Perinatal Adverse Events Linked To Increased Risk of OCD Interview with:
Gustaf Brander
Department of Clinical Neuroscience
Karolinska Institutet What is the background for this study?

Response: Obsessive-compulsive disorder (OCD) is believed to be caused by a complex interaction between genetic and environmental factors. Whereas genetic studies are well underway, the research on environmental factors has been lagging behind. As they explain a significant portion of the variance, are potentially malleable, and are essential for understanding how the genetic component works, this area of research is of great importance. What are the main findings?

Response: In this large whole population study from Sweden, investigators examined whether a wide range of perinatal complications are prospectively associated with increased risk of developing OCD later in life. A range of adverse perinatal events namely maternal smoking during pregnancy, breech presentation, delivery by caesarean section, preterm birth, low birth weight, being large for gestational age, among others were all associated with an increased risk to develop OCD.

Another finding was that the higher the number of adverse perinatal events, the higher the risk for OCD. These findings were independent from familial confounders, such as socioeconomic status or parental mental illness. To reach this conclusion, the Swedish team compared full siblings with and without OCD, something that previous studies had been unable to do. The study is unique in its size (the authors studied a population of over 2.4 M individuals, of which over 17,000 had OCD, over long periods of time) and the strict control of potential confounding variables. What should readers take away from your report?

Response: The specific causes of OCD are unknown. While both genetic and environmental risk factors are thought to be associated with OCD, this is the first time that a set of environmental risk factors is convincingly associated with the condition. Together with other on-going gene-discovery efforts, the results pave the way for a deeper understanding of the causes of OCD. What recommendations do you have for future research as a result of this study?

Response: Replication of these findings is essential. Using these results, further gene-environment interaction and epigenetic studies should follow to unravel the roles and mechanisms of genetic and environmental factors in OCD. Thank you for your contribution to the community.


Association of Perinatal Risk Factors with Obsessive-Compulsive Disorder: A Population-Based Birth Cohort, Sibling Control Study
G Brander, M Rydell, R, Kuja-Halkola, L Fernández de la Cruz, P Lichtenstein, E Serlachius, C Almqvist, C Rück, BM D’Onofrio, H Larsson, D Mataix-Cols.
JAMA Psychiatry. Published online October 5, 2016. doi:10.1001/jamapsychiatry.2016.2095

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on October 5, 2016 by Marie Benz MD FAAD

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