title: Comorbidity variation in patients with obsessive-compulsive disorder according to symptom dimensions: Results from a large multicentre clinical sample.
abstract: BACKGROUND
  Obsessive-compulsive disorder (OCD) has a heterogeneous and complex phenomenological picture, characterized by different symptom dimensions and comorbid psychiatric disorders, which frequently co-occur or are replaced by others over the illness course. To date, very few studies have investigated the associations between specific OCD symptom dimensions and comorbid disorders.
  
  
  METHODS
  Cross-sectional, multicenter clinical study with 1001 well-characterized OCD patients recruited within the Brazilian Research Consortium on Obsessive-Compulsive and Related Disorders. The primary instruments were the Dimensional Yale-Brown Obsessive Compulsive Scale (DY-BOCS) and the Structured Clinical Interview for DSM-IV Axis I Disorders. Bivariate analyses between symptom dimensions and comorbidities were followed by logistic regression.
  
  
  RESULTS
  The most common comorbidities among participants (56.8% females) were major depression (56.4%), social phobia (34.6%), generalized anxiety disorder (34.3%), and specific phobia (31.4%). The aggressive dimension was independently associated with posttraumatic stress disorder (PTSD), separation anxiety disorder, any impulse-control disorder and skin picking; the sexual-religious dimension was associated with mood disorders, panic disorder/agoraphobia, social phobia, separation anxiety disorder, non-paraphilic sexual disorder, any somatoform disorder, body dysmorphic disorder and tic disorders; the contamination-cleaning dimension was related to hypochondriasis; and the hoarding dimension was associated with depressive disorders, specific phobia, PTSD, impulse control disorders (compulsive buying, skin picking, internet use), ADHD and tic disorders. The symmetry-ordering dimension was not independently associated with any comorbidity.
  
  
  CONCLUSIONS
  Cross-sectional design; participants from only tertiary mental health services; personality disorders not investigated.
  
  
  CONCLUSIONS
  Different OCD dimensions presented some specific associations with comorbid disorders, which may influence treatment seeking behaviors and response, and be suggestive of different underlying pathogenic mechanisms.
authors.affiliation: Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, Univ Estadual Paulista, Brazil. Electronic address: torresar@fmb.unesp.br.
authors.forename: Albina R
authors.initials: AR
authors.lastname: Torres
authors.affiliation: Anxiety and Depression Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro & D'Or Institute for Research and Education, Brazil.
authors.forename: Leonardo F
authors.initials: LF
authors.lastname: Fontenelle
authors.affiliation: Department of Psychiatry, University of São Paulo Medical School, Brazil.
authors.forename: Roseli G
authors.initials: RG
authors.lastname: Shavitt
authors.affiliation: Department of Psychiatry, Health Sciences Federal University of Porto Alegre, Brazil.
authors.forename: Ygor A
authors.initials: YA
authors.lastname: Ferrão
authors.affiliation: Child and Adolescent Psychiatry Unit (UPIA) at the Department of Psychiatry, Federal University of São Paulo, Brazil.
authors.forename: Maria Conceição
authors.initials: MC
authors.lastname: do Rosário
authors.affiliation: Department of Pediatrics and Department of Health Policy and Management, University of South Florida, Rogers Behavioral Health - Tampa Bay, All Children's Hospital - Johns Hopkins Medicine, USA.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Storch
authors.affiliation: Department of Psychiatry, University of São Paulo Medical School, Brazil.
authors.forename: Euripedes C
authors.initials: EC
authors.lastname: Miguel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; 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
keywords: Comorbid disorders; Comorbidity; Obsessive–compulsive disorder; Symptom dimensions