Immune-Related Comorbidities in Childhood-Onset Obsessive Compulsive Disorder: Lifetime Prevalence in the Obsessive Compulsive Disorder Collaborative Genetics Association Study.
paper
Cited
Public
- Authors
- Westwell-Roper, Clara; Williams, Kyle A; Samuels, Jack; Bienvenu, O Joseph; Cullen, Bernadette; Goes, Fernando S; Grados, Marco A; Geller, Daniel; Greenberg, Benjamin D; Knowles, James A; Krasnow, Janice; McLaughlin, Nicole C; Nestadt, Paul; Shugart, Yin-Yao; Nestadt, Gerald; Stewart, S Evelyn
- Year
- 2019
- Journal
- Journal of child and adolescent psychopharmacology
- PMID
- 31170001
- DOI
- 10.1089/cap.2018.0140
- PMCID
- PMC6786333
To evaluate the lifetime prevalence of infectious, inflammatory, and autoimmune disorders in a multisite study of probands with childhood-onset obsessive compulsive disorder (OCD) and their first-degree relatives. Medical questionnaires were completed by 1401 probands and 1045 first-degree relatives in the OCD Collaborative Genetics Association Study. Lifetime prevalence of immune-related diseases was compared with the highest available population estimate and reported as a point estimate with 95% adjusted Wald interval. Worst-episode OCD severity and symptom dimensions were assessed with the Yale-Brown Obsessive Compulsive Scale (YBOCS) and Symptom Checklist (YBOCS-CL). Probands reported higher-than-expected prevalence of scarlet fever (4.0 [3.1-5.2]% vs. 1.0%-2.0%, = 1.491, < 0.001, = 1389), encephalitis or meningitis (1.4 [0.9-2.1]% vs. 0.1%-0.4%, = 5.913, < 0.001, = 1393), rheumatoid arthritis (1.1 [0.6-2.0]% vs. 0.2%-0.4%, = 3.416, < 0.001, = 949) and rheumatic fever (0.6 [0.3-1.2]% vs. 0.1%-0.2%, = 3.338, < 0.001, = 1390), but not systemic lupus erythematosus, diabetes, asthma, multiple sclerosis, psoriasis, or inflammatory bowel disease. First-degree relatives reported similarly elevated rates of scarlet fever, rheumatic fever, and encephalitis or meningitis independent of OCD status. There was no association between worst-episode severity and immune-related comorbidities, although probands reporting frequent ear or throat infections had increased severity of cleaning-/contamination-related symptoms (mean factor score 2.5 ± 0.9 vs. 2.3 ± 1.0, = 3.183, = 0.002, = 822). These data suggest high rates of streptococcal-related and other immune-mediated diseases in patients with childhood-onset OCD and are consistent with epidemiological studies in adults noting familial clustering. Limitations include potential reporting bias and absence of a control group, underscoring the need for further prospective studies characterizing medical and psychiatric disease clusters and their interactions in children. Such studies may ultimately improve our understanding of OCD pathogenesis and aid in the development of adjunctive immune-modulating therapeutic strategies.
Associations among immune-related comorbidities in OCD Collaborative Genetics Association Study probands with childhood-onset OCD. Significant associations described in Supplementary Table S4 are depicted by two-way arrows. Comorbidities include diseases with autoimmune (green; SLE, RA, MS), infectious (red; ear/throat infections, scarlet fever), combined autoimmune and infectious (RF), atopic (purple; asthma), and inflammatory (blue; psoriasis, IBD) etiologies, although recent data suggest significant overlap in pathophysiology and genetic predisposition among these conditions. All except for an association between IBD and rheumatic fever have been reported for the general population. IBD, inflammatory bowel disease; SLE, systemic lupus erythematosus; RA, rheumatoid arthritis; MS, multiple sclerosis; RF, rheumatic fever; OCD, obsessive compulsive disorder.
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In this knowledge base
| Title | Year | PMID |
|---|---|---|
| Genome-wide analyses identify 30 loci associated with obsessive-compulsive disorder. | 2025 | 40360802 |
External
| Title | Authors | Journal | Year | Link |
|---|---|---|---|---|
| Black EquaLity in OCD NeuroGenomics (BELONG): Study Protocol. | Williams IJ et al. | — | 2026 | → |
| DNA variants affecting chromatin structure are key to the genetic architecture of obsessive compulsive disorder. | Han VX et al. | — | 2026 | → |
| A Population-Based Multigenerational Family Coaggregation Study of Severe Infections and Obsessive-Compulsive Disorder. | Pol-Fuster J et al. | — | 2025 | → |
| Biological, Psychosocial, and Microbial Determinants of Childhood-Onset Obsessive-Compulsive Disorder: A Narrative Review. | Borrego-Ruiz A et al. | — | 2025 | → |
| Genome-wide analyses identify 30 loci associated with obsessive-compulsive disorder. | Strom NI et al. | — | 2025 | → |
| Gut Microbiota and Obsessive-Compulsive Disorder: A Systematic Review of Mechanistic Links, Evidence from Human and Preclinical Studies, and Therapeutic Prospects. | Eghdami S et al. | — | 2025 | → |
| Bibliometric Analysis of Development Trends and Research Hotspots in the Study of Data Mining in Nursing Based on CiteSpace. | Zhang R et al. | — | 2024 | → |
| General somatic health and lifestyle habits in individuals with obsessive- compulsive disorder: an international survey. | Holmberg A et al. | — | 2024 | → |
| Immunomodulatory options for neurodevelopmental spectrum conditions: are we there yet? | Arenella M | — | 2024 | → |
| Targeting inflammatory signaling in obsessive compulsive disorder: a promising approach. | Bhatt S et al. | — | 2024 | → |
| The Oxidative Status and Na<sup>+</sup>/K<sup>+</sup>-ATPase Activity in Obsessive-Compulsive Disorder: A Case Control Study. | Mohammadi AH et al. | — | 2024 | → |
| Microbial Reprogramming in Obsessive-Compulsive Disorders: A Review of Gut-Brain Communication and Emerging Evidence. | Bendriss G et al. | — | 2023 | → |
| Neuroinflammation in Obsessive-Compulsive Disorder: Sydenham Chorea, Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, and Pediatric Acute Onset Neuropsychiatric Syndrome. | Vreeland A et al. | — | 2023 | → |
| Pediatric Acute-Onset Neuropsychiatric Syndrome: Current Perspectives. | Gagliano A et al. | — | 2023 | → |
| Celecoxib versus placebo as an adjunct to treatment-as-usual in children and youth with obsessive-compulsive disorder: protocol for a single-site randomised quadruple-blind phase II study. | Westwell-Roper C et al. | — | 2022 | → |
| Children With PANS May Manifest POTS. | Chan A et al. | — | 2022 | → |
| Immunological causes of obsessive-compulsive disorder: is it time for the concept of an "autoimmune OCD" subtype? | Endres D et al. | — | 2022 | → |
| Morbidity and mortality in obsessive-compulsive disorder: A narrative review. | Fernández de la Cruz L et al. | — | 2022 | → |
| Neurocircuit models of obsessive-compulsive disorder: limitations and future directions for research. | Shephard E et al. | — | 2022 | → |
| The oxidative status and Na + /K + -ATPase activity in obsessive-compulsive disorder: a case control study | Mohammadi AH et al. | — | 2022 | — |
| Obsessive-Compulsive Disorder With Rheumatological and Inflammatory Diseases: A Systematic Review. | Alsheikh AM et al. | — | 2021 | → |
| Peripartum complications associated with obsessive compulsive disorder exacerbation during pregnancy. | Holingue C et al. | — | 2021 | → |
| Searching for host immune-microbiome mechanisms in obsessive-compulsive disorder: A narrative literature review and future directions. | Troyer EA et al. | — | 2021 | → |
| Association of Pediatric Acute-Onset Neuropsychiatric Syndrome With Microstructural Differences in Brain Regions Detected via Diffusion-Weighted Magnetic Resonance Imaging. | Zheng J et al. | — | 2020 | → |
| Familial Clustering of Immune-Mediated Diseases in Children with Abrupt-Onset Obsessive Compulsive Disorder. | Chan A et al. | — | 2020 | → |
| What Does Immunology Have to Do With Normal Brain Development and the Pathophysiology Underlying Tourette Syndrome and Related Neuropsychiatric Disorders? | Martino D et al. | — | 2020 | → |