Systematic review of co-occurring OCD and TD: Evidence for a tic-related OCD subtype?

Kloft, Lisa; Steinel, Theresa; Kathmann, Norbert

doi:10.1016/j.neubiorev.2018.09.021

Cited by 36 publications

(22 citation statements)

References 208 publications

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“…This register-based study confirmed the clinical observations of many previous specialist clinic-based studies [20] in a population-based cohort. Indeed, compared with individuals with OCD and no history of tics, individuals with ticrelated OCD had earlier age at first OCD diagnosis [20,21], were more likely males [5,[22][23][24], had a higher number of comorbidities [27], and, in particular, higher rates of ADHD and ASD [25], but also epilepsy and intellectual disability. Conversely, compared with individuals with tic-related OCD, individuals with non-tic-related OCD had higher rates of comorbid anxiety disorders, mood disorders, and bipolar disorder, also in line with previous work [25,44].…”

Section: Discussionsupporting

confidence: 88%

“…These patients present with typical clinical characteristics: earlier age of OCD onset [9,20,21], greater proportion of males [5,9,[22][23][24], higher rates of symmetry and sexual/ aggressive obsessions [9,24,25], and sensory phenomena preceding the compulsions [22,26]. Albeit less consistently, studies have also reported a greater number of psychiatric comorbidities [27] and higher rates of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASD) [25] in this patient group.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, early age of OCD onset has not sufficiently been taken into account in previous studies. Since early onset OCD has been associated with increased familiality compared with late onset OCD [4,5], and tic-related OCD has, in turn, been associated with early onset [20,21], it is important to take this variable into account. It is also possible that the higher familiality of tic-related OCD simply reflects the fact that tic disorders themselves are highly heritable [35,36].…”

Section: Introductionmentioning

confidence: 99%

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A population-based family clustering study of tic-related obsessive-compulsive disorder

et al. 2019

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In the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), obsessive-compulsive disorder (OCD) included a new "tic-related" specifier. However, strong evidence supporting tic-related OCD as a distinct subtype of OCD is lacking. This study investigated whether, at the population level, tic-related OCD has a stronger familial load than non-ticrelated OCD. From a cohort of individuals born in Sweden between 1967 and 2007 (n = 4,085,367; 1257 with tic-related OCD and 20,975 with non-tic-related OCD), we identified all twins, full siblings, maternal and paternal half siblings, and cousins. Sexand birth year-adjusted hazard ratios (aHR) were calculated to estimate the risk of OCD in relatives of individuals with OCD with and without comorbid tics, compared with relatives of unaffected individuals. We found that OCD is a familial disorder, regardless of comorbid tic disorder status. However, the risk of OCD in relatives of individuals with tic-related OCD was considerably greater than the risk of OCD in relatives of individuals with non-tic-related OCD (e.g., risk for full siblings: aHR = 10.63 [95% CI, 7.92-14.27] and aHR = 4.52 [95% CI, 4.06-5.02], respectively; p value for the difference < 0.0001). These differences remained when the groups were matched by age at first OCD diagnosis and after various sensitivity analyses. The observed familial patterns of OCD in relation to tics were not seen in relation to other neuropsychiatric comorbidities. Tic-related OCD is a particularly familial subtype of OCD. The results have important implications for ongoing gene-searching efforts.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A population-based family clustering study of tic-related obsessive-compulsive disorder

et al. 2019

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“…One potential approach to alternative treatments includes looking at psychological disorders by taking into account the shared pathophysiology and comorbidity with OCD, such as in the case with tic disorders [ 8 ]. Studies about the comorbidity of OCD and tic disorders have revealed lifetime prevalence rates ranging from 14 to 61.5% of all patients, while studies focused on the prevalence of comorbidity in pediatric patients have shown rates ranging from 37.6 to 42.5% of patients [ 9 ]. Moreover, preliminary evidence shows that co-occurring OCD and tic disorders show stronger alterations with respect to dopaminergic and serotoninergic systems than do patients with mutually exclusive OCD or tic disorders when compared with healthy individuals [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

The Use of Clonidine in the Treatment of Debilitating Obsessive-Compulsive Behaviors Comorbid With Depression and Post-Traumatic Stress Disorder: A Case Report

Sarangi¹,

Payberah²,

McMahon³

2021

Cureus

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Clonidine is an alpha-2 agonist traditionally used as an antihypertensive, and more recently in the treatment of psychiatric disorders such as attention-deficit hyperactive disorder (ADHD), tic disorders such as Tourette’s syndrome, and post-traumatic stress disorder (PTSD). However, there are scarce data in the literature about the use of clonidine in the treatment of obsessive-compulsive disorder (OCD). In this report, we present the case of a 16-year-old female suffering from OCD. The first-line treatment with sertraline was not very efficacious in improving her symptoms and even led to worsening of the same. However, subsequent treatment with clonidine resulted in rapid and significant improvement in her condition. We postulate that further research is required to gain more insight into the therapeutic potential of clonidine in OCD patients.

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“…There might be cognitive differences between clinical subgroups of OCD (i.e; obsessing/checking (O/C) v. symmetry/ordering (S/O); autogenous v. reactive) (Abramovitch & Cooperman, 2015; Bragdon, Gibb, & Coles, 2018; Fan et al, 2016; Lee, Yost, & Telch, 2009) and none of the studies included in this review explored the effect of symptoms dimensions in the probands of the OCDrel. Neurobiological subtypes including ‘neurodevelopmental’ and ‘Tic-related OCD’ subtypes might potentially be associated with distinctive cognitive deficits (Blanes & McGuire, 1997; Castle & Phillips, 2006; Kloft, Steinel, & Kathmann, 2018; Leckman, Bloch, & King, 2009; Saxena, Brody, Schwartz, & Baxter, 1998). Unfortunately, the studies included in this meta-analysis did not include relevant data to investigate the relationship between cognitive functioning and neurobiological subtypes of OCD in the patient sample or in probands of OCDrel sample.…”

Section: Discussionmentioning

confidence: 99%

Meta-analysis of neurocognitive deficits in unaffected relatives of obsessive-compulsive disorder (OCD): comparison with healthy controls and patients with OCD

Bora

2020

Psychol. Med.

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BackgroundObsessive-compulsive disorder (OCD) has been associated with cognitive deficits, particularly with executive functions. These findings support fronto-striatal dysfunction in OCD. However, it is not certain whether these findings are trait features of OCD. In recent years, a number of studies have investigated cognitive functions in unaffected relatives of OCD (OCDrel) but the findings of these studies are contradictory.MethodsA systematic review in Pubmed and Scopus databases was performed until 18 March 2019, to locate the studies comparing cognitive functions of OCDrel with healthy controls and OCD patients (OCDpt). A random-effects meta-analysis was conducted.ResultsCurrent meta-analysis included 16 studies including 527 OCDrel, 445 OCDpt and 639 healthy controls. Healthy controls overperformed OCDpt in all cognitive domains (d = 0.36–0.86). OCDrel underperformed healthy controls in inhibition (d = 0.58, CI = 0.29–0.86), planning (d = 0.45, CI = 0.28–0.63), decision-making (d = 0.58, CI = 0.19–0.98). OCDrel also had small-sized deficits in set-shifting (d = 0.37, CI = 0.04–0.69) and visual memory (d = 0.28, CI = 0.08–0.49). OCDpt underperformed OCDrel in visual memory (d = 0.45, CI = 0.22–0.67) and set-shifting (d = 0.23, CI = 0.04–0.42).ConclusionsCurrent findings suggest that abnormalities in inhibition, planning/problem solving and reward-based decision-making are shared features of OCDrel and OCDpt and might be trait markers related to vulnerability for developing OCD. Visual memory and set-shifting deficits might potentially be biomarkers of incipient illness or subthreshold OCD presentation among OCDrel. Further exploration of cognitive heterogeneity in OCDrel and investigating the effects of the subtypes of OCD in probands on cognitive impairment in OCDrel are needed.

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Systematic review of co-occurring OCD and TD: Evidence for a tic-related OCD subtype?

Cited by 36 publications

References 208 publications

A population-based family clustering study of tic-related obsessive-compulsive disorder

A population-based family clustering study of tic-related obsessive-compulsive disorder

The Use of Clonidine in the Treatment of Debilitating Obsessive-Compulsive Behaviors Comorbid With Depression and Post-Traumatic Stress Disorder: A Case Report

Meta-analysis of neurocognitive deficits in unaffected relatives of obsessive-compulsive disorder (OCD): comparison with healthy controls and patients with OCD

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