Gender differences in obsessive-compulsive symptom dimensions

Abstract

The aim of our study was to assess the role of gender in OCD symptom dimensions with a multivariate analysis while controlling for history of tic disorders and age at onset of OCD. One hundred and eighty-six consecutive outpatients with a DSM-IV diagnosis of OCD were interviewed. Yale-Brown Obsessive-Compulsive Scale (YBOC-S), YBOC-S Symptom Checklist, and Hamilton Depression and Anxiety Scales were administered to all patients. Lifetime history of tic disorders was assessed with the tic inventory section of the Yale Global Tic Severity Scale. Age at onset of OCD was assessed by direct interview. Statistical analysis was carried out through logistic regression to calculate adjusted female:male odds ratios (OR) for each dimension. A relationship was found between gender and two main OCD dimensions: contamination/cleaning (higher in females; female:male OR=2.02, P=0.03) and sexual/religious (lower in females; female:male OR=0.41, P=0.03). We did not find gender differences in the aggressive/checking, symmetry/ordering, or hoarding dimensions. We also found a greater history of tic disorders in those patients with symptoms from the symmetry/ordering, dimension (P<0.01). Both symmetry/ordering and sexual/religious dimensions were associated with an earlier age at onset of OCD (P<0.05). Gender is a variable that plays a role in the expression of OCD, particularly the contamination/cleaning and sexual/religious dimensions. Our results underscore the need to examine the relationship between OCD dimensions and clinical variables such as gender, tics, age at onset and severity of the disorder to improve the identification of OCD subtypes.

Gender differences in obsessive-compulsive disorder: a literature review

“…A study of individuals without any psychiatric disorder suggested that the same cerebral areas contain a large number of sex hormone receptors, with relevant sexual dimorphism, with women presenting larger volumes of these structures. 45 According to Labad et al, 6 this finding could at least partially explain the greater proportion of women with these symptoms. Regarding psychiatric comorbidities in OCD, some of them seem to be more associated with one gender than the other.…”

“…Women are more prone to contamination obsessions, 22 usually associated with cleaning rituals; 6,19,23,24 whereas sexual obsessions are more common among men. 19,22,23,35 Several studies combine rates of sexual and religious symptoms, which are more frequent in males.…”

“…19,22,23,35 Several studies combine rates of sexual and religious symptoms, which are more frequent in males. 6,24,36 Results are inconclusive regarding aggressive obsessions, with studies showing varying predominance between genders. 22,36,37 In male, symmetry obsessions would be more common, 23,24,38 as well as ordering, 36,38 repeating, 19 checking, 23 and hoarding compulsions.…”

“…This strategy may enhance our understanding of the pathophysiology of OCD, including gene-environment interactions. 6 Also, as a considerable proportion of OCD patients is not responsive to first line treatments, 7 the identification of more homogeneous subgroups may lead to more tailored and effective treatments. 8 Until now, some OCD subgroups have been proposed based on age of OCS onset, presence of tics, and history of streptococcal infection.…”

Mitochondria and the central nervous system: searching for a pathophysiological basis of psychiatric disorders

“…Prevalence differences between the genders of OCD patients have been previously reported. [130][131][132] Yamada et al 133 showed that mitochondrial uncoupling protein 2 (UCP-2) regulates neurotransmission and that overexpression of UCP2 prevents dopamine transmission in the CNS. Knockdown of the UCP2 gene increases mitochondrial membrane potential and ROS production in murine endothelial cells.…”