The relationship between obsessive-compulsive disorder and anxiety and affective disorders: results from the Johns Hopkins OCD Family Study

Objective. This study investigates the relationship of specific anxiety and affective disorders to obsessive-compulsive disorder (OCD) in a blind, con trolled family study. Method. Eighty case and 73 control probands, as well as 343 case and 300 co ntrol first-degree relatives of these probands, participated in the study. Subjects were examined by psychologists or psychiatrists using the Schedule for Affective Disorder and Schizophrenia-Lifetime Anxiety version (SADS-LA ). Two experienced psychiatrists independently reviewed all clinical materi als, and final diagnoses were made according to DSM-IV criteria, by consens us procedure. Results. Except for bipolar disorder, all anxiety and affective disorders i nvestigated were more frequent in case than control probands. Substance dep endence disorders were not more frequent. Generalized anxiety disorder (GAD ), panic disorder, agoraphobia, separation anxiety disorder (SAD) and recur rent major depression were more common in case than control relatives. Thes e disorders occurred more frequently if the relative was diagnosed with OCD . Only GAD and agoraphobia were more frequent in case relatives independent of OCD. Conclusion. GAD and agoraphobia share a common familial aetiology with OCD. The other anxiety and affective disorders, when comorbid with OCD, may eme rge as a consequence of the OCD or as a more complex syndrome.