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Gender in obsessive–compulsive disorder: clinical and genetic findings
Abstract
Background There is increasing recognition that obsessive-compulsive disorder (OCD) is not a homogeneous entity. It has been suggested that gender may contribute to the clinical and biological heterogeneity of OCD.Methods Two hundred and twenty patients (n=220; 107 male, 113 female) with DSM-IV OCD (age: 36.40+/-13.46) underwent structured interviews. A subset of Caucasian subjects (n=178), including subjects from the genetically homogeneous Afrikaner population (n=81), and of matched control subjects (n=161), was genotyped for polymorphisms in genes involved in monoamine function. Clinical and genetic data were statistically analyzed across gender.Results Compared with females, males with OCD (1) had an earlier age of onset, and a trend toward having more tics and worse outcome, (2) had somewhat differing patterns of OCD symptomatology and axis I comorbidity, and (3) in the Caucasian group, were more likely to have the high activity T allele of the EcoRV variant of the monoamine oxidase A (MAO-A) gene compared to controls, and (4) in the Afrikaner subgroup, were more frequently homozygous for the C allele at the G861C variant of the 5HT(1D beta) gene than controls. Females with OCD (1) reported more sexual abuse during childhood than males, (2) often noted changes in obsessive-compulsive symptoms in the premenstrual/menstrual period as well as during/shortly after pregnancy, and with menopause, and (3) in the Caucasian subgroup, were more frequently homozygous for the low activity C allele of the EcoRV variant of the MAO-A gene compared to controls, with this allele also more frequent in female patients than controls.Conclusion This study supports the hypothesis that gender contributes to the clinical and biological heterogeneity of OCD. A sexually dimorphic pattern of genetic susceptibility to OCD may be present. Further work is, however, needed to delineate the mechanisms that are responsible for mediating the effects of gender.
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“Furthermore, males with OCD have an earlier age of onset and being of male gender is a prognostic factor for a poor treatment outcome [10, 45, 47].”
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“Furthermore, males with OCD have an earlier age of onset and being of male gender is a prognostic factor for a poor treatment outcome [10, 45, 47].”
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Stein, D. J., Costa, D. L. C., Lochner, C., Miguel, E. C., Reddy, Y. C. J., Shavitt, R. G., van den Heuvel, O. A., & Simpson, H. B. (2019) · Nature Reviews Disease Primers · doi:10.1038/s41572-019-0102-3 · Cited by 895
Self-citationRepeated cortico-striatal stimulation generates persistent OCD-like behavior
Ahmari, S. E., Spellman, T., Douglass, N. L., Kheirbek, M. A., Simpson, H. B., Deisseroth, K., Gordon, J. A., & Hen, R. (2013) · Science · doi:10.1126/science.1234733 · Cited by 502
Dalal, P., & Agarwal, M. (2015) · Indian Journal of Psychiatry · doi:10.4103/0019-5545.161483 · Cited by 382
Neural correlates of cognitive inflexibility during task-switching in obsessive-compulsive disorder
Gu, B.-M., Park, J.-Y., Kang, D.-H., Lee, S. J., Yoo, S. Y., Jo, H. J., Choi, C.-H., Lee, J.-M., & Kwon, J. S. (2007) · Brain · doi:10.1093/brain/awm277 · Cited by 284
Taylor, S. (2013) · Molecular Psychiatry · doi:10.1038/mp.2012.76 · Cited by 264
Metadata
- Authors
- Lochner, C., Hemmings, S. M. J., Kinnear, C. J., Moolman-Smook, J. C., Corfield, V. A., Knowles, J. A., Niehaus, D. J. H., & Stein, D. J.
- Affiliations
- Stellenbosch University (ZA)
- New York State Psychiatric Institute (US)
- Venue
- European Neuropsychopharmacology
- Publisher
- Elsevier BV
- Published
- 2004-03
- Volume
- 14
- Issue
- 2
- Pages
- 105-113
- ISSN
- 0924-977X (ISSN-L)
- OpenAlex
- W2073715978
- Cited by
- 141
- References
- 99
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 5 · 2023: 5 · 2022: 2 · 2021: 8 · 2020: 2 · 2019: 5 · 2018: 3 · 2017: 4 · 2016: 1 · 2015: 14 · 2014: 6 · 2013: 8 · 2012: 6
- FWCI
- 6.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Neuropsychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- obsessive-compulsive disorder, gender differences, sexual dimorphism, monoamine oxidase A, genetic susceptibility, age of onset, tics, Axis I comorbidity, child sexual abuse, Afrikaner population, clinical heterogeneity
- MeSH terms
- Adolescent, Adult, Aged, Cysteine, Female, Gene Frequency, Genotype, Glycine, Humans, Interviews as Topic, Male, Middle Aged, Monoamine Oxidase, Obsessive-Compulsive Disorder, Polymorphism, Genetic, Pregnancy, Psychiatric Status Rating Scales, Quality of Life, Serotonin, Sex Characteristics, South Africa, Genetic Variation, Comorbidity, Case-Control Studies, Age of Onset, Genetic Predisposition to Disease, Receptor, Serotonin, 5-HT1D
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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