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Familial studies on obsessive-compulsive disorders (OCD) have suggested that OCD is a heterogeneous condition, with some cases being familial and others being isolated cases in their families. Nevertheless, no studies evaluated whether there are clinical differences between OCD cases with and without a familial component. The current report presents data on the prevalence of OCD in first-degree relatives of OCD probands and compares phenomenological characteristics of familial and non-familial OCD types. The family study and the family history methods were used to estimate the prevalence of OCD in first-degree relatives of 74 OCD probands. A statistical comparison between OCD probands with and without familial loading was performed using Pearson’s χ2 test, Fisher’s exact test, or Student’s t test when appropriate. The rate of OCD was 3.5% in directly interviewed first-degree relatives. Eleven percent of the probands had at least one family member with OCD. There were no differences between the two types of OCD (familial vs. non-familial) except for life events prior to the onset of OCD, which were more common and more severe in non-familial OCD subtypes. In conclusion, our results (1) confirm that there is a familial component in the expression of some forms of OCD and (2) indicate that familial OCD patients are not characterized by peculiar clinical features, but appear to have a lower threshold for precipitating events.

The present study was performed in a group of bulimic (BN) females (1) to assess prevalence rates of comorbid obsessive-compulsive phenomena; (2) to investigate whether BN patients display a characteristic cluster of obsessive-compulsive symptoms; and (3) to determine whether obsessive-compulsive symptoms influence the clinical picture of BN. Thirty-eight DSM-IV BN females were interviewed by means of the Structured Clinical Interview for DSM-III-R (SCID) to assess the prevalence rate of obsessive compulsive disorder (OCD); the Yale-Brown Obsessive-Compulsive Symptom Scale (Y-BOCS) Symptom Check-List was also used to evaluate the presence of obsessive-compulsive symptoms. The phenomenology of BN females with obsessive-compulsive syndromes (OCS) as detected by the Y-BOCS was compared to that shown by a “control” group of nonbulimic OCD females. Finally, the eating-related psychopathology of BN women with and without OCS was compared. The current prevalence rates of OCD and of subthreshold obsessive-compulsive syndrome (sOCS) in our sample were 10.5% and 15.8%, respectively. Thus, a total of 26.3% of BN females had a current OCS that comprised both clinical disorders and subthreshold syndromes. No differences were detected between obsessive-compulsive symptoms of these females and those of the control group of nonbulimic OCD females. BN females with OCS had higher ratings on the Eating Disorder Inventory (EDI) total score and on the “drive for thinness” and the “bulimia” items of the scale, as compared to BN females without OCS. In conclusion, it appears that a considerable proportion of BN females display OCS, which sometimes are not severe enough to fulfill diagnostic criteria for OCD. Moreover, in these patients, obsessive-compulsive symptoms are undistinguishable from those of OCD females, and exert a negative influence on the clinical picture of the bulimic disorder.

Conflicting results have been reported on the possible role of life events in triggering OCD onset. Moreover, pregnancy and/or delivery, among life events, appear to influence the OCD course and, in some cases, appear related to its onset. Our purpose was to assess the occurrence of potentially traumatizing events among patients with OCD. The study also provides an initial exploration of the association between OCD and pregnancy or delivery. The number and type of stressful life events which occurred in the 12 months before the onset of OCD were determined for both OCD patients (N = 68, 33 women and 35 men) and a group of comparison subjects (N = 68, 33 women and 35 men) by using a semistructured interview in accordance with Paykel's list. The results did not show a significant excess of life events in patients compared with healthy subjects. No differences were detected between OCD patients according to gender. When examining the type of events, OCD female individuals were found to be more likely than normal female subjects to report exposure to postpartum events, and high rates of obstetric complications were observed in these patients. Subjects with postpartum OCD had significantly higher rates of aggressive obsessions to harm the newborn. OCD male subjects did not show an association between a specific event and onset of the disorder. The findings confirm that the postpartum period represents a risk factor for OCD in some individuals, and suggest that obstetric complications may be relevant to the development of the disorder.

This article focuses on the clinical onset of obsessive-compulsive disorder (OCD), specifically addressing the of onset, gradual and acute onset, and whether there are some types of premorbid conditions or a prodromal phase that predispose individuals to the onset of OCD. Clinical and epidemiological studies have come to different conclusions regarding age at onset as well as regarding differences between the sexes. Data gleaned from research to date have demonstrated a relationship between OCD and obsessive-compulsive personality disorder (OCPD), although OCPD does not appear to be the more prevalent personality disorder among patients with OCD. Preliminary research has suggested that Axis I disorders may predispose individuals to OCD onset; however, the significance of this relationship remains to be clarified. Evidence of the association between OCD and subthreshold obsessive-compulsive syndrome suggests that these disorders lie on a continuum of severity, with some cases developing OCD while others do not.

Although many investigations into the onset of obsessive-compulsive disorder (OCD) suggest the occurrence of potential life events as triggering factors, such an association has not been well studied to date. The purpose of the present paper is to review the literature on OCD onset in order to determine whether OCD is triggered by recent life events, what specific events may serve as triggers, and the clinical and research implications of these factors. Overall, the available studies do not consistently support the theory that OCD is triggered by specific antecedent life events. However, there is a body of evidence to support the theory that the specific life events of pregnancy and birth of a child can trigger OCD. This apparent association has led to the investigation of certain neurohormonal factors, including changes in estrogen or oxytocin levels, that may be of etiopathogenetic significance in OCD. Confirming such associations may allow clinicians to provide more targeted preventive and therapeutic interventions.

The paper reports a sensitive Ion-Interaction Reverse Phase HPLC-UV method for the separation and determination of fluoxetine ((±)N-methyl-(4-(trifluoromethyl)phenoxy) benzene-propanamine) in human plasma. An ODS silica-based column is used as the stationary phase and the mobile phase consists of 5.00 mM octylamine in water/acetonitrile (60/40 v/v), at pH = 6.4, with UV detection at 230 nm. The method is selective towards potentially interferent drugs, such as paroxetine, amylsulpride, fluvoxamine, mianserin, imipramine, amitryptiline, cromipramine, maprotiline, haloperidol, flunitrazepam and diazepam. The proposed method was successfully applied to the determination of fluoxetine and norfluoxetine in plasma of some patients being treated for obsessive-compulsive disorders.

Objective This report presents data on the prevalence of both obsessive-compulsive disorder (OCD) and subthreshold obsessive-compulsive syndrome (sOCS) in a representative sample of older male adolescents living in Piedmont, Italy. Method A total of 1883 recruits to the Italian Defence Force were interviewed using the OC portion of the Diagnostic Interview Schedule. A diagnosis of sOCS was made for individuals who had obsessive and/or compulsive symptoms but who failed to meet one of the severity criteria of impairment. Results The point and lifetime prevalence rates of OCD were 2.0% and 2.6%, respectively. In total, 12.3% of the subjects received a current diagnosis of sOCS. No differences were found when examining prevalence rates according to area of residence or occupational status of the subjects. Conclusion Our findings suggest that OCD is as common in older male adolescents as it is in adults, and that sOCS, being commonly endorsed in a general adolescent population, may represent a normal phenomenon in older adolescents.

The efficacy of clomipramine and selective serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors (SSRIs) in treating obsessive-compulsive disorder (OCD) is now established. However, few studies are available on long term treatment strategies in patients with OCD. In this article, recent literature on drug discontinuation and maintenance treatment of OCD is reviewed and discussed. All studies which have evaluated recurrence rates after drug discontinuation have found that up to 80% of patients who respond to SSRIs relapse if the medication is withdrawn. The studies that have been performed on long term treatment of OCD with both clomipramine and SSRIs show that patients who continue medication maintain and slightly increase the level of improvement achieved in short term trials. Several authors suggest that, in maintenance treatment, drug dosages can be reduced to between 40 and 60% of those used in acute episodes without a significant difference in symptom improvement. Preliminary data concerning drug tolerability in patients receiving long term treatment for OCD indicate that SSRIs are well tolerated, and that the rate of adverse effects tends to decrease compared with short term treatment. Several recent reports suggest that patients who have taken SSRIs for at least 2 months are at risk of developing withdrawal symptoms when treatment is discontinued. However, no data are available concerning the relationship between the duration of OCD treatment and the onset of withdrawal symptoms.