Genetic and phenotypic overlap of specific obsessive-compulsive and attention-deficit/hyperactive subtypes with Tourette syndrome

Hirschtritt, M. E., Darrow, S. M., Illmann, C., Osiecki, L., Grados, M., Sandor, P., Dion, Y., King, R. A., Pauls, D., Budman, C. L., Cath, D. C., Greenberg, E., Lyon, G. J., Yu, D., McGrath, L. M., McMahon, W. M., Lee, P. C., Delucchi, K. L., Scharf, J. M., Mathews, C. A. (June 2017) Genetic and phenotypic overlap of specific obsessive-compulsive and attention-deficit/hyperactive subtypes with Tourette syndrome. Psychol Med. pp. 1-15. ISSN 0033-2917

DOI: 10.1017/s0033291717001672


BACKGROUND: The unique phenotypic and genetic aspects of obsessive-compulsive (OCD) and attention-deficit/hyperactivity disorder (ADHD) among individuals with Tourette syndrome (TS) are not well characterized. Here, we examine symptom patterns and heritability of OCD and ADHD in TS families. METHOD: OCD and ADHD symptom patterns were examined in TS patients and their family members (N = 3494) using exploratory factor analyses (EFA) for OCD and ADHD symptoms separately, followed by latent class analyses (LCA) of the resulting OCD and ADHD factor sum scores jointly; heritability and clinical relevance of the resulting factors and classes were assessed. RESULTS: EFA yielded a 2-factor model for ADHD and an 8-factor model for OCD. Both ADHD factors (inattentive and hyperactive/impulsive symptoms) were genetically related to TS, ADHD, and OCD. The doubts, contamination, need for sameness, and superstitions factors were genetically related to OCD, but not ADHD or TS; symmetry/exactness and fear-of-harm were associated with TS and OCD while hoarding was associated with ADHD and OCD. In contrast, aggressive urges were genetically associated with TS, OCD, and ADHD. LCA revealed a three-class solution: few OCD/ADHD symptoms (LC1), OCD & ADHD symptoms (LC2), and symmetry/exactness, hoarding, and ADHD symptoms (LC3). LC2 had the highest psychiatric comorbidity rates (50% for all disorders). CONCLUSIONS: Symmetry/exactness, aggressive urges, fear-of-harm, and hoarding show complex genetic relationships with TS, OCD, and ADHD, and, rather than being specific subtypes of OCD, transcend traditional diagnostic boundaries, perhaps representing an underlying vulnerability (e.g. failure of top-down cognitive control) common to all three disorders.

Item Type: Paper
Uncontrolled Keywords: Attention-deficit/hyperactivity disorder Tourette syndrome factors heritability latent classes obsessive-compulsive disorder
Subjects: bioinformatics > genomics and proteomics > genetics & nucleic acid processing
diseases & disorders > mental disorders > Tourette Syndrome
CSHL Authors:
Communities: CSHL labs > Lyon lab
Depositing User: Matt Covey
Date: 27 June 2017
Date Deposited: 29 Jun 2017 16:36
Last Modified: 06 Jul 2021 19:28
PMCID: PMC7909616
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