Obsessive - Compulsive and Related Disorders Across the Lifespan – David Mataix-Cols research group

Obsessive-Compulsive and Related Disorders Across the Lifespan

Obsessive-Compulsive Disorder (OCD) is a major psychiatric disorder of unclear causes characterized by intrusive and anxiety-provoking thoughts (obsessions) and repetitive behaviours or mental acts (compulsions). These symptoms are time-consuming (often taking several hours a day) and cause substantial distress and disability. OCD typically starts in adolescence but can affect people of all ages. It is a prevalent disorder, affecting about 2% of the general population, and often co-occurs with other psychiatric disorders, such as major depression and anxiety disorders. OCD is associated with multiple medical and socioeconomic adversities. OCD is closely related to other frequent but less well understood psychiatric disorders, including:

• Body Dysmorphic Disorder (BDD): Preoccupation with perceived defects in appearance leading to repetitive behaviours (e.g., mirror checking).
• Hoarding Disorder: Persistent difficulty discarding possessions, resulting in congestive clutter in the house, causing marked disability.
• Hair Pulling Disorder (or Trichotillomania): Repetitive pulling of head and body hair, resulting in noticeable hair loss.
• Skin-Picking Disorder (or Excoriation Disorder): Repetitive picking of the skin resulting in skin lesions.
• Tourette Syndrome and Chronic Tic Disorder: Multiple motor and/or vocal tics for a period of more than one year.

Collectively, OCD and the disorders listed above are known as Obsessive-Compulsive Disorder and Related Disorders (OCD-RDs). These disorders generally start during childhood or adolescence but are associated with considerable morbidity and socioeconomic burden across the lifespan. Despite their relatively high combined prevalence, associated disability, and costs to society, OCD-RDs are severely under-detected, under-treated, and under-researched.

Our research programme primarily focuses on three major areas.

The first aims to understand the genetic and environmental risk factors of OCD-RDs using a variety of methods, including epidemiological studies, twin studies and genome-wide association studies (GWAS). Examples of this work are the Nordic OCD and related disorders consortium, which aims to collect DNA samples from 10,000 well characterised patients across the Nordic countries, or OCDTWIN, a unique study recruiting monozygotic twins who are discordant or concordant for OCD.

The second major area of interest focuses on the long-term consequences of OCD-RDs, both medical and socioeconomic, with a strong emphasis on clinically-relevant questions that can inform prevention and intervention work. These studies primarily employ the rich Swedish nationwide registers to follow-up large cohorts of patients over several decades. Outcomes of interest include, among others, autoimmune diseases, metabolic and cardiovascular diseases, specific causes of death (including deaths by suicide), educational outcomes, and labour market participation.

The third major focus is the design of novel interventions for OCD-RDs and their evaluation in clinical trials. Many of the group members are clinically active and work in specialist OCD-RDs services in Stockholm. We are also very interested in the dissemination of evidence-based treatments using novel technologies. For example, in collaboration with other senior colleagues at the Department of Clinical Neuroscience (Prof Christian Rückand Dr Eva Serlachius), we have developed Internet-based interventions for young people and adults with OCD, BDD, tic disorders, and various anxiety disorders. Some of these interventions are now being implemented in routine clinical care in Sweden and abroad.

For a list of publications, see PubMed

Major funders of our research include the Swedish Research Council, the Swedish Research Council for Health, Working Life and Welfare, Region Stockholm, Hjärnfonden, the US National Institute of Mental Health, the International OCD Foundation, or the UK National Institute for Health Research.

The broader research group comprises of two research sub-groups:

Lorena Fernández de la Cruz

The “Health consequences and lifestyle modification group”, led by senior researcher Dr Lorena Fernández de la Cruz, primarily focuses on the long-term medical and socioeconomic consequences of OCD-RDs, such as metabolic and cardiovascular diseases, suicide, educational attainment or labour market participation. Her group is currently developing and evaluating a lifestyle intervention for individuals with OCD who are at high risk for cardiometabolic disorders.

Anna Sidorchuk

The “Epidemiology and pharmacoepidemiology group”, led by senior researcher Dr Anna Sidorchuk, focuses on a wide range of epidemiological designs to study the risk factors and consequences of OCD-RDs and how psychotropic drugs can influence health outcomes. A major ongoing project specifically focuses on understanding the predictors and consequences of inappropriate prescription of benzodiazepines and the development of an easily scalable intervention to reduce long-term benzodiazepine prescribing in primary care.