title: Comorbidity in obsessive-compulsive disorder (OCD): a report from the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS).
abstract: BACKGROUND
  Obsessive-compulsive disorder (OCD) is often associated with significant psychiatric comorbidity. Comorbid disorders include mood and anxiety disorders as well as obsessive-compulsive spectrum disorders (OCSDs). This paper aims to investigate comorbidity of DSM Axis I-disorders, including OCSDs, in patients with OCD from 10 centers affiliated with the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS).
  
  
  METHODS
  This is a cross-sectional study of comorbidity of Axis I disorders including OCSDs in 457 outpatients with primary OCD (37% male; 63% female), with ages ranging from 12 to 88years (mean: 39.8±13). Treating clinicians assessed Axis I disorders using the Mini International Neuropsychiatric Interview and assessed OCSDs using the Structured Clinical Interview for OCD related/spectrum disorders (SCID-OCSD).
  
  
  RESULTS
  In terms of the OCSDs, highest comorbidity rates were found for tic disorder (12.5%), BDD (8.71%) and self-injurious behavior (7.43%). In terms of the other Axis I-disorders, major depressive disorder (MDD; 15%), social anxiety disorder (SAD; 14%), generalized anxiety disorder (GAD; 13%) and dysthymic disorder (13%) were most prevalent.
  
  
  CONCLUSIONS
  High comorbidity of some OCSDs in OCD supports the formal recognition of these conditions in a separate chapter of the nosology. Rates of other Axis I disorders are high in both the general population and in OCSDs, indicating that these may often also need to be the focus of intervention in OCD.
authors.affiliation: MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, University of Stellenbosch, South Africa. Electronic address: cl2@sun.ac.za.
authors.forename: Christine
authors.initials: C
authors.lastname: Lochner
authors.affiliation: Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom; Department of Psychiatry (NAF), Queen Elizabeth II Hospital, Welwyn Garden City, Hertfordshire, United Kingdom; Postgraduate Medical School (NAF), University of Hertfordshire, Hatfield, United Kingdom.
authors.forename: Naomi A
authors.initials: NA
authors.lastname: Fineberg
authors.affiliation: Department of Psychiatry, Chaim Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Joseph
authors.initials: J
authors.lastname: Zohar
authors.affiliation: Department of Psychiatry and Behavioural Neurosciences, McMaster University, Ontario, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: van Ameringen
authors.affiliation: Department of Psychiatry, Chaim Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Alzbeta
authors.initials: A
authors.lastname: Juven-Wetzler
authors.affiliation: Department of Psychiatry, University of Milan, Fondazione IRCCS Policlinico, Milan, Italy.
authors.forename: Alfredo Carlo
authors.initials: AC
authors.lastname: Altamura
authors.affiliation: Department of Psychiatry and Mental Health, University of Cape Town, South Africa.
authors.forename: Natalie L
authors.initials: NL
authors.lastname: Cuzen
authors.affiliation: Department of Psychiatry, Montefiore Medical Center University Hospital, Albert Einstein College of Medicine, New York, NY, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Hollander
authors.affiliation: Department of Psychiatry, Academic Medical Center, University of Amsterdam, the Netherlands; The Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands.
authors.forename: Damiaan
authors.initials: D
authors.lastname: Denys
authors.affiliation: Center for Genomic Sciences, Universidad Autónoma de la Ciudad de México and Carracci Medical Group, Mexico City, Mexico.
authors.forename: Humberto
authors.initials: H
authors.lastname: Nicolini
authors.affiliation: Department of Psychiatry, University of Milan, Fondazione IRCCS Policlinico, Milan, Italy.
authors.forename: Bernardo
authors.initials: B
authors.lastname: Dell'Osso
authors.affiliation: Department of Psychiatry, University of Florence, Florence, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Pallanti
authors.affiliation: MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, University of Stellenbosch, South Africa; Department of Psychiatry and Mental Health, University of Cape Town, South Africa.
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D055815:Young Adult