The genetic epidemiology of obsessive-compulsive disorder: a systematic review and meta-analysis.

paper Cited Public

Authors: Blanco-Vieira, Thiago; Radua, Joaquim; Marcelino, Lívia; Bloch, Michael; Mataix-Cols, David; do Rosário, Maria Conceição
Year: 2023
Journal: Translational psychiatry
PMID: 37380645
DOI: 10.1038/s41398-023-02433-2
PMCID: PMC10307810

Fig. 1

PRISMA flow diagram.From the 4022 studies screened, 19 family studies and 29 twin studies were selected for the systematic review and meta-analysis.

LLM interpretation

This is a PRISMA flow diagram illustrating the study selection process for a systematic review and meta-analysis. It tracks the flow of records from initial identification (n=4022 after duplicates removed) through screening (n=4009) and eligibility assessment (n=95). The final selection includes 19 family studies and 29 twin studies for quantitative synthesis, incorporating additional records identified through other sources.

Fig. 2

Definite OCD prevalence.First-degree relatives of OCD probands had odds ratio of 7.18 (95% CI 4.13–12.47, p < 0.00001) for definite OCD in comparison to controls.

LLM interpretation

This is a forest plot showing the odds ratio (OR) for definite OCD prevalence in first-degree relatives of OCD probands compared to controls. The data is stratified by age group (Children/adolescents and Adults), with individual study results and subgroup totals represented by squares and diamonds. The overall pooled odds ratio is 7.18 (95% CI 4.13–12.47), indicating a statistically significant increase in prevalence (p < 0.00001).

Fig. 3

Definite/subthreshold OCD prevalence.First-degree relatives of definite and subthreshold OCD probands had 4.6-times higher risk of OC symptoms compared to controls.

LLM interpretation

This is a forest plot showing the odds ratio (OR) for obsessive-compulsive (OC) symptoms in first-degree relatives of OCD probands compared to controls across eight studies. All individual studies and the overall total show an increased risk (OR > 1), with a pooled odds ratio of 4.06 (95% CI: 2.91, 5.66). The overall effect is statistically significant (p < 0.01), with no observed heterogeneity among the studies ($I^2 = 0\%$).

Fig. 4

Age of onset.Only four samples remained for OCD family recurrence rate statistical analysis. The studies showed a high heterogeneity for the analyzed outcome.

LLM interpretation

This is a forest plot analyzing the odds ratio (OR) for age of onset across four studies (Pauls 1995, Nestadt 2000, Fyer 2005, and Chabane 2005). The plot compares "Rel. early" versus "Rel. late" onset, showing a pooled OR of 4.50 (95% CI: 1.07, 18.89), indicating a statistically significant overall effect (p = 0.04). High heterogeneity is noted among the studies, with $I^2 = 71\%$ and $p = 0.02$.

Fig. 5

Monozigotic twin OCS resemblance.OCS coccurrence rate in monozigotic twin pairs was about 47%.

LLM interpretation

This is a forest plot showing the OCD concordance rates in monozygotic twin pairs, stratified by age groups (Children/adolescents and Adults). The plot displays individual study results with confidence intervals, showing a subtotal concordance of 0.50 (95% CI: 0.39, 0.60) for children/adolescents and 0.45 (95% CI: 0.40, 0.49) for adults. The overall pooled concordance rate is 0.46 (95% CI: 0.41, 0.51), with a test for subgroup differences indicating no significant difference between the two age groups (p = 0.40).

Fig. 6

Dizogotic twin OCS resemblance.OCS cooccurence rate between dizigotic twin pairs was about 23%.

LLM interpretation

This is a forest plot showing the OCD concordance rates between dizygotic twin pairs, stratified by age group (Children/adolescents and Adults). The plot displays individual study effect sizes (COR) with 95% confidence intervals, with subtotal and total pooled estimates represented by diamonds. The total pooled concordance rate is 0.19 (95% CI: 0.14, 0.23), with both subgroups showing statistically significant effects (p < 0.01).

Fig. 7

Fisher Z-score between monozigotic and dizogotic twins.MZ twins has considerably higher correlations for OCS than DZ twins.

LLM interpretation

This is a forest plot comparing the Fisher Z-scores of correlations for OCS between monozygotic (rMZ) and dizygotic (rDZ) twins across multiple studies. The data is categorized into two subgroups: "Children / adolescents" and "Adults," with both subgroups and the overall total showing a positive difference (Diff Z) that is statistically significant (p < 0.01). The plot includes individual study effect sizes with 95% confidence intervals, weights, and pooled subtotal estimates represented by black squares.

#	Section	Preview
0	Introduction	Obsessive-compulsive disorder (OCD) is a prevalent and highly heterogeneous disorder of unknown…
1	Introduction	Since the beginning of the twentieth century, family studies have consistently reported that OCD is…
2	Introduction	Since OCD is a heterogeneous disorder, it may be possible that certain OCD phenotypes (i.e., early…
3	Introduction	The first systematic review and meta-analysis of OCD genetic epidemiology were published…
4	Introduction	Considering the relevance of all the studies published since 2001, the current study aimed to update…
5	Methods — Search strategy and selection criteria	The present meta-analysis was conducted according to the Preferred Reporting Items for Systematic…
6	Methods — Search strategy and selection criteria	The PECO strategy [58] was used to frame the systematic review procedure criteria, as follows.…
7	Methods — Search strategy and selection criteria	For this systematic review and meta-analysis, we considered all studies that examined familial…
8	Methods — Search strategy and selection criteria	A specific search strategy was used to locate previous reviews. The reference lists of all…
9	Methods — Search strategy and selection criteria	Studies were included if the following criteria were met: OCD diagnosis was assessed using…
10	Methods — Search strategy and selection criteria	Review studies, case reports, expert consensus, letters to editor, opinion papers, segregation…
11	Methods — Search strategy and selection criteria	A flowchart illustrating the study search and selection process is presented in Fig. 1.
12	Methods — Search strategy and selection criteria	Two independent OCD experts (T.B.V. and L.M.) performed the screening procedure for the databases to…
13	Methods — Search strategy and selection criteria	During the study selection procedure, the reviewers concluded that all twin studies were based on…
14	Methods — Search strategy and selection criteria	From the 95 full-text records evaluated, 58 were excluded. A list of all the excluded studies after…
15	Methods — Search strategy and selection criteria	The Newcastle-Ottawa Scale (NOS) [60] tool was used for the investigation of the risk of bias in…
16	Methods — Data analyses	For the coding process, a standardized data extraction form was used by the reviewers consisting of…
17	Methods — Data analyses	For family studies, it also included: case definition methods, including the adoption of the best…
18	Methods — Data analyses	For family studies, the analysis unit was the FDR(s) of the OCD patients or controls, and the…
19	Methods — Data analyses	For each outcome of interest reported by ≥2 family studies, we performed a random-effects…

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