The identification of OCD-related subgroups based on comorbidity

Gerald Nestadt, Anjene Addington, Jack Samuels, Kung Yee Liang, O. Joseph Bienvenu, Mark Riddle, Marco Grados, Rudolf Hoehn-Saric, Bernadette Cullen

Research output: Contribution to journalArticlepeer-review

106 Scopus citations


Background: Individuals with obsessive-compulsive disorder (OCD) frequently have other psychiatric disorders. This study employed latent class analysis (LCA) to explore whether there are underlying clinical constructs that distinguish "OCD-related" subgroups. Methods: The study included 450 subjects, case and control probands and their first-degree relatives, and LCA was used to derive empirically based subgroups of 10 disorders: OCD, obsessive-compulsive personality disorder (OCPD), recurrent major depressive disorder (RMDD), separation anxiety disorder, panic disorder or agoraphobia (PD/AG), tic disorders (TD), generalized anxiety disorder (GAD), somatoform disorders (hypochondriasis or body dysmorphic disorder), pathologic skin picking or nail biting (PSP/NB), and eating disorders (EDs). The derived classes were compared on several clinical variables. Results: The best fitting model is a four-class structure: minimal disorder, predominant RMDD and GAD, "highly comorbid," and PD/AG and TD. The nature and number of disorders represented suggests that the first classes are distributed ordinally on a dimension of severity, and the fourth class is qualitatively distinct. Support for this structure is based on the number of disorders, age at onset of OCD, neuroticism, and extraversion. Conclusions: In this OCD enriched sample, LCA identified four classes of disorder. These classes appear to conform to two subgroups that may prove useful in investigating the etiology of OCD.

Original languageEnglish (US)
Pages (from-to)914-920
Number of pages7
JournalBiological psychiatry
Issue number10
StatePublished - May 15 2003


  • Anxiety disorders
  • Familiality
  • Latent class analysis
  • OCD
  • OCD spectrum disorders
  • Subtypes

ASJC Scopus subject areas

  • Biological Psychiatry


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