
  CONCLUSIONS
  This study supports the hypothesis that gender contributes to the clinical and biological heterogeneity of OCD. A sexually dimorphic pattern of genetic susceptibility to OCD may be present. Further work is, however, needed to delineate the mechanisms that are responsible for mediating the effects of gender.
authors.affiliation: MRC Unit on Anxiety Disorders, Department of Psychiatry, University of Stellenbosch, P.O. Box 19063, Tygerberg 7505, Cape Town, South Africa. cla@sun.ac.za
authors.forename: Christine
authors.initials: C
authors.lastname: Lochner
authors.forename: Sian M J
authors.initials: SM
authors.lastname: Hemmings
authors.forename: Craig J
authors.initials: CJ
authors.lastname: Kinnear
authors.forename: Johanna C
authors.initials: JC
authors.lastname: Moolman-Smook
authors.forename: Valerie A
authors.initials: VA
authors.lastname: Corfield
authors.forename: James A
authors.initials: JA
authors.lastname: Knowles
authors.forename: Dana J H
authors.initials: DJ
authors.lastname: Niehaus
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D016022:Case-Control Studies; D015897:Comorbidity; D003545:Cysteine / Q000235:genetics; D005260:Female; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D014644:Genetic Variation; D005838:Genotype; D005998:Glycine / Q000235:genetics; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D008995:Monoamine Oxidase / Q000235:genetics*; D009771:Obsessive-Compulsive Disorder / Q000235:genetics* / Q000503:physiopathology*; D011110:Polymorphism, Genetic; D011247:Pregnancy; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D044346:Receptor, Serotonin, 5-HT1D / Q000235:genetics; D012701:Serotonin / Q000235:genetics; D012727:Sex Characteristics; D013019:South Africa / Q000453:epidemiology
chemical_list: D044346:Receptor, Serotonin, 5-HT1D; D012701:Serotonin; D008995:Monoamine Oxidase; D003545:Cysteine; D005998:Glycine