title: Comparing two basic subtypes in OCD across three large community samples: a pure compulsive versus a mixed obsessive-compulsive subtype.
abstract: Due to its heterogeneous phenomenology, obsessive-compulsive disorder (OCD) has been subtyped. However, these subtypes are not mutually exclusive. This study presents an alternative subtyping approach by deriving non-overlapping OCD subtypes. A pure compulsive and a mixed obsessive-compulsive subtype (including subjects manifesting obsessions with/without compulsions) were analyzed with respect to a broad pattern of psychosocial risk factors and comorbid syndromes/diagnoses in three representative Swiss community samples: the Zurich Study (n = 591), the ZInEP sample (n = 1500), and the PsyCoLaus sample (n = 3720). A selection of comorbidities was examined in a pooled database. Odds ratios were derived from logistic regressions and, in the analysis of pooled data, multilevel models. The pure compulsive subtype showed a lower age of onset and was characterized by few associations with psychosocial risk factors. The higher social popularity of the pure compulsive subjects and their families was remarkable. Comorbidities within the pure compulsive subtype were mainly restricted to phobias. In contrast, the mixed obsessive-compulsive subtype had a higher prevalence and was associated with various childhood adversities, more familial burden, and numerous comorbid disorders, including disorders characterized by high impulsivity. The current comparison study across three representative community surveys presented two basic, distinct OCD subtypes associated with differing psychosocial impairment. Such highly specific subtypes offer the opportunity to learn about pathophysiological mechanisms specifically involved in OCD.
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 1930, 8021, Zurich, Switzerland. stephanie.rodgers@dgsp.uzh.ch.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Rodgers
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 1930, 8021, Zurich, Switzerland.
authors.forename: Vladeta
authors.initials: V
authors.lastname: Ajdacic-Gross
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 1930, 8021, Zurich, Switzerland.|University of Zurich, Zurich, Switzerland.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Kawohl
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 1930, 8021, Zurich, Switzerland.
authors.forename: Mario
authors.initials: M
authors.lastname: Müller
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 1930, 8021, Zurich, Switzerland.|Collegium Helveticum, University of Zurich and Swiss Federal Institute of Technology, Zurich, Switzerland.|Laboratory of Neuroscience (LIM 27), Institute of Psychiatry, University of Sao Paulo, São Paulo, Brazil.
authors.forename: Wulf
authors.initials: W
authors.lastname: Rössler
authors.affiliation: Department of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Hengartner
authors.affiliation: Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Enrique
authors.initials: E
authors.lastname: Castelao
authors.affiliation: Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Caroline
authors.initials: C
authors.lastname: Vandeleur
authors.affiliation: Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, PO Box 1930, 8021, Zurich, Switzerland.
authors.forename: Jules
authors.initials: J
authors.lastname: Angst
authors.affiliation: Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Preisig
mesh_terms: D015897:Comorbidity; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012111:Residence Characteristics; D013557:Switzerland / Q000453:epidemiology
keywords: Comorbidity; Distinct subtypes; Epidemiology; Obsessive–compulsive disorder
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