The relationship between obsessive-compulsive disorder and anxiety disorders: A question of diagnostic boundaries or simply severity of symptoms?

  • Background: A growing number of studies are questioning the validity of current DSM diagnoses, either as "discrete" or distinct mental disorders and/or as phenotypically homogeneous syndromes. In this study, we investigated how symptom domains in patients with a main diagnosis of obsessive-compulsive disorder (OCD), panic disorder (PD) and social anxiety disorder (SAD) coaggregate. We predicted that symptom domains would be unrelated to DSM diagnostic categories and less likely to cluster with each other as severity increases. Methods: One-hundred eight treatment seeking patients with a main diagnosis of OCD, SAD or PD were assessed with the Dimensional Obsessive-Compulsive Scale (DOCS), the Social Phobia Inventory (SPIN), the Panic and Agoraphobia Scale (PAS), the Anxiety Sensitivity Index-Revised (ASI-R), and the Beck Depression and Anxiety Inventories (BDI and BAI, respectively). Subscores generated by each scale (herein termed "symptom domains") were used to categorize individuals into mild, moderate and severe subgroups through K-means clusterization and subsequently analysed by means of multiple correspondence analysis. Results: Broadly, we observed that symptom domains of OCD, SAD or PD tend to cluster on the basis of their severities rather than their DSM diagnostic labels. In particular, symptom domains and disorders were grouped into (1) a single mild "neurotic" syndrome characterized by multiple, closely related and co-occurring mild symptom domains; (2) two moderate (complicated and uncomplicated) "neurotic" syndromes (the former associated with panic disorder); and (3) severe but dispersed "neurotic" symptom domains. Conlusion: Our findings suggest that symptoms domains of treatment seeking patients with OCD and anxiety disorders tend to be better conceptualized in terms of severity rather than rigid diagnostic boundaries.

Download full text files

Export metadata

Author:Paula Vigne, Bruno F. T. Simões, Gabriela B. de Menezes, Pedro P. Fortes, Rafaela V. Dias, Luana D. Laurito, Carla P. Loureiro, Maria Eduarda Moreira-de-Oliveira, Lucy Albertella, Rico S. C. Lee, Ulrich StangierORCiDGND, Leonardo F. Fontenelle
Pubmed Id:
Parent Title (English):Comprehensive psychiatry
Place of publication:Amsterdam [u. a.]
Document Type:Article
Year of Completion:2019
Date of first Publication:2019/08/08
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2020/06/24
Tag:Anxiety sensitivity; General neurotic syndrome; Neuroticism; Obsessive–compulsive disorder; Panic disorder; Severity of symptoms; Social anxiety disorder
Issue:Art. 152116
Page Number:6
First Page:1
Last Page:6
© 2019 Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (
Institutes:Psychologie und Sportwissenschaften / Psychologie
Dewey Decimal Classification:1 Philosophie und Psychologie / 15 Psychologie / 150 Psychologie
Licence (German):License LogoCreative Commons - Namensnennung-Nicht kommerziell - Keine Bearbeitung 4.0