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
40	Results — Twin studies	12 y); self-rated BOCS (18 y)0.020.02–0.627Burton et al. [54]CanadaAdolescent (6–18…
41	Results — Twin studies	The Fisher z-score analysis confirmed that MZ twins showed considerably higher correlations for OCS…
42	Results — Twin studies	Of note, there was a high heterogeneity index across the twin analyses. However, it is important to…
43	Results — Population-based cohorts (post hoc)	Six large nationwide register-based cohorts [7–12] did not meet our initial inclusion criteria…
44	Results — Population-based cohorts (post hoc)	From a cohort of more than 13.5 million people who were born or lived in Sweden between 1969 and…
45	Results — Population-based cohorts (post hoc)	Brander et al. [10] studied the same population between 1967 and 2007. They reported that full…
46	Results — Population-based cohorts (post hoc)	Mahjani et al. [11] also analyzed the OCD familial risk in the Swedish population. The cohort…
47	Results — Population-based cohorts (post hoc)	Steinhausen et al. [8] investigated a population sample from 1969 until 2009 in Denmark. The data…
48	Results — Population-based cohorts (post hoc)	Browne et al. [9] analyzed data from the same Danish population (born from 1980 to 2007). The…
49	Results — Population-based cohorts (post hoc)	Finally, Huang et al. [12] investigated the risk of OCD among 89,500 FDRs of OCD patients in Taiwan…
50	Discussion	The current meta-analysis included all OCD family and twin studies published until September 2021.…
51	Discussion	According to the 18 OCD family studies included in the analyses, OCD was 7.2 times more frequent in…
52	Discussion	Of note, the OCD rates among control relatives (2.3%) were very similar to the lifetime prevalence…
53	Discussion	Additional analyses of very large population-based studies, primarily conducted in Scandinavian…
54	Discussion	The twin studies demonstrated that OCD, or at least its dimensional representation, is not only…
55	Discussion	Notably, the shared environment component (C) did not have any contribution to the etiology of OCS…
56	Discussion	Some limitations of the present study should be highlighted, such as the fact that the data were not…
57	Discussion	Despite these limitations, the current systematic review and meta-analysis represent a much needed…
58	Supplementary information	Box S1 Table S1 Table S2 Prisma 2020 Checklist

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