Symptom dimensions in OCD and their association with clinical characteristics and comorbid disorders

The complex clinical phenotype of obsessive–compulsive disorder (OCD) can be summarized in to a few temporally stable and consistent symptom dimensions that may have distinct clinical and neurobiological correlates. We examined the relationship between symptom dimensions and clinical characteristics in 161 consecutive patients with DSM-IV diagnosis of OCD with the Yale–Brown Obsessive–Compulsive Scale severity score of ≥20 recruited from a specialty OCD clinic in India. Clinician administered version of the Dimensional-Yale–Brown Obsessive–Compulsive Scale (D-YBOCS) was used to assess symptom dimensions. Earlier age of onset of OCD was associated with sexual/religious, aggression and symmetry dimensions. Fear of contamination was associated with female sex, higher family loading, greater severity of illness, poorer insight, and somewhat poorer functioning and lower physical quality of life. Aggression dimension was associated with presence of anxiety disorders and social phobia in particular. Our study demonstrates relatively specific associations between OCD symptom dimensions and clinical characteristics supporting the view that symptom dimensions could be employed to reduce the heterogeneity of OCD. The study encourages research on neurobiological and genetic underpinnings of symptom dimensions and supports inclusion of symptom dimensions in characterizing OCD in DSM-5 text.

► Earlier age of onset is associated with sexual/religious and symmetry dimensions.
► Contamination is associated with female sex, illness severity, and poorer insight.
► Aggression dimension is associated with presence of anxiety disorders.
► OCD symptom dimensions have specific association with clinical characteristics.
► Symptom dimensions may have to be included in DSM-5 text to characterize OCD.