Aetiological overlap between obsessive-compulsive related and anxiety disorder symptoms: multivariate twin study.
BACKGROUND
The aetiological boundary between obsessive-compulsive related disorders (OCRDs) including obsessive-compulsive disorder (OCD) and anxiety disorders is unclear and continues to generate debate.


OBJECTIVE
To determine the genetic overlap and the pattern of causal relationships among OCRDs and anxiety disorders.


METHODS
Multivariate twin modelling methods and a new regression analysis to infer causation were used, involving 2495 male and female twins.


RESULTS
The amount of common genetic liability observed for OCD symptoms was higher when considering anxiety disorders and OCRDs in the model v. modelling OCRD symptoms alone. OCD symptoms emerged as risk factors for the presence of generalised anxiety, panic and hoarding symptoms, whereas social phobia appeared as a risk factor for OCD symptoms.


CONCLUSIONS
OCD represents a complex phenotype that includes important shared features with anxiety disorders and OCRDs. The novel patterns of risk identified between OCD and anxiety disorder may help to explain their frequent co-occurrence.
Clara López-Solà, MSc, Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, CIBERSAM (G17), Barcelona and Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Leonardo F. Fontenelle, MD, PhD, Programa de Transtornos Obsessivo-Compulsivos e de Ansiedade, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro and Instituto de Saúde da Comunidade, Universidade Federal Fluminense (UFF), Rio de Janeiro, Brazil; Minh Bui, PhD, John L. Hopper, PhD, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, The University of Melbourne, Australia; Christos Pantelis, MD, PhD, Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Australia; Murat Yücel, PhD, Monash Clinical and Imaging Neuroscience Laboratory, School of Psychology and Psychiatry, Monash University, Australia; José M. Menchón, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, CIBERSAM (G17), Barcelona and Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Pino Alonso, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, CIBERSAM (G17), Barcelona and Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Ben J. Harrison, PhD, Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Australia.
Clara
C
López-Solà
Clara López-Solà, MSc, Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, CIBERSAM (G17), Barcelona and Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Leonardo F. Fontenelle, MD, PhD, Programa de Transtornos Obsessivo-Compulsivos e de Ansiedade, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro and Instituto de Saúde da Comunidade, Universidade Federal Fluminense (UFF), Rio de Janeiro, Brazil; Minh Bui, PhD, John L. Hopper, PhD, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, The University of Melbourne, Australia; Christos Pantelis, MD, PhD, Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Australia; Murat Yücel, PhD, Monash Clinical and Imaging Neuroscience Laboratory, School of Psychology and Psychiatry, Monash University, Australia; José M. Menchón, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, CIBERSAM (G17), Barcelona and Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Pino Alonso, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, CIBERSAM (G17), Barcelona and Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Ben J. Harrison, PhD, Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Australia.
Leonardo F
LF
Fontenelle
Clara López-Solà, MSc, Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, CIBERSAM (G17), Barcelona and Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Leonardo F. Fontenelle, MD, PhD, Programa de Transtornos Obsessivo-Compulsivos e de Ansiedade, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro and Instituto de Saúde da Comunidade, Universidade Federal Fluminense (UFF), Rio de Janeiro, Brazil; Minh Bui, PhD, John L. Hopper, PhD, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, The University of Melbourne, Australia; Christos Pantelis, MD, PhD, Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Australia; Murat Yücel, PhD, Monash Clinical and Imaging Neuroscience Laboratory, School of Psychology and Psychiatry, Monash University, Australia; José M. Menchón, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, CIBERSAM (G17), Barcelona and Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Pino Alonso, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, CIBERSAM (G17), Barcelona and Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Ben J. Harrison, PhD, Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Australia.
Minh
M
Bui
Clara López-Solà, MSc, Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, CIBERSAM (G17), Barcelona and Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Leonardo F. Fontenelle, MD, PhD, Programa de Transtornos Obsessivo-Compulsivos e de Ansiedade, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro and Instituto de Saúde da Comunidade, Universidade Federal Fluminense (UFF), Rio de Janeiro, Brazil; Minh Bui, PhD, John L. Hopper, PhD, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, The University of Melbourne, Australia; Christos Pantelis, MD, PhD, Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Australia; Murat Yücel, PhD, Monash Clinical and Imaging Neuroscience Laboratory, School of Psychology and Psychiatry, Monash University, Australia; José M. Menchón, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, CIBERSAM (G17), Barcelona and Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Pino Alonso, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, CIBERSAM (G17), Barcelona and Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Ben J. Harrison, PhD, Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Australia.
John L
JL
Hopper
Clara López-Solà, MSc, Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, CIBERSAM (G17), Barcelona and Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Leonardo F. Fontenelle, MD, PhD, Programa de Transtornos Obsessivo-Compulsivos e de Ansiedade, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro and Instituto de Saúde da Comunidade, Universidade Federal Fluminense (UFF), Rio de Janeiro, Brazil; Minh Bui, PhD, John L. Hopper, PhD, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, The University of Melbourne, Australia; Christos Pantelis, MD, PhD, Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Australia; Murat Yücel, PhD, Monash Clinical and Imaging Neuroscience Laboratory, School of Psychology and Psychiatry, Monash University, Australia; José M. Menchón, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, CIBERSAM (G17), Barcelona and Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Pino Alonso, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, CIBERSAM (G17), Barcelona and Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Ben J. Harrison, PhD, Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Australia.
Christos
C
Pantelis
Clara López-Solà, MSc, Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, CIBERSAM (G17), Barcelona and Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Leonardo F. Fontenelle, MD, PhD, Programa de Transtornos Obsessivo-Compulsivos e de Ansiedade, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro and Instituto de Saúde da Comunidade, Universidade Federal Fluminense (UFF), Rio de Janeiro, Brazil; Minh Bui, PhD, John L. Hopper, PhD, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, The University of Melbourne, Australia; Christos Pantelis, MD, PhD, Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Australia; Murat Yücel, PhD, Monash Clinical and Imaging Neuroscience Laboratory, School of Psychology and Psychiatry, Monash University, Australia; José M. Menchón, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, CIBERSAM (G17), Barcelona and Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Pino Alonso, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, CIBERSAM (G17), Barcelona and Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Ben J. Harrison, PhD, Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Australia.
Murat
M
Yücel
Clara López-Solà, MSc, Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, CIBERSAM (G17), Barcelona and Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Leonardo F. Fontenelle, MD, PhD, Programa de Transtornos Obsessivo-Compulsivos e de Ansiedade, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro and Instituto de Saúde da Comunidade, Universidade Federal Fluminense (UFF), Rio de Janeiro, Brazil; Minh Bui, PhD, John L. Hopper, PhD, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, The University of Melbourne, Australia; Christos Pantelis, MD, PhD, Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Australia; Murat Yücel, PhD, Monash Clinical and Imaging Neuroscience Laboratory, School of Psychology and Psychiatry, Monash University, Australia; José M. Menchón, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, CIBERSAM (G17), Barcelona and Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Pino Alonso, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, CIBERSAM (G17), Barcelona and Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Ben J. Harrison, PhD, Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Australia.
José M
JM
Menchón
Clara López-Solà, MSc, Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, CIBERSAM (G17), Barcelona and Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Leonardo F. Fontenelle, MD, PhD, Programa de Transtornos Obsessivo-Compulsivos e de Ansiedade, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro and Instituto de Saúde da Comunidade, Universidade Federal Fluminense (UFF), Rio de Janeiro, Brazil; Minh Bui, PhD, John L. Hopper, PhD, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, The University of Melbourne, Australia; Christos Pantelis, MD, PhD, Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Australia; Murat Yücel, PhD, Monash Clinical and Imaging Neuroscience Laboratory, School of Psychology and Psychiatry, Monash University, Australia; José M. Menchón, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, CIBERSAM (G17), Barcelona and Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Pino Alonso, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, CIBERSAM (G17), Barcelona and Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Ben J. Harrison, PhD, Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Australia.
Pino
P
Alonso
Clara López-Solà, MSc, Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, CIBERSAM (G17), Barcelona and Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Leonardo F. Fontenelle, MD, PhD, Programa de Transtornos Obsessivo-Compulsivos e de Ansiedade, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Instituto D'Or de Pesquisa e Ensino (IDOR), Rio de Janeiro and Instituto de Saúde da Comunidade, Universidade Federal Fluminense (UFF), Rio de Janeiro, Brazil; Minh Bui, PhD, John L. Hopper, PhD, Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, The University of Melbourne, Australia; Christos Pantelis, MD, PhD, Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Australia; Murat Yücel, PhD, Monash Clinical and Imaging Neuroscience Laboratory, School of Psychology and Psychiatry, Monash University, Australia; José M. Menchón, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, CIBERSAM (G17), Barcelona and Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Pino Alonso, MD, PhD, Bellvitge Biomedical Research Institute-IDIBELL, Department of Psychiatry, Bellvitge University Hospital, CIBERSAM (G17), Barcelona and Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Spain; Ben J. Harrison, PhD, Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Australia habj@unimelb.edu.au.
Ben J
BJ
Harrison
D000328:Adult; D001007:Anxiety; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000235:genetics*; D001315:Australia / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004200:Diseases in Twins / Q000453:epidemiology* / Q000235:genetics; D005260:Female; D000067836:Hoarding Disorder; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009771:Obsessive-Compulsive Disorder / Q000453:epidemiology* / Q000235:genetics*; D010200:Panic; D010641:Phenotype; D011569:Psychiatric Status Rating Scales; D012042:Registries; D012044:Regression Analysis; D011795:Surveys and Questionnaires