Comparison of clinical characteristics of familial and sporadic obsessive-compulsive disorder

Background: Obsessive-compulsive disorder (OCD) is a heterogeneous condition with evidence of familiality in a considerable proportion of patients. A classification into familial and sporadic forms has been proposed to explain the heterogeneity. The current study aims to compare the demographic, clinical and comorbidity patterns of patients with and without a family history of OCD in first-degree relatives. Method: 802 consecutive patients who consulted a specialty OCD Clinic at a tertiary care psychiatric hospital in India were evaluated with the Mini-International Neuropsychiatric Interview, the Yale-Brown Obsessive-Compulsive Scale, and the Clinical Global Impression Scale. Family history was assessed by interviewing patients and at least one first-degree relative. Results: Family history of OCD was seen in 152 patients (19%). Family history was associated with juvenile onset (X-2 = 19.472, p < 0.001), obsessions of contamination (X-2 = 6.658, p = 0.01), hoarding (X-2 = 4.062, p = 0.032), need for symmetry (X-2 = 3.95, p = 0.047), washing compulsion (X-2 = 7.923, p = 0.005), ordering compulsions (X-2 = 6.808, p = 0.009), repeating compulsions (X-2 = 4.950, p = 0.026) and compulsions by proxy (X-2 = 7.963, p = 0.005). Family history was also associated with greater severity of OCD (t = -2.31, p = 0.022) and compulsions (t = -3.09, p = 0.002) and longer duration of illness at presentation (t = -2.93, p = 0.004). Conclusion: Our findings suggest that familial OCD may have distinctive clinical features. Studying familial forms of OCD may offer unique insight in to understanding the genetic basis of OCD. (C) 2014 Elsevier Inc. All rights reserved.