Comprehensive Psychiatry
Volume 52, Issue 3 , Pages 334-341 , May 2011

Latent class analysis of the Yale-Brown Obsessive-Compulsive Scale symptoms in obsessive-compulsive disorder

  • Kevin L. Delucchi

      Affiliations

    • Department of Psychiatry, University of California, Box 0984-TRC, San Francisco, CA 94143-0984, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1 415 476 4180; fax: +1 415 476 7677.
    • ,
  • Hilga Katerberg

      Affiliations

    • Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
    • Department of Psychiatry, MRC Unit on Anxiety and Stress Disorders, University of Stellenbosch, South Africa
    • ,
  • S. Evelyn Stewart

      Affiliations

    • Obsessive-Compulsive Disorder Clinics (Adult and Pediatric), Massachusetts General Hospital, Boston, MA, USA
    • Psychiatric and Neurodevelopmental Genetics Unit, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
    • Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, MA, USA
    • ,
  • Damiaan A.J.P. Denys

      Affiliations

    • Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
    • Netherlands Institute for Neuroscience, an institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands
    • ,
  • Christine Lochner

      Affiliations

    • Department of Psychiatry, MRC Unit on Anxiety and Stress Disorders, University of Stellenbosch, South Africa
    • ,
  • Denise E. Stack

      Affiliations

    • Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, MA, USA
    • ,
  • Johan A. den Boer

      Affiliations

    • Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
    • ,
  • Anton J.L.M. van Balkom

      Affiliations

    • Department of Clinical and Health Psychology, Utrecht University and Altrecht Anxiety Outpatient program, Utrecht, the Netherlands
    • ,
  • Michael A. Jenike

      Affiliations

    • Obsessive-Compulsive Disorder Clinics (Adult and Pediatric), Massachusetts General Hospital, Boston, MA, USA
    • Obsessive-Compulsive Disorder Institute, McLean Hospital, Belmont, MA, USA
    • ,
  • Dan J. Stein

      Affiliations

    • Department of Psychiatry, MRC Unit on Anxiety and Stress Disorders, University of Stellenbosch, South Africa
    • Department of Psychiatry, University of Cape Town, South Africa
    • ,
  • Danielle C. Cath

      Affiliations

    • Department of Psychiatry, VU University Medical Center, GGZ Buitenamstel, Amsterdam, the Netherlands
    • Department of Clinical and Health Psychology, Utrecht University and Altrecht Anxiety Outpatient program, Utrecht, the Netherlands
    • ,
  • Carol A. Mathews

      Affiliations

    • Department of Psychiatry, University of California, Box 0984-TRC, San Francisco, CA 94143-0984, USA

References 

  1. Bebbington PE. Epidemiology of obsessive-compulsive disorder. Br J Psychiatry Suppl. 1998;(35):2–6
  2. Horwath E, Weissman MM. The epidemiology and cross-national presentation of obsessive-compulsive disorder. Psychiatr Clin North Am. 2000;23(3):493–507
  3. Ruscio AM, Stein DJ, Chiu WT, Kessler RC. The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Mol Psychiatry. 2008;
  4. APA . Diagnostic and statistical manual of mental disorders. 4th Ed., Text Rev. ed. Washington, DC: American Psychiatric Association; 2000;
  5. do Rosario-Campos MC, Leckman JF, Curi M, Quatrano S, Katsovitch L, Miguel EC, et al. A family study of early-onset obsessive-compulsive disorder. Am J Med Genet B Neuropsychiatr Genet. 2005;136(1):92–97
  6. Alsobrook IJ, Leckman JF, Goodman WK, Rasmussen SA, Pauls DL. Segregation analysis of obsessive-compulsive disorder using symptom-based factor scores. Am J Med Genet. 1999;88(6):669–675
  7. Cavallini MC, Pasquale L, Bellodi L, Smeraldi E. Complex segregation analysis for obsessive compulsive disorder and related disorders. Am J Med Genet. 1999;88(1):38–43
  8. Hanna GL, Fingerlin TE, Himle JA, Boehnke M. Complex segregation analysis of obsessive-compulsive disorder in families with pediatric probands. Hum Hered. 2005;60(1):1–9
  9. Nestadt G, Lan T, Samuels J, Riddle M, Bienvenu OJ, Liang KY, et al. Complex segregation analysis provides compelling evidence for a major gene underlying obsessive-compulsive disorder and for heterogeneity by sex. Am J Hum Genet. 2000;67(6):1611–1616
  10. Bloch MH, Landeros-Weisenberger A, Rosario MC, Pittenger C, Leckman JF. Meta-analysis of the symptom structure of obsessive-compulsive disorder. Am J Psychiatry. 2008;165(12):1532–1542
  11. Calamari JE. Understanding the heterogeneity of OCD. Am J Psychiatry. 2005;162(11):2193–2194author reply 4
  12. Tukel R, Meteris H, Koyuncu A, Tecer A, Yazici O. The clinical impact of mood disorder comorbidity on obsessive-compulsive disorder. Eur Arch Psychiatry Clin Neurosci. 2006;
  13. Ivarsson T, Melin K, Wallin L. Categorical and dimensional aspects of co-morbidity in obsessive-compulsive disorder (OCD). Eur Child Adolesc Psychiatry. 2008;17(1):20–31
  14. Delorme R, Bille A, Betancur C, Mathieu F, Chabane N, Mouren-Simeoni MC, et al. Exploratory analysis of obsessive compulsive symptom dimensions in children and adolescents: a prospective follow-up study. BMC Psychiatry. 2006;6:1
  15. Hasler G, Kazuba D, Murphy DL. Factor analysis of obsessive-compulsive disorder YBOCS-SC symptoms and association with 5-HTTLPR SERT polymorphism. Am J Med Genet B Neuropsychiatr Genet. 2006;141(4):403–408
  16. Hasler G, LaSalle-Ricci VH, Ronquillo JG, Crawley SA, Cochran LW, Kazuba D, et al. Obsessive-compulsive disorder symptom dimensions show specific relationships to psychiatric comorbidity. Psychiatry Res. 2005;135(2):121–132
  17. Kim SJ, Lee HS, Kim CH. Obsessive-compulsive disorder, factor-analyzed symptom dimensions and serotonin transporter polymorphism. Neuropsychobiology. 2005;52(4):176–182
  18. Denys D, de Geus F, van Megen HJ, Westenberg HG. Symptom dimensions in obsessive-compulsive disorder: factor analysis on a clinician-rated scale and a self-report measure. Psychopathology. 2004;37(4):181–189
  19. Denys D, de Geus F, van Megen HJ, Westenberg HG. Use of factor analysis to detect potential phenotypes in obsessive-compulsive disorder. Psychiatry Res. 2004;128(3):273–280
  20. Feinstein SB, Fallon BA, Petkova E, Liebowitz MR. Item-by-item factor analysis of the Yale-Brown Obsessive-Compulsive Scale Symptom Checklist. J Neuropsychiatry Clin Neurosci. 2003;15(2):187–193
  21. Nestadt G, Addington A, Samuels J, Liang KY, Bienvenu OJ, Riddle M, et al. The identification of OCD-related subgroups based on comorbidity. Biol Psychiatry. 2003;53(10):914–920
  22. Cavallini MC, Di Bella D, Siliprandi F, Malchiodi F, Bellodi L. Exploratory factor analysis of obsessive-compulsive patients and association with 5-HTTLPR polymorphism. Am J Med Genet. 2002;114(3):347–353
  23. Mataix-Cols D, Rauch SL, Manzo PA, Jenike MA, Baer L. Use of factor-analyzed symptom dimensions to predict outcome with serotonin reuptake inhibitors and placebo in the treatment of obsessive-compulsive disorder. Am J Psychiatry. 1999;156(9):1409–1416
  24. Summerfeldt LJ, Richter MA, Antony MM, Swinson RP. Symptom structure in obsessive-compulsive disorder: a confirmatory factor-analytic study. Behav Res Ther. 1999;37(4):297–311
  25. McKay D, Danyko S, Neziroglu F, Yaryura-Tobias JA. Factor structure of the Yale-Brown Obsessive-Compulsive Scale: a two dimensional measure. Behav Res Ther. 1995;33(7):865–869
  26. Baer L. Factor analysis of symptom subtypes of obsessive compulsive disorder and their relation to personality and tic disorders. J Clin Psychiatry. 1994;55(Suppl):18–23
  27. Thomsen PH, Jensen J. Latent class analysis of organic aspects of obsessive-compulsive disorder in children and adolescents. Acta Psychiatr Scand. 1991;84(4):391–395
  28. Lochner C, Stein DJ. Does work on obsessive-compulsive spectrum disorders contribute to understanding the heterogeneity of obsessive-compulsive disorder?. Prog Neuropsychopharmacol Biol Psychiatry. 2006;30(3):353–361
  29. Lochner C, Hemmings SM, Kinnear CJ, Niehaus DJ, Nel DG, Corfield VA, et al. Cluster analysis of obsessive-compulsive spectrum disorders in patients with obsessive-compulsive disorder: clinical and genetic correlates. Compr Psychiatry. 2005;46(1):14–19
  30. Pinto A, Eisen JL, Mancebo MC, Greenberg BD, Stout RL, Rasmussen SA. Taboo thoughts and doubt/checking: a refinement of the factor structure for obsessive-compulsive disorder symptoms. Psychiatry Res. 2007;151(3):255–258
  31. Matsunaga H, Maebayashi K, Hayashida K, Okino K, Matsui T, Iketani T, et al. Symptom structure in Japanese patients with obsessive-compulsive disorder. Am J Psychiatry. 2008;165(2):251–253
  32. Stein DJ, Andersen EW, Overo KF. Response of symptom dimensions in obsessive-compulsive disorder to treatment with citalopram or placebo. Rev Bras Psiquiatr. 2007;29(4):303–307
  33. Hudziak JJ, Heath AC, Madden PF, Reich W, Bucholz KK, Slutske W, et al. Latent class and factor analysis of DSM-IV ADHD: a twin study of female adolescents. J am Acad Child Adolesc Psychiatry. 1998;37(8):848–857
  34. Lubke GH, Muthen B, Moilanen IK, McGough JJ, Loo SK, Swanson JM, et al. Subtypes versus severity differences in attention-deficit/hyperactivity disorder in the Northern Finnish Birth Cohort. J am Acad Child Adolesc Psychiatry. 2007;46(12):1584–1593
  35. Neuman RJ, Heath A, Reich W, Bucholz KK, Madden PAF, Sun L, et al. Latent class analysis of ADHD and comorbid symptoms in a population sample of adolescent female twins. J Child Psychol Psychiatry. 2001;42(7):933–942
  36. Neuman RJ, Todd RD, Heath AC, Reich W, Hudziak JJ, Bucholz KK, et al. Evaluation of ADHD typology in three contrasting samples: a latent class approach. J Am Acad Child Adolesc Psychiatry. 1999;38(1):25–33
  37. Rasmussen ER, Neuman RJ, Heath AC, Levy F, Hay DA, Todd RD. Replication of the latent class structure of attention-deficit/hyperactivity disorder (ADHD) subtypes in a sample of Australian twins. J Child Psychol Psychiatry. 2002;43(8):1018–1028
  38. Rasmussen ER, Neuman RJ, Heath AC, Levy F, Hay DA, Todd RD. Familial clustering of latent class and DSM-IV defined attention-deficit/hyperactivity disorder (ADHD) subtypes. J Child Psychol Psychiatry. 2004;45(3):589–598
  39. Rasmussen ER, Todd RD, Neuman RJ, Heath AC, Reich W, Rohde LA. Comparison of male adolescent-report of attention-deficit/hyperactivity disorder (ADHD) symptoms across two cultures using latent class and principal components analysis. J Child Psychol Psychiatry. 2002;43(6):797–805
  40. Rohde LA, Barbosa G, Polanczyk G, Eizirik M, Rasmussen ER, Neuman RJ, et al. Factor and latent class analysis of DSM-IVADHD symptoms in a school sample of Brazilian adolescents. J Am Acad Child Adolesc Psychiatry. 2001;40(6):711–718
  41. Nestadt G, Di CZ, Riddle MA, Grados MA, Greenberg BD, Fyer AJ, et al. Obsessive-compulsive disorder: subclassification based on co-morbidity. Psychol Med. 2008;2:1–11
  42. Althoff RR, Rettew DC, Boomsma DI, Hudziak JJ. Latent class analysis of the Child Behavior Checklist Obsessive-Compulsive Scale. Compr Psychiatry. 2009;50(6):584–592
  43. Katerberg H, Delucchi KL, Stewart SE, Lochner C, Denys D, Stack DE, et al. Symptom Dimensions in OCD: Item-Level Factor Analysis and Heritability Estimates. Behav Genet. 2010;40(4):505–517
  44. Stewart SE, Rosario MC, Baer L, Carter AS, Brown TA, Scharf JM, et al. Four-factor structure of obsessive-compulsive disorder symptoms in children, adolescents, and adults. J am Acad Child Adolesc Psychiatry. 2008;47(7):763–772
  45. Mataix-Cols D, Nakatani E, Micali N, Heyman I. Structure of obsessive-compulsive symptoms in pediatric OCD. J am Acad Child Adolesc Psychiatry. 2008;
  46. Cullen B, Brown CH, Riddle MA, Grados M, Bienvenu OJ, Hoehn-Saric R, et al. Factor analysis of the Yale-Brown Obsessive-Compulsive Scale in a family study of obsessive-compulsive disorder. Depress Anxiety. 2007;24(2):130–138
  47. Saxena S. Neurobiology and treatment of compulsive hoarding. CNS Spectr. 2008;13(9 Suppl 14):29–36
  48. Labad J, Menchon JM, Alonso P, Segalas C, Jimenez S, Jaurrieta N, et al. Gender differences in obsessive-compulsive symptom dimensions. Depress Anxiety. 2008;25(10):832–838
  49. Mathews CA, Nievergelt CM, Azzam A, Garrido H, Chavira DA, Wessel J, et al. Heritability and clinical features of multigenerational families with obsessive-compulsive disorder and hoarding. Am J Med Genet B Neuropsychiatr Genet. 2007;144(2):174–182
  50. Chavira DA, Garrido H, Bagnarello M, Azzam A, Reus VI, Mathews CA. A comparative study of obsessive-compulsive disorder in Costa Rica and the United States. Depress Anxiety. 2007;
  51. Stewart SE, Stack DE, Farrell C, Pauls DL, Jenike MA. Effectiveness of intensive residential treatment (IRT) for severe, refractory obsessive-compulsive disorder. J Psychiatr Res. 2005;39(6):603–609
  52. Goodman WK, Price LH, Rasmussen SA, Mazure C, Delgado P, Heninger GR, et al. The Yale-Brown Obsessive Compulsive Scale. II. Validity. Arch Gen Psychiatry. 1989;46(11):1012–1016
  53. Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, et al. The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability. Arch Gen Psychiatry. 1989;46(11):1006–1011
  54. Muthen LK, Muthen BO. MPLUS: statistical analyses with latent variables. 3rd ed. Los Angeles, CA: Muthen & Muthen; 2004;
  55. Schwarz G. Estimating dimension of a model. Ann Stat. 1978;6(2):461–464
  56. Akaike H. Stochastic theory of minimal realization. IEEE Trans Automatic Control. 1974;AC19(6):667–674
  57. Freyer T, Kloppel S, Tuscher O, Kordon A, Zurowski B, Kuelz AK, et al. Frontostriatal activation in patients with obsessive-compulsive disorder before and after cognitive behavioral therapy. Psychol Med. Mar 18;18:1-10.
  58. Deckersbach T, Dougherty DD, Rauch SL. Functional imaging of mood and anxiety disorders. J Neuroimaging. 2006;16(1):1–10
  59. Radua J, Mataix-Cols D. Voxel-wise meta-analysis of grey matter changes in obsessive-compulsive disorder. Br J Psychiatry. 2009;195(5):393–402
  60. Clifton A, Pilkonis PA. Evidence for a single latent class of Diagnostic and Statistical Manual of Mental Disorders borderline personality pathology. Compr Psychiatry. 2007;48(1):70–78
  61. Mauricio AM, Lopez FG. A latent classification of male batterers. Violence Vict. 2009;24(4):419–438
  62. Manley MJ, de Jonge P, Kershaw TS, Desai RA, Lin H, Kasl SV. Association of major depression with subtypes of nicotine dependence found among adult daily smokers: a latent class analysis. Drug Alcohol Depend. 2009;104(1-2):126–132

PII: S0010-440X(10)00077-5

doi: 10.1016/j.comppsych.2010.06.007

Comprehensive Psychiatry
Volume 52, Issue 3 , Pages 334-341 , May 2011

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