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. 2018 Jul;23(7):1652-1658.
doi: 10.1038/mp.2017.215. Epub 2017 Nov 14.

A total-population multigenerational family clustering study of autoimmune diseases in obsessive-compulsive disorder and Tourette's/chronic tic disorders

D Mataix-Cols  1   2 , E Frans  3 , A Pérez-Vigil  4 , R Kuja-Halkola  3 , C Gromark  4   5 , K Isomura  4   5 , L Fernández de la Cruz  4 , E Serlachius  4   5 , J F Leckman  6 , J J Crowley  4   7 , C Rück  4   5 , C Almqvist  3   8 , P Lichtenstein  3 , H Larsson  3   9
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A total-population multigenerational family clustering study of autoimmune diseases in obsessive-compulsive disorder and Tourette's/chronic tic disorders

D Mataix-Cols et al. Mol Psychiatry. 2018 Jul.

Abstract

The association between obsessive-compulsive disorder (OCD) and Tourette's/chronic tic disorders (TD/CTD) with autoimmune diseases (ADs) is uncertain. In this nationwide study, we sought to clarify the patterns of comorbidity and familial clustering of a broad range of ADs in individuals with OCD, individuals with TD/CTD and their biological relatives. From a birth cohort of 7 465 455 individuals born in Sweden between 1940 and 2007, we identified 30 082 OCD and 7279 TD/CTD cases in the National Patient Register and followed them up to 31 December 2013. The risk of 40 ADs was evaluated in individuals with OCD, individuals with TD/CTD and their first- (siblings, mothers, fathers), second- (half siblings) and third-degree (cousins) relatives, compared with population controls. Individuals with OCD and TD/CTD had increased comorbidity with any AD (43% and 36%, respectively) and many individual ADs. The risk of any AD and several individual ADs was consistently higher among first-degree relatives than among second- and third-degree relatives of OCD and TD/CTD probands. The risk of ADs was very similar in mothers, fathers and siblings of OCD probands, whereas it tended to be higher in mothers and fathers of TD/CTD probands (compared with siblings). The results suggest a familial link between ADs in general (that is, not limited to Streptococcus-related conditions) and both OCD and TD/CTD. Additional mother-specific factors, such as the placental transmission of antibodies, cannot be fully ruled out, particularly in TD/CTD.

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Figures

Figure 1
Figure 1
Sensitivity analyses. Risk (ORs and 95% CI) of any AD in probands and relatives of probands with OCD (panel A) and TD/CTD (panel B). Analyses exclude any AD amongst probands as well as OCD or TD/CTD in the relatives (full data available in Supplementary Table 5). Footnotes: Gray shapes = probands; red shapes = first-degree relatives, green shapes = second-degree relatives, yellow shapes = third-degree relatives. Abbreviations: AD = autoimmune diseases; CI = confidence interval; CTD = chronic tics disorder; OCD = obsessive-compulsive disorder; OR = odds ratio; TD = Tourette's disorder.
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