Matti Cervin1, Euripedes C Miguel2, Ayşegül Selcen Güler3, Ygor A Ferrão4, Ayşe Burcu Erdoğdu5, Luisa Lazaro6, Sebla Gökçe7, Daniel A Geller8, Yasemin Yulaf9, Şaziye Senem Başgül10, Özlem Özcan11, Koray Karabekiroğlu12, Leonardo F Fontenelle13,14, Yankı Yazgan15,16, Eric A Storch17, James F Leckman18, Maria Conceição do Rosário19, David Mataix-Cols20,21. 1. Department of Clinical Sciences Lund, Lund University, Lund, Sweden. 2. Department of Psychiatry, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil. 3. Department of Psychology, Beykent University, Istanbul, Turkey. 4. Department of Clinical Medicine (Neurosciences), Porto Alegre Health Sciences Federal University, Porto Alegre, Brazil. 5. Department of Child and Adolescent Psychiatry, Marmara University, Istanbul, Turkey. 6. Department of Child and Adolescent Psychiatry and Psychology, Hospital Clínic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Spain. 7. Department of Child and Adolescent Psychiatry, Maltepe University, Istanbul, Turkey. 8. Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA. 9. Department of Psychology, Gelişim University, Istanbul, Turkey. 10. Department of Psychology, Hasan Kalyoncu University, Gaziantep, Turkey. 11. Department of Child and Adolescent Psychiatry, İnönü University, Malatya, Turkey. 12. Department of Child and Adolescent Psychiatry, Ondokuz Mayıs University, Samsun, Turkey. 13. Turner Institute for Brain and Mental Health, Monash University, Victoria, Australia. 14. D'Or Institute for Research and Education (IDOR) and Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. 15. Güzel Günler Clinic, Istanbul, Turkey. 16. Yale Child Study Center, New Haven, CT, USA. 17. Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA. 18. Departments of Psychiatry, Pediatrics & Psychology, Child Study Center, Yale University, New Haven, CT, USA. 19. Department of Psychiatry, Federal University of São Paulo (UNIFESP), Brazil. 20. Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden. 21. Health Care Services, Region Stockholm, Stockholm, Sweden.
Abstract
BACKGROUND: The symptoms of obsessive-compulsive disorder (OCD) are highly heterogeneous and it is unclear what is the optimal way to conceptualize this heterogeneity. This study aimed to establish a comprehensive symptom structure model of OCD across the lifespan using factor and network analytic techniques. METHODS: A large multinational cohort of well-characterized children, adolescents, and adults diagnosed with OCD (N = 1366) participated in the study. All completed the Dimensional Yale-Brown Obsessive-Compulsive Scale, which contains an expanded checklist of 87 distinct OCD symptoms. Exploratory and confirmatory factor analysis were used to outline empirically supported symptom dimensions, and interconnections among the resulting dimensions were established using network analysis. Associations between dimensions and sociodemographic and clinical variables were explored using structural equation modeling (SEM). RESULTS: Thirteen first-order symptom dimensions emerged that could be parsimoniously reduced to eight broad dimensions, which were valid across the lifespan: Disturbing Thoughts, Incompleteness, Contamination, Hoarding, Transformation, Body Focus, Superstition, and Loss/Separation. A general OCD factor could be included in the final factor model without a significant decline in model fit according to most fit indices. Network analysis showed that Incompleteness and Disturbing Thoughts were most central (i.e. had most unique interconnections with other dimensions). SEM showed that the eight broad dimensions were differentially related to sociodemographic and clinical variables. CONCLUSIONS: Future research will need to establish if this expanded hierarchical and multidimensional model can help improve our understanding of the etiology, neurobiology and treatment of OCD.
BACKGROUND: The symptoms of obsessive-compulsive disorder (OCD) are highly heterogeneous and it is unclear what is the optimal way to conceptualize this heterogeneity. This study aimed to establish a comprehensive symptom structure model of OCD across the lifespan using factor and network analytic techniques. METHODS: A large multinational cohort of well-characterized children, adolescents, and adults diagnosed with OCD (N = 1366) participated in the study. All completed the Dimensional Yale-Brown Obsessive-Compulsive Scale, which contains an expanded checklist of 87 distinct OCD symptoms. Exploratory and confirmatory factor analysis were used to outline empirically supported symptom dimensions, and interconnections among the resulting dimensions were established using network analysis. Associations between dimensions and sociodemographic and clinical variables were explored using structural equation modeling (SEM). RESULTS: Thirteen first-order symptom dimensions emerged that could be parsimoniously reduced to eight broad dimensions, which were valid across the lifespan: Disturbing Thoughts, Incompleteness, Contamination, Hoarding, Transformation, Body Focus, Superstition, and Loss/Separation. A general OCD factor could be included in the final factor model without a significant decline in model fit according to most fit indices. Network analysis showed that Incompleteness and Disturbing Thoughts were most central (i.e. had most unique interconnections with other dimensions). SEM showed that the eight broad dimensions were differentially related to sociodemographic and clinical variables. CONCLUSIONS: Future research will need to establish if this expanded hierarchical and multidimensional model can help improve our understanding of the etiology, neurobiology and treatment of OCD.
Authors: Behrang Mahjani; Lambertus Klei; Manuel Mattheisen; Matthew W Halvorsen; Abraham Reichenberg; Kathryn Roeder; Nancy L Pedersen; Julia Boberg; Elles de Schipper; Cynthia M Bulik; Mikael Landén; Bengt Fundín; David Mataix-Cols; Sven Sandin; Christina M Hultman; James J Crowley; Joseph D Buxbaum; Christian Rück; Bernie Devlin; Dorothy E Grice Journal: Am J Psychiatry Date: 2021-11-18 Impact factor: 18.112
Authors: Matti Cervin; Morgan M McNeel; Sabine Wilhelm; Joseph F McGuire; Tanya K Murphy; Brent J Small; Daniel A Geller; Eric A Storch Journal: Behav Ther Date: 2021-08-20
Authors: Marcelo C Batistuzzo; Leonardo Fontenelle; Ygor A Ferrão; Maria C Rosário; Euripedes C Miguel; Daniel Fatori Journal: Braz J Psychiatry Date: 2022 Jan-Feb Impact factor: 2.697