OBSESSIVE-COMPULSIVE DISORDER - FAMILIAL-DEVELOPMENTAL HISTORY, SYMPTOMATOLOGY, COMORBIDITY AND COURSE WITH SPECIAL REFERENCE TO GENDER-RELATED DIFFERENCES

Background. Demographic data, family history, psychopathological featu res, comorbidity and course of obsessive-compulsive disorder (OCD) are investigated and data generated to support the possible existence of two subgroups with gender-related differences of a broader nature. Met hod. Two hundred and sixty-three OCD patients. consecutive admissions to the Institute of Psychiatry, University of Pisa over a period of 5 years, not excluding those with comorbid Axis I and Axis II conditions , were studied. Patients were evaluated with a specifically designed s emistructured OCD interview. Results. We found a significantly greater history of perinatal trauma in men who also had an earlier onset. gre ater likelihood of never having been married and a higher frequency of such symptoms as sexual, exactness and symmetry obsessions and odd ri tuals; by contrast, women suffered a later onset of the disorder. were more likely to be married, had higher rates of associated panic attac ks after the onset of OCD and a higher frequency of aggressive obsessi ons at the onset of their illness, and were less frequently associated with bipolar disorders. Conclusions. Pathophysiological mechanisms in OCD seem to differ by gender. Perinatal trauma might predispose to ea rlier onset in men, whereas in women there is a close association betw een OCD and panic disorder.