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Blanco-Vieira T, Radua J, Marcelino L, Bloch M, Mataix-Cols D, do Rosário MC. The genetic epidemiology of obsessive-compulsive disorder: a systematic review and meta-analysis. Transl Psychiatry 2023; 13:230. [PMID: 37380645 PMCID: PMC10307810 DOI: 10.1038/s41398-023-02433-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 04/04/2023] [Accepted: 04/14/2023] [Indexed: 06/30/2023] Open
Abstract
The first systematic review and meta-analysis of obsessive-compulsive disorder (OCD) genetic epidemiology was published approximately 20 years ago. Considering the relevance of all the studies published since 2001, the current study aimed to update the state-of-art knowledge on the field. All published data concerning the genetic epidemiology of OCD from the CENTRAL, MEDLINE, EMBASE, BVS, and OpenGrey databases were searched by two independent researchers until September 30, 2021. To be included, the articles had to fulfill the following criteria: OCD diagnosis provided by standardized and validated instruments; or medical records; inclusion of a control group for comparison and case-control, cohort or twin study designs. The analysis units were the first-degree relatives (FDRs) of OCD or control probands and the co-twins in twin pairs. The outcomes of interest were the familial recurrence rates of OCD and the correlations of OCS in monozygotic compared with dizygotic twins. Nineteen family, twenty-nine twin, and six population-based studies were included. The main findings were that OCD is a prevalent and highly familial disorder, especially among the relatives of children and adolescent probands, that OCD has a phenotypic heritability of around 50%; and that the higher OCS correlations between MZ twins were mainly due to additive genetic or to non-shared environmental components.
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Affiliation(s)
- Thiago Blanco-Vieira
- Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.
| | - Joaquim Radua
- Institut d'Investigacions Biomediques August Pi i Sunyer, CIBERSAM, Instituto de Salud Carlos III, University of Barcelona, Barcelona, Spain
| | - Lívia Marcelino
- Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Michael Bloch
- Yale Child Study Center, Yale University, School of Medicine, New Heaven, USA
| | - David Mataix-Cols
- Department of Clinical Neuroscience, Centre for Psychiatric Research, Karolinska Institutet, Stockholm, Sweden
| | - Maria Conceição do Rosário
- Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.
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Blanco-Vieira T, Hoexter MQ, Batistuzzo MC, Alvarenga P, Szejko N, Fumo AMT, Miguel EC, do Rosário MC. Association Between Obsessive-Compulsive Symptom Dimensions in Mothers and Psychopathology in Their Children. Front Psychiatry 2021; 12:674261. [PMID: 34262490 PMCID: PMC8273307 DOI: 10.3389/fpsyt.2021.674261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/06/2021] [Indexed: 12/21/2022] Open
Abstract
Background: The non-clinical presentation of obsessive-compulsive symptoms (OCS) in women may impact not only their daily lives and well-being but also increase the risk for emotional and behavioral problems in their children. This study aims to investigate the OCS dimension distribution in a large sample of mothers from a cohort of school age children and the association between these OCS dimensions with their own psychopathology, and with the presence of OCS and other psychopathology in their children. Method: Our final sample consisted of 2,511 mother-children dyads recruited from the elementary schools of two large cities. Throughout multiple regression analysis, we examined the correlations between demographic and clinical variables of mothers assessed by the Mini International Psychiatric Interview (MINI) and the Dimensional Yale-Brown Obsessive-Compulsive Scale-Short Version (DY-BOCS-SV) with children's psychopathology status reported by the Child Behavior Checklist (CBCL). Results: The overall prevalence of mothers who reported experiencing at least one OCS was 40% (N = 1,004). "Aggression/violence" was the most frequent symptom dimension (32.2%), followed by the "symmetry/ordering" (16.4%) and the "sexual/religious" dimensions (13.8%). There was a significant correlation between the presence of OCS and maternal psychopathology in general (p < 0.001, r = 0.397). Not only the presence but also the severity of the mother's OCS were strongly correlated to the total (p < 0.001), internalizing (p < 0.001), externalizing (p < 0.001), and OCS subscale scores (p < 0.001) on the CBCL. Conclusion: OCS dimensions are highly prevalent in women. Presence and severity of maternal OCS are related to children's psychopathology and behavioral problems.
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Affiliation(s)
- Thiago Blanco-Vieira
- Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Marcelo Queiroz Hoexter
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.,Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
| | - Marcelo C Batistuzzo
- Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil.,Department of Methods and Techniques in Psychology, Pontifical Catholic University, São Paulo, Brazil
| | - Pedro Alvarenga
- Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.,Sírio-Libanês Hospital, São Paulo, Brazil
| | - Natalia Szejko
- Department of Neurology, Yale School of Medicine, New Haven, CT, United States.,Department of Neurology, Medical University of Warsaw, Warsaw, Poland.,Department of Bioethics, Medical University of Warsaw, Warsaw, Poland
| | - Afonso Mazine Tiago Fumo
- Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.,Hospital Central da Beira, Beira, Mozambique
| | - Eurípedes C Miguel
- Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
| | - Maria Conceição do Rosário
- Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
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Blanco-Vieira T, Santos M, Ferrão YA, Torres AR, Miguel EC, Bloch MH, Leckman JF, do Rosario MC. The impact of attention deficit hyperactivity disorder in obsessive-compulsive disorder subjects. Depress Anxiety 2019; 36:533-542. [PMID: 30990937 DOI: 10.1002/da.22898] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 02/21/2019] [Accepted: 03/08/2019] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Recent findings suggest an association between attention deficit hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD). Thus, we evaluated the clinical associated features of ADHD in a large sample of adult OCD patients. METHODS A cross-sectional study including 955 adult patients with OCD from the Brazilian Research Consortium of Obsessive-Compulsive Spectrum Disorders (C-TOC). Clinical characteristics in adult OCD patients with and without comorbid ADHD were compared using Fisher's exact test, t-tests or Mann-Whitney tests. Bivariate analyses were followed by logistic regression analysis to identify clinical characteristics independently associated with ADHD comorbidity. RESULTS The lifetime prevalence of ADHD in adult OCD patients was 13.7%. The current results indicate that OCD + ADHD patients were more severe, had an earlier onset of the obsessive-compulsive symptoms, a higher history of rheumatic fever, with higher frequencies of sensory phenomena and comorbidity with Tourette syndrome. They also had an increased risk for academic impairment and suicide attempts. CONCLUSION Adult OCD patients with ADHD present some specific clinical features and may represent a special subgroup of adult OCD. Future studies should focus on the development of interventions more tailored to the phenotype of this subgroup of patients.
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Affiliation(s)
- Thiago Blanco-Vieira
- Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Matheus Santos
- Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Ygor A Ferrão
- Department od Psychiatry, Porto Alegre Health Science Federal University, Porto Alegre, Brazil.,Brazilian OCD Research Consortium (CTOC), Brazil
| | - Albina R Torres
- Brazilian OCD Research Consortium (CTOC), Brazil.,Department of Psychiatry, Faculty of Medicine of Botucatu, State University of São Paulo, São Paulo, Brazil
| | - Eurípedes C Miguel
- Brazilian OCD Research Consortium (CTOC), Brazil.,Psychiatry Institute, Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | | | - Maria C do Rosario
- Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.,Brazilian OCD Research Consortium (CTOC), Brazil.,Child Study Center, Yale University, New Haven, Connecticut
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Blanco-Vieira T, Ramos FADC, Lauridsen-Ribeiro E, Ribeiro MVV, Meireles EA, Nóbrega BA, Motta Palma SM, Ratto MDF, Caetano SC, Ribeiro WS, Rosário MCD. A Guide for Planning and Implementing Successful Mental Health Educational Programs. J Contin Educ Health Prof 2018; 38:126-136. [PMID: 29851717 DOI: 10.1097/ceh.0000000000000197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Considering the global burden of mental disorders, there is a worldwide need to improve the quality of mental health care. In order to address this issue, a change in how health care professionals are trained may be essential. However, the majority of the few reports published on this field's training programs do not discuss the characteristics associated with the success or failure of these strategies. The purpose of this review was to systematically examine the literature about mental health training programs designed for health care professionals in order to identify the relevant factors associated with their effective implementation. METHODS The MEDLINE/PubMed, SciELO, and Virtual Health Library databases were used to search for articles published before February 2017 and reviewed by two double-blind reviewers. RESULTS We found 77 original papers about mental health educational programs. Many of these studies were conducted in the USA (39%), addressed depression as the main subject (34%), and applied a quasi-experimental design (52%). Effective interventions were associated with the following characteristics: the use of learner-centered and interactive methodological approaches; a curriculum based on challenges in the trainees' daily routines; the involvement of experts in the program's development; the enrollment of experienced participants; interdisciplinary group work; flexible timing; the use of e-learning resources; and optimizing the implementation of knowledge into the participants' routine work practices. IMPLICATIONS FOR PRACTICE These results will be helpful for planning and improving the quality of future educational programs in mental health.
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Affiliation(s)
- Thiago Blanco-Vieira
- Dr. Blanco-Vieira: Child Psychiatrist, Post Graduation Student, Department of Psychiatry, UNIFESP, and Collaborator Professor at the Child and Adolescent Mental Health Specialization Course (CESMIA), Federal University of São Paulo (UNIFESP), São Paulo, Brazil. Dr. Ramos: Child Psychiatrist, Coordinator of Rio de Janeiro Mental Health School (ESAM), Collaborator Professor at the Child and Adolescent Mental Health Specialization Course (CESMIA), UNIFESP, São Paulo, Brazil. Dr. Lauridsen-Ribeiro: Pediatrician, Child Psychiatrist, Collaborator Professor at the Child and Adolescent Mental Health Specialization Course (CESMIA), UNIFESP, São Paulo, Brazil. Dr. Vieira Ribeiro: Child Psychiatrist, Collaborator at the Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, UNIFESP, São Paulo, Brazil. Dr. Meireles: Psychologist, Collaborator at the Child and Adolescent Psychiatry Unit (UPIA), UNIFESP, São Paulo, Brazil. Dr. Nóbrega: Child Psychiatrist, Collaborator at the Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, UNIFESP, São Paulo, Brazil. Dr. Palma: Child Psychiatrist, Collaborator at the Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, UNIFESP, São Paulo, Brazil. Dr. Ratto: Psychologist, Collaborator at the Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, UNIFESP, São Paulo, Brazil. Dr. Caetano: Associate Professor, Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), and Professor of the Child and Adolescent Mental Health Specialization Course (CESMIA), UNIFESP, São Paulo, Brazil. Dr. Ribeiro: Personal Social Services Research Unit, London School of Economics and Political Science, London, United Kingdom. Dr. Rosário: Associate Professor, Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo (UNIFESP), and Coordinator of the Child and Adolescent Mental Health Specialization Course (CESMIA), UNIFESP, São Paulo, Brazil
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Blanco-Vieira T, Silva Ribeiro W, Lauridsen-Ribeiro E, Graça Fatori de Sá D, Palma SMM, Vieira Ribeiro MV, Cavalcante Caetano S, Ramos FADC, Conceição do Rosário M. An evaluation of a collaborative course for child and adolescent mental health professionals. J Interprof Care 2017; 31:664-666. [PMID: 28686508 DOI: 10.1080/13561820.2017.1322561] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
There is a considerable gap between the offer and the demand for mental health treatment of children and adolescents, especially in low- and middle-income countries (LMICs). Permanent education in these countries is a promising and needed strategy to reduce this gap. This study was designed to evaluate the perceived impact of an educational intervention for child and adolescent mental health professionals in Brazil, the Child and Adolescent Mental Health Specialization Course (CESMIA). The intervention consisted of a 360-hour interprofessional postgraduation course. The CESMIA offered lectures and small-group case discussions for exchanging their experiences in dealing with the patients. The students were placed in these groups according to their professions in order to ensure a proportional distribution of healthcare professionals in each group. The evaluation employed a quasi-experimental design by the use of a knowledge, attitude, and practice (KAP) survey. The 39 participants reported significant improvement in all KAP dimensions. More specifically, the data indicated a 17% improvement for attitudes, a 9.4% increase for knowledge, and a 14% improvement for the practice dimensions. The CESMIA appeared to improve the level of knowledge of participants and their attitudes and actions towards patients, which reinforces the relevance of similar courses.
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Affiliation(s)
- Thiago Blanco-Vieira
- a Child and Adolescent Mental Health Specialization Course (CESMIA), Department of Psychiatry , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | - Wagner Silva Ribeiro
- a Child and Adolescent Mental Health Specialization Course (CESMIA), Department of Psychiatry , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil.,b Research Unit, Department of Personal Social Services , London School of Economics , London , UK
| | - Edith Lauridsen-Ribeiro
- a Child and Adolescent Mental Health Specialization Course (CESMIA), Department of Psychiatry , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | - Daniel Graça Fatori de Sá
- a Child and Adolescent Mental Health Specialization Course (CESMIA), Department of Psychiatry , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | - Sonia Maria Motta Palma
- a Child and Adolescent Mental Health Specialization Course (CESMIA), Department of Psychiatry , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil.,c Department of Psychobiology , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | - Marcos Vinícius Vieira Ribeiro
- a Child and Adolescent Mental Health Specialization Course (CESMIA), Department of Psychiatry , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | - Sheila Cavalcante Caetano
- a Child and Adolescent Mental Health Specialization Course (CESMIA), Department of Psychiatry , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | - Fernando Augusto da Cunha Ramos
- a Child and Adolescent Mental Health Specialization Course (CESMIA), Department of Psychiatry , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
| | - Maria Conceição do Rosário
- a Child and Adolescent Mental Health Specialization Course (CESMIA), Department of Psychiatry , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil.,d Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry , Federal University of São Paulo (UNIFESP) , São Paulo , Brazil
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