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Uncomplicated and Comorbid Obsessive-Compulsive Disorder in an Epidemiologic Sample

Published online by Cambridge University Press:  07 November 2014

Abstract

This study investigates lifetime prevalence rates, demographic characteristics, childhood conduct disorder and adult antisocial features, suicide attempts, and cognitive impairment in individuals with obsessive-compulsive disorder (OCD) uncomplicated by or comorbid with any other psychiatric disorder. The data are from the NIMH Epidemiological Catchment Area (ECA) study, and the current analyses compared subjects with uncomplicated OCD (no history of any other lifetime psychiatric disorder) comorbid OCD (with any other lifetime disorder), other lifetime psychiatric disorders, and no lifetime psychiatric disorders across these variables. OCD in its uncomplicated and comorbid form had significantly higher rates of childhood conduct symptoms, adult antisocial personality disorder problems, and of suicide attempts than did no or other disorders. Comorbid OCD subjects had higher rates of mild cognitive impairment on the Mini-Mental Status Exam than did subjects with other disorders. These findings suggest that a subgroup of OCD patients may have impulsive features, including childhood conduct disorder symptoms and an increased rate of suicide attempts; wider clinical attention to these outcomes is needed.

Type
Supplement Monograph
Copyright
Copyright © Cambridge University Press 1998

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References

REFERENCES

1.Karno, M, Golding, JM, Sorensson, SB, Burnam, MA. The epidemiology of obsessive-compulsive disorder in five US communities. Arch Gen Psychiatr. 1988;45:10941099.CrossRefGoogle ScholarPubMed
2.Weissman, MM, Bland, R, Canino, G, et al.The cross national epidemiology of obsessive-compulsive disorder. J Clin Psychiatr. 1994;55(Suppl. 3):510.Google ScholarPubMed
3.Rasmussen, SA, Eisen, JL. Epidemiology and clinical features of obsessive-compulsive disorder. In: Jenike, MA, Baer, L, Minichiello, WE, eds. Obsessive-Compulsive Disorders: Theory and Management. Chicago: Year Book Medical Publishers; 1990:1027.Google Scholar
4.Marks, IM. Fears, Phobias and Rituals: Panic Anxiety and Their Disorders. New York: Oxford University Press; 1978.Google Scholar
5.Flament, MF, Whitaker, A, Rapoport, JL, et al.Obsessive compulsive disorder in adolescence: an epidemiological study. J Am Acad Child Adolesc Psychiatr. 1988;27:764771.CrossRefGoogle ScholarPubMed
6.Valleni-Basile, LA, Garrison, CZ, et al.Frequency of obsessive-compulsive disorder in a community sample of young adults. J Am Acad Child Adolesc Psychiatry. 1994;33:782791.Google Scholar
7.Swedo, SE, Rapoport, JL, Leonard, H, Lenane, M, Cheslow, D. Obsessive-compulsive disorder in children and adolescents. Arch Gen Psychiatr. 1989;46:335341.Google Scholar
8.Hollander, E, ed. Obsessive-Compulsive Related Disorders. Washington, DC: American Psychiatric Press; 1993.Google Scholar
9.Bolton, D, Turner, T. Obsessive-compulsive neurosis with conduct disorder in adolescence: a report of two cases. J Child Psychol Psychiatr. 1984;25:133139.CrossRefGoogle ScholarPubMed
10.Robins, LN, Price, RK. Adult disorders predicted by childhood conduct problems: results from the NIMH Epidemiologic Catchment Area Project. Psychiatry. 1991;54:116132.Google Scholar
11.Hymas, N, Lees, A, Bolton, D, Epps, K, Head, D. The neurology of obsessional slowness. Brain. 1991;114:22032233.CrossRefGoogle ScholarPubMed
12.Hollander, E, Schiffman, E, Cohen, B, et al.Signs of central nervous system dysfunction in obsessive-compulsive disorder. Arch Gen Psychiatr. 1990;47:2732.CrossRefGoogle ScholarPubMed
13.WW, Eaton, LG, Kessler. Epidemiological Field Methods in Psychiatry: The NIMH Epidemiologic Catchment Area Program. Orlando, FL: Academic Press; 1985.Google Scholar
14.Robins, LN, Regier, DA, eds. Psychiatric Disorders in America: The Epidemiologic Catchment Area Study. New York: Free Press; 1991.Google Scholar
15.Robins, LN, Helzer, JE, Croughan, J, Ratcliff, KS. National Institute of Mental Health Diagnostic Interview Schedule: its history, characteristics, and validity. Arch Gen Psychiatr. 1981;98:381389.CrossRefGoogle Scholar
16.Karno, M, Golding, JM. Obsessive compulsive disorder. In: Robins, LN, Regier, DA, eds. Psychiatric Disorders in America: The Epidemiologic Catchment Area Study. New York: Free Press; 1991:204219.Google Scholar
17.Helzer, JE, Robins, LN, McEvoy, LT, et al.A comparison of clinical and diagnostic interview schedule diagnoses. Arch Gen Psychiatr. 1985;42:657666.CrossRefGoogle ScholarPubMed
18.Wittchen, HU, Semler, G, von Zerssen, D. A comparison of two diagnostic methods. Arch Gen Psychiatr. 1985;42:677684.CrossRefGoogle ScholarPubMed
19.Burnam, MA, Karno, M, Hough, RL, Escobar, JK. The Spanish Diagnostic Interview Schedule: reliability and comparison with clinical diagnoses. Arch Gen Psychiatr. 1983;40:11891196.Google Scholar
20.American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders. 3rd ed. Washington, DC: American Psychiatric Association; 1980.Google Scholar
21.Robins, LN, Tipp, J, Przybeck, T. Antisocial personality. In: Robins, LN, Regier, DA, eds. Psychiatric Disorders in America: The Epidemiologic Catchment Area Study. New York: Free Press; 1991:258290.Google Scholar
22.Folstein, MF, Folstein, SE, McHugh, PR. Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189198.Google Scholar
23.George, LK, Landerman, R, Blazer, DG, Anthony, JC. Cognitive impairment. In: Robins, LN, Regier, DA, eds. Psychiatric Disorders in America: The Epidemiologic Catchment Area Study. New York: Free Press; 1991:291327.Google Scholar
24.Kleinbaum, DG, Kupper, LL, Morgenstern, H. Epidemiologie Research: Principles and Quantitative Methods. Belmont, CA: Wadsworth; 1982.Google Scholar
25.Crum, RM, Anthony, JC, Basset, SS, Folstein, MF. Population-based norms for the Mini-Mental State Examination by age and educational level. JAMA. 1993;269:23862391.CrossRefGoogle ScholarPubMed
26.Mantel, N, Haenszel, W. Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst. 1959;22:719748.Google Scholar
27.Stein, DJ, Hollander, E. The spectrum of obsessive-compulsive related disorder. In: Hollander, E, ed. Obsessive-Compulsive Related Disorders. Washington, DC: American Psychiatric Press; 1993:241271.Google Scholar
28.Hoehn-Saric, R, Barksdale, VC. Impulsiveness in obsessive-compulsive patients. Br J Psychiatr. 1983;143:177182.Google Scholar
29.Pauls, DL, Leckman, JF. The inheritance of Gilles de la Tourette's syndrome and associated behaviors: evidence for autosomal dominant transmissions. N Engl J Med. 1986;315:993997.CrossRefGoogle Scholar
30.Rasmussen, SA, Tsuang, MT. Clinical characteristics and family history in DSM-III obsessive-compulsive disorder. Am J Psychiatr. 1986;143:317322.Google ScholarPubMed
31.Leonard, HL, Swedo, SE, Lenane, MC, et al.A 2- to 7-year follow-up study of 54 obsessive-compulsive children and adolescents. Arch Gen Psychiatr. 1993;50:429439.Google Scholar
32.Riddle, MA, Scahill, L, King, RA, et al.Obsessive compulsive disorder in children and adolescents: phenomenology and family history. J Am Acad Child Adolesc Psychiatr. 1990;29:766772.CrossRefGoogle ScholarPubMed
33.Primeau, F, Fontaine, R. Obsessive disorder with self-mutilation. Can J Psychiatr. 1987;32:699701.CrossRefGoogle ScholarPubMed
34.Nichols, PL, Chen, TC. Minimal Brain Dysfunction: A Prospective Study. Hillsdale, NJ: Erlbaum; 1981.Google Scholar
35.Quitkin, F, Rifkin, A, Klein, DF. Neurological soft-signs in schizophrenia and character disorders. Arch Gen Psychiatr. 1976;33:845853.CrossRefGoogle ScholarPubMed
36.Hollander, E, DeCaria, CM, Aronowitz, B, Klein, DF, Leibowitz, MR, Shaffer, D. A pilot follow-up study of childhood soft-signs and the development of adult psychopathology. J Neuropsychiatr Clin Neurosci. 1991;3:186189.Google Scholar