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

摘要

The association between obsessive-compulsive disorder (OCD) and Tourette's/chronic tic disorders (TD/CTD) with autoimmune diseases (AD) is uncertain. In this nationwide study, we sought to clarify the patterns of comorbidity and familial clustering of a broad range of AD in individuals with OCD and/or 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 7,279 TD/CTD cases in the National Patient Register and followed them up to December 31, 2013. The risk of 40 AD was evaluated in individuals with OCD and/or TD/CTD and their first (siblings, mothers, fathers), second (half siblings), and third degree (cousins) relatives, compared to population controls. Individuals with OCD and TD/CTD had increased comorbidity with any AD (43% and 36%, respectively) and many individual AD. The risk of any AD and several individual AD was consistently higher among first-degree relatives than among second- and third-degree relatives of OCD and TD/CTD probands. The risk of AD 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 to siblings). The results suggest a familial link between AD in general (i.e., 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.