title: Predictive value of familiality, stressful life events and gender on the course of obsessive-compulsive disorder.
abstract: BACKGROUND
  Familiality, stressful life events (SLE) and gender significantly affect the onset of obsessive-compulsive disorder (OCD). However, their combined impact on the probability of OCD chronicity is largely unknown. With the objective of clarifying their predictive value, we tested a model of interaction effects between these influences.
  
  
  METHODS
  A sample of 449 patients with OCD was systematically assessed for familial loading, exposure to stressful life events, gender and course of the disease at the OCD referral unit at Bellvitge University Hospital. Multiple ordinal logistic regression was used to test interaction models.
  
  
  RESULTS
  Familiality presented a main negative association with chronicity (OR=0.83, CI97.5%=0.70-0.98). This association was additively moderated by both exposure to SLE before onset and gender, and showed a positive slope among female patients not exposed to SLE before onset (Familiality*SLEbo: OR=0.69, CI97.5%=0.47-1; Familiality*gender: OR=1.30, CI97.5%=0.91-1.84).
  
  
  CONCLUSIONS
  The findings are based on cross-sectional data. Assessment of course is based on a retrospective measure, which may imply the possibility of overestimation of chronicity.
  
  
  CONCLUSIONS
  The predictive value of familiality on the course of OCD is only partially informative as both SLEbo and gender modify the association. When other risk factors are included in the model, familiality may predict decreased chances of chronicity. The mediation effects identified could explain the discrepancies found in previous research on this topic. Increased chances of presenting a chronic course of OCD may be found in association with familial vulnerability among female patients not exposed to SLEbo.
authors.affiliation: Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Mental Health CIBER (CIBERSAM), Carlos III Health Institute, Spain. Electronic address: xgoldberg@idibell.cat.
authors.forename: Ximena
authors.initials: X
authors.lastname: Goldberg
authors.affiliation: Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Mental Health CIBER (CIBERSAM), Carlos III Health Institute, Spain; Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Spain. Electronic address: csoriano@idibell.cat.
authors.forename: Carles
authors.initials: C
authors.lastname: Soriano-Mas
authors.affiliation: Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Mental Health CIBER (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain.
authors.forename: Pino
authors.initials: P
authors.lastname: Alonso
authors.affiliation: Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Mental Health CIBER (CIBERSAM), Carlos III Health Institute, Spain.
authors.forename: Cinto
authors.initials: C
authors.lastname: Segalàs
authors.affiliation: Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Mental Health CIBER (CIBERSAM), Carlos III Health Institute, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Real
authors.affiliation: Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Mental Health CIBER (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain.
authors.forename: Clara
authors.initials: C
authors.lastname: López-Solà
authors.affiliation: Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Mental Health CIBER (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Subirà
authors.affiliation: Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Via
authors.affiliation: Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain; Physiopathology, Obesity and Nutrition CIBER (CIBERobn), Carlos III Health Institute, Barcelona, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Jiménez-Murcia
authors.affiliation: Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Mental Health CIBER (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Menchón
authors.affiliation: Department of Psychiatry, Bellvitge University Hospital - Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Mental Health CIBER (CIBERSAM), Carlos III Health Institute, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Spain.
authors.forename: Narcís
authors.initials: N
authors.lastname: Cardoner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015897:Comorbidity; D005190:Family / Q000523:psychology; D005260:Female; D020022:Genetic Predisposition to Disease / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000453:epidemiology* / Q000235:genetics* / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013315:Stress, Psychological / Q000453:epidemiology* / Q000235:genetics* / Q000523:psychology; D055815:Young Adult
keywords: Course; Interaction; Obsessive-compulsive disorder; Prognosis; Risk factors