A network analysis of obsessive-compulsive symptoms and their comorbidity with other disorders

To improve our understanding of the heterogeneity of obsessive-compulsive disorder (OCD) and its comorbidity with other disorders by using network analysis.

An existing data base of 257 participants with a primary diagnosis of OCD and whose symptoms were evaluated using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was subjected to network analysis.

The analysis revealed eight clusters of characteristics. Two clusters were too small in numbers to reach any meaningful conclusion. The other six clusters included patients with: 1) contamination and cleaning symptoms with little comorbidity; 2) high prevalence checking symptoms with comorbid depression and anxiety disorders; 3) high prevalence contamination and cleaning symptoms with aggressive obsessions and checking compulsions; 4) high prevalence hoarding symptoms with comorbid depression and anxiety; 5) high prevalence impulsive aggressive, sexual and checking symptoms, hair-pulling and comorbid body dysmorphic disorder; and 6) high prevalence hoarding with impulsive aggressive and checking symptoms with comorbid alcohol use disorder and psychosis.

This study highlights the potential role of comorbidity. Contamination/cleaning symptoms were observed to have less psychiatric comorbidity. Symmetry/ordering symptoms did not feature prominently in the symptom clusters, whilst checking compulsions were common to multiple clusters.