Differenze di genere nel disturbo ossessivo-compulsivo: uno studio clinico su 415 pazienti

Abstract

Objectives

Obsessive-compulsive disorder (OCD), as reported by studies in the literature, has a significant clinical heterogeneity; indeed, authors have moved different subtypes based on the main symptom dimensions, course (episodic vs. chronic), age at onset (early vs. late) and comorbidity (bipolar or tic disorder). Finally, gender has been proposed as a possible subtype. The aim of the study is to evaluate gender-related socio-demographic and clinical differences in a large sample of patients.

Materials and methods

Four hundred fifteen patients with a primary diagnosis of OCD were recruited and evaluated by a semistructured interview. Assessment has been completed with the following rating scales: Y-BOCS, HAM-D, HAM-A, Paykel's scale, SCID-II. The sample was split into two subgroups according to gender.

Results

Males, 217 patients (52.3%), showed an earlier age at onset of obsessive-compulsive symptoms and a significant association with bipolar disorder, sexual obsessions and repetitive rituals. Females showed a correlation between the onset of the disorder and the presence of at least one stressful life event. Also, they were associated with minor depression, eating disorders and washer symptoms.

Discussion

Our study, according to literature data, shows OCD to have specific gender-related differences; to our opinion, however, differences do not completely support the hypothesis of subtyping OCD according to gender. Gender differences seem to be related to other elements such as age at onset; this may be more useful in the future for identifying genetic and environmental predisposing factors and therapeutic strategies.