Obsessive-compulsive disorder. Familial-developmental history, symptomatology, comorbidity and course with special reference to gender-related differences

Br J Psychiatry. 1996 Jul;169(1):101-7. doi: 10.1192/bjp.169.1.101.


Background: Demographic data, family history, psychopathological features, comorbidity and course of obsessive-compulsive disorder (OCD) are investigated and data generated to support the possible existence of two subgroups with gender-related differences of a broader nature.

Method: Two hundred and sixty-three OCD patients, consecutive admissions to the Institute of Psychiatry, University of Pisa over a period of 5 years, not excluding those with comorbid Axis I and Axis II conditions, were studied. Patients were evaluated with a specifically designed semi-structured OCD interview.

Results: We found a significantly greater history of perinatal trauma in men who also had an earlier onset, greater likelihood of never having been married and a higher frequency of such symptoms as sexual, exactness and symmetry obsessions and odd rituals; by contrast, women suffered a later onset of the disorder, were more likely to be married, had higher rates of associated panic attacks after the onset of OCD and a higher frequency of aggressive obsessions at the onset of their illness, and were less frequently associated with bipolar disorders.

Conclusions: Pathophysiological mechanisms in OCD seem to differ by gender. Perinatal trauma might predispose to earlier onset in men, whereas in women there is a close association between OCD and panic disorder.

MeSH terms

  • Adult
  • Child of Impaired Parents / psychology*
  • Comorbidity
  • Female
  • Humans
  • Life Change Events*
  • Male
  • Middle Aged
  • Obsessive-Compulsive Disorder / classification
  • Obsessive-Compulsive Disorder / diagnosis*
  • Obsessive-Compulsive Disorder / genetics
  • Obsessive-Compulsive Disorder / psychology
  • Personality Development*
  • Risk Factors
  • Sex Factors