Identification of OCD subtypes

Identification of biologically homogeneous subtypes of obsessive compulsive disorder (OCD) may facilitate advances along a number of fronts including the development of early detection and intervention programs and the development of more specific forms of treatment. Progress in this area will also set the stage for advances in genetics, in studies of risk and protective factors, and in neurobiology. Thus far, at least three putative forms of OCD can be discerned: familial tic-related OCD, familial non-tic related OCD (possibly involving alterations in activity of the central oxytocin systems), and sporadic, non-familial (or not) OCD (possibly involving a range of traumatic, infectious, autoimmune injuries to specific brain regions participating in the lateral orbital frontal and limbic cortico-striato-thalamo-cortical circuits). Although overlapping, we anticipate that these forms of OCD will have distinctive phenotypic, genetic, environmental and neurobiological features. Above all, these forms of OCD may show unique or distinctive patterns of treatment response. It is also possible that the clear delineation of OCD subtypes may shed light on periods of heightened preoccupation that occur normally during the course of development.