What is the optimal way to subdivide obsessive-compulsive disorder?

Area of Science:

• Psychiatry
• Neuroscience
• Genetics

Background:

• Obsessive-compulsive disorder (OCD) exhibits significant clinical variability among patients and over time.
• This heterogeneity poses challenges for psychopathological, longitudinal, genetic, and treatment research.
• Defining clinically meaningful subgroups is essential for a deeper understanding of OCD.

Purpose of the Study:

• To explore strategies for addressing OCD heterogeneity.
• To identify more homogeneous phenotypic categories and endophenotypes.
• To discuss the implications of broadening diagnostic boundaries for OCD research.

Main Methods:

• Reviewing strategies for phenotypical description and subgrouping.
• Investigating the use of endophenotypes (neurophysiological, immunological, genetic, neuropsychological, neuroanatomic).
• Examining obsessive-compulsive symptom dimensions as quantitative traits.
• Considering the expansion of diagnostic boundaries to related conditions.

Main Results:

• OCD heterogeneity complicates research efforts.
• Homogeneous phenotypical descriptions and endophenotype research are key strategies.
• Utilizing symptom dimensions and related conditions may refine subgrouping.

Conclusions:

• Multiple heuristic strategies, potentially combined, are needed to effectively address OCD heterogeneity.
• Further research into homogeneous subgroups is vital for advancing OCD etiology and treatment.
• Understanding OCD's diverse expressions is critical for future scientific endeavors.