Familial clustering of tic disorders and obsessive-compulsive disorder.

IMPORTANCE Tourette syndrome/chronic tic disorder (TS/CT) and obsessive-compulsive disorder (OCD) overlap in their phenomenological features and often co-occur in affected individuals and families. Understanding how these disorders cluster in families provides important clinical information and is an important step in understanding the causes of these disorders. OBJECTIVE To determine familial recurrence for TS/CT and OCD using a national epidemiologic sample. DESIGN, SETTING, AND PARTICIPANTS We performed a population-based study of national health registries in Denmark, including all individuals (n = 1 741 271) born in Denmark from January 1, 1980, through December 31, 2007, and followed up through December 31, 2013. We identified those with TS/CT and/or OCD. MAIN OUTCOMES AND MEASURES The prevalence of TS/CT and OCD and relative recurrence risk (RRR) for TS/CT or OCD among individuals with an oldest sibling or a parent diagnosed as having TS/CT or OCD compared with individuals without an affected oldest sibling or an affected parent. RESULTS In this sample, 5596 individuals were diagnosed as having TS/CT; 6191, OCD; and 412, both disorders. The overall cohort prevalence of TS/CT was 0.42% (95% CI, 0.41%-0.43%) and of OCD, 0.84% (95% CI, 0.81%-0.87%). The mean sibling recurrence risk for TS/CT across all birth years was 9.88% (95% CI, 8.02%-12.16%) and for OCD, 4.01% (95% CI, 2.78%-5.76%). The sibling RRR for TS/CT was 18.63 (95% CI, 15.34-22.63). In contrast, the sibling RRR for OCD was 4.89 (95% CI, 3.45-6.93). The parent-offspring RRR for TS/CT was 61.02 (95% CI, 44.43-83.82), whereas the parent-offspring RRR for OCD was 6.25 (95% CI, 4.82-8.11). The sibling and parent-offspring cross-disorder risks were also significant, ranging from 3.20 (95% CI, 2.22-4.62) to 10.27 (95% CI, 5.17-20.39). CONCLUSIONS AND RELEVANCE Tourette syndrome/CT and OCD cluster in families. The familial aggregation of TS/CT is profound and substantially higher than the familial aggregation for OCD. The recurrence risk estimates provide an important clinical framework for identifying individuals at risk and provide insights into the causes of these disorders.

[1]  V. Smith,et al.  Prenatal valproate exposure and risk of autism spectrum disorders and childhood autism , 2014, Archives of Disease in Childhood: Education & Practice Edition.

[2]  F. Rijsdijk,et al.  The structure of genetic and environmental risk factors for dimensional representations of DSM-5 obsessive-compulsive spectrum disorders. , 2014, JAMA psychiatry.

[3]  P. Munk-Jørgensen,et al.  FAMILY AGGREGATION AND RISK FACTORS OF OBSESSIVE–COMPULSIVE DISORDERS IN A NATIONWIDE THREE‐GENERATION STUDY , 2013, Depression and anxiety.

[4]  D. Schendel,et al.  Antidepressant exposure in pregnancy and risk of autism spectrum disorders , 2013, Clinical epidemiology.

[5]  Benjamin D. Greenberg,et al.  Partitioning the Heritability of Tourette Syndrome and Obsessive Compulsive Disorder Reveals Differences in Genetic Architecture , 2013, PLoS genetics.

[6]  Erik T Parner,et al.  Recurrence of autism spectrum disorders in full- and half-siblings and trends over time: a population-based cohort study. , 2013, JAMA pediatrics.

[7]  R. Shavitt,et al.  Symptom dimensions, clinical course and comorbidity in men and women with obsessive-compulsive disorder , 2013, Psychiatry Research.

[8]  J. Leckman,et al.  Clinical assessment of Tourette syndrome and tic disorders , 2013, Neuroscience & Biobehavioral Reviews.

[9]  P. Lichtenstein,et al.  Population-based, multigenerational family clustering study of obsessive-compulsive disorder. , 2013, JAMA psychiatry.

[10]  Janet B W Williams,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[11]  Mogens Vestergaard,et al.  Prenatal valproate exposure and risk of autism spectrum disorders and childhood autism. , 2013, JAMA.

[12]  Kim W. Carter,et al.  The International Collaboration for Autism Registry Epidemiology (iCARE): Multinational Registry-Based Investigations of Autism Risk Factors and Trends , 2013, Journal of Autism and Developmental Disorders.

[13]  Christina L. Boisseau,et al.  Five-year course of obsessive-compulsive disorder: predictors of remission and relapse. , 2013, The Journal of clinical psychiatry.

[14]  Nathalie Jette,et al.  Prevalence of tic disorders: a systematic review and meta-analysis. , 2012, Pediatric neurology.

[15]  M. Lewis,et al.  Abnormal repetitive behaviours: shared phenomenology and pathophysiology. , 2012, Journal of intellectual disability research : JIDR.

[16]  Eli R. Lebowitz,et al.  Tourette syndrome in youth with and without obsessive compulsive disorder and attention deficit hyperactivity disorder , 2012, European Child & Adolescent Psychiatry.

[17]  S. Baron-Cohen,et al.  Parental age and autism spectrum disorders. , 2012, Annals of epidemiology.

[18]  J. Scharf,et al.  Prevalence of Tourette Syndrome and Chronic Tics in the Population-Based Avon Longitudinal Study of Parents and Children Cohort , 2012, Journal of the American Academy of Child and Adolescent Psychiatry.

[19]  Steven Taylor,et al.  Early versus late onset obsessive-compulsive disorder: evidence for distinct subtypes. , 2011, Clinical psychology review.

[20]  J. Nissen,et al.  Obsessive–compulsive disorder in children and adolescents. Symptom dimensions in a naturalistic setting , 2011, Nordic journal of psychiatry.

[21]  C. Pedersen,et al.  The Danish Civil Registration System , 2011, Scandinavian journal of public health.

[22]  O. Mors,et al.  The Danish Psychiatric Central Research Register , 2011, Scandinavian journal of public health.

[23]  C. Gillberg,et al.  The genetics of autism spectrum disorders and related neuropsychiatric disorders in childhood. , 2010, The American journal of psychiatry.

[24]  H. Hjalgrim,et al.  Predictive factors for familiality in a Danish clinical cohort of children with Tourette syndrome. , 2010, European journal of medical genetics.

[25]  D. Pauls,et al.  The genetics of obsessive-compulsive disorder: a review , 2010, Dialogues in clinical neuroscience.

[26]  M. Lauritsen,et al.  Validity of Childhood Autism in the Danish Psychiatric Central Register: Findings from a Cohort Sample Born 1990–1999 , 2010, Journal of autism and developmental disorders.

[27]  Dongmei Yu,et al.  The genetics of Tourette syndrome: a review. , 2009, Journal of psychosomatic research.

[28]  D. Boomsma,et al.  Genetic Factors Underlie Stability of Obsessive–Compulsive Symptoms , 2009, Twin Research and Human Genetics.

[29]  Mark H Lewis,et al.  The pathophysiology of restricted repetitive behavior , 2009, Journal of Neurodevelopmental Disorders.

[30]  Tyrone D. Cannon,et al.  Common genetic determinants of schizophrenia and bipolar disorder in Swedish families: a population-based study , 2009, The Lancet.

[31]  S. Rauch,et al.  Obsessive–compulsive disorder: subclassification based on co-morbidity , 2008, Psychological Medicine.

[32]  A. Graybiel.  Habits, rituals, and the evaluative brain. , 2008, Annual review of neuroscience.

[33]  H. Hjalgrim,et al.  Validation of the Presence of Comorbidities in a Danish Clinical Cohort of Children With Tourette Syndrome , 2008, Journal of child neurology.

[34]  T. Ivarsson,et al.  Categorical and dimensional aspects of co-morbidity in obsessive-compulsive disorder (OCD) , 2008, European Child & Adolescent Psychiatry.

[35]  S. Dalsgaard,et al.  Time trends in reported diagnoses of childhood neuropsychiatric disorders: a Danish cohort study. , 2007, Archives of pediatrics & adolescent medicine.

[36]  J. Walkup,et al.  Co-occurring Psychiatric Disorders in Children and Adolescents With Tourette Syndrome , 2006, Journal of child neurology.

[37]  B. Peterson,et al.  Increased number of subcortical hyperintensities on MRI in children and adolescents with Tourette's syndrome, obsessive-compulsive disorder, and attention deficit hyperactivity disorder. , 2006, The American journal of psychiatry.

[38]  Leonardo Franklin Fontenelle,et al.  The descriptive epidemiology of obsessive–compulsive disorder , 2006, Progress in Neuro-Psychopharmacology and Biological Psychiatry.

[39]  D. Boomsma,et al.  Twin studies on obsessive-compulsive disorder: a review. , 2005, Twin research and human genetics : the official journal of the International Society for Twin Studies.

[40]  L. Saccomani,et al.  Tourette syndrome and chronic tics in a sample of children and adolescents , 2005, Brain and Development.

[41]  A. Fyer,et al.  A direct interview family study of obsessive–compulsive disorder. I , 2005, Psychological Medicine.

[42]  J. Leckman,et al.  A family study of early‐onset obsessive‐compulsive disorder , 2005, American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics.

[43]  G. Curtis,et al.  A family study of obsessive‐compulsive disorder with pediatric probands , 2005, American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics.

[44]  D. Boomsma,et al.  Genetic and environmental contributions to the Child Behavior Checklist Obsessive-Compulsive Scale: a cross-cultural twin study. , 2004, Archives of general psychiatry.

[45]  M. Symons,et al.  Hazard rate ratio and prospective epidemiological studies. , 2002, Journal of clinical epidemiology.

[46]  R. Hoehn-Saric,et al.  The familial phenotype of obsessive-compulsive disorder in relation to tic disorders: the Hopkins OCD family study , 2001, Biological Psychiatry.

[47]  K. Kendler,et al.  Obsessive and compulsive symptoms in a general population sample of female twins. , 2000, American journal of medical genetics.

[48]  Paul Sandor,et al.  An international perspective on Tourette syndrome: selected findings from 3500 individuals in 22 countries , 2000, Developmental medicine and child neurology.

[49]  R L Williams,et al.  A Note on Robust Variance Estimation for Cluster‐Correlated Data , 2000, Biometrics.

[50]  T. F. Andersen,et al.  The Danish National Hospital Register. A valuable source of data for modern health sciences. , 1999, Danish medical bulletin.

[51]  J. Olsen,et al.  The Danish Medical Birth Registry. , 1998, Danish medical bulletin.

[52]  H. Singer,et al.  Family study and segregation analysis of Tourette syndrome: evidence for a mixed model of inheritance. , 1996, American journal of human genetics.

[53]  W. McMahon,et al.  Bilineal transmission and phenotypic variation of Tourette's disorder in a large pedigree. , 1996, Journal of the American Academy of Child and Adolescent Psychiatry.

[54]  P. Lavori,et al.  Assessing risk for the Tourette spectrum of disorders among first-degree relatives of probands with Tourette syndrome. , 1996, American journal of medical genetics.

[55]  S. Faraone,et al.  The relationship between tic disorders and Tourette's syndrome revisited. , 1995, Journal of the American Academy of Child and Adolescent Psychiatry.

[56]  D. Pauls,et al.  Evidence for Autosomal Dominant Transmission in Tourette's Syndrome , 1993, British Journal of Psychiatry.

[57]  D. Benson,et al.  Obsessions and compulsions in Gilles de la Tourette's syndrome , 1986, Neurology.

[58]  K. Kidd,et al.  A twin study of Tourette syndrome. , 1985, Archives of general psychiatry.

[59]  J. Feighner,et al.  A family study of Gilles de la Tourette syndrome. , 1976, Diseases of the nervous system.

[60]  M. Grados,et al.  Familiality of Tourette syndrome, obsessive-compulsive disorder, and attention-deficit/hyperactivity disorder: heritability analysis in a large sib-pair sample. , 2011, Journal of the American Academy of Child and Adolescent Psychiatry.

[61]  Dan J Stein,et al.  The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication , 2010, Molecular Psychiatry.

[62]  R. Hoehn-Saric,et al.  A family study of obsessive-compulsive disorder. , 1992, Archives of general psychiatry.