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A multidimensional model of obsessive-compulsive disorder.

David Mataix-Cols1, Maria Conceição do Rosario-Campos, James F Leckman

  • 1Institute of Psychiatry, London.

The American Journal of Psychiatry
|January 29, 2005
PubMed
Summary

Obsessive-compulsive disorder (OCD) is complex, but research shows it can be understood through distinct symptom dimensions like hoarding and cleaning. These dimensions help clarify findings in OCD research and treatment.

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Behavioral Neuroscience

Background:

  • Obsessive-compulsive disorder (OCD) presents a significant clinical heterogeneity.
  • This heterogeneity complicates research findings in areas such as genetics, neuroimaging, and clinical trials.
  • A multidimensional model is proposed to better understand OCD's complex presentation.

Purpose of the Study:

  • To review evidence supporting a multidimensional model of obsessive-compulsive disorder (OCD).
  • To identify consistent symptom dimensions within OCD research.
  • To explore the utility of these dimensions in advancing OCD understanding and treatment.

Main Methods:

  • Conducted comprehensive literature searches for factor-analytic studies on obsessive-compulsive symptoms.

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  • Included studies with novel, important findings relevant to mental health professionals.
  • Analyzed data from over 2,000 patients across twelve factor-analytic studies.
  • Main Results:

    • Identified four consistent symptom dimensions in OCD: symmetry/ordering, hoarding, contamination/cleaning, and obsessions/checking.
    • These dimensions demonstrated distinct patterns in comorbidity, genetic transmission, neural substrates, and treatment response.
    • The hoarding dimension showed particularly robust supporting evidence.

    Conclusions:

    • OCD's clinical presentation can be effectively summarized by stable symptom dimensions.
    • These dimensions represent a spectrum of overlapping syndromes that may extend beyond traditional OCD boundaries.
    • A dimensional approach to OCD phenotypes offers potential for improved understanding and endophenotype identification.