A total-population multigenerational family clustering study of autoimmune diseases in obsessive-compulsive disorder and Tourette's/chronic tic disorders

Mol Psychiatry. 2018 Jul;23(7):1652-1658. doi: 10.1038/mp.2017.215. Epub 2017 Nov 14.

Abstract

The association between obsessive-compulsive disorder (OCD) and Tourette's/chronic tic disorders (TD/CTD) with autoimmune diseases (ADs) is uncertain. In this nationwide study, we sought to clarify the patterns of comorbidity and familial clustering of a broad range of ADs in individuals with OCD, individuals with TD/CTD and their biological relatives. From a birth cohort of 7 465 455 individuals born in Sweden between 1940 and 2007, we identified 30 082 OCD and 7279 TD/CTD cases in the National Patient Register and followed them up to 31 December 2013. The risk of 40 ADs was evaluated in individuals with OCD, individuals with TD/CTD and their first- (siblings, mothers, fathers), second- (half siblings) and third-degree (cousins) relatives, compared with population controls. Individuals with OCD and TD/CTD had increased comorbidity with any AD (43% and 36%, respectively) and many individual ADs. The risk of any AD and several individual ADs was consistently higher among first-degree relatives than among second- and third-degree relatives of OCD and TD/CTD probands. The risk of ADs was very similar in mothers, fathers and siblings of OCD probands, whereas it tended to be higher in mothers and fathers of TD/CTD probands (compared with siblings). The results suggest a familial link between ADs in general (that is, not limited to Streptococcus-related conditions) and both OCD and TD/CTD. Additional mother-specific factors, such as the placental transmission of antibodies, cannot be fully ruled out, particularly in TD/CTD.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Autoimmune Diseases / epidemiology*
  • Autoimmune Diseases / physiopathology
  • Case-Control Studies
  • Child
  • Cluster Analysis
  • Comorbidity
  • Family
  • Female
  • Humans
  • Male
  • Obsessive-Compulsive Disorder / complications
  • Obsessive-Compulsive Disorder / genetics
  • Obsessive-Compulsive Disorder / immunology*
  • Pedigree
  • Risk Factors
  • Siblings
  • Sweden / epidemiology
  • Tic Disorders / epidemiology
  • Tourette Syndrome / complications
  • Tourette Syndrome / genetics
  • Tourette Syndrome / immunology*