Are there different subtypes of obsessive-compulsive disorder (OCD)?
Since I started treating and researching OCD, my colleagues and I have assumed that OCD is heterogeneous. We have searched for different homogeneous subtypes that could be based upon clinical characteristics or biologic markers. When I developed the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) with Steven A. Rasmussen, MD, and Larry H. Price, MD, it was believed that the content of OCD was relatively unimportant. We concentrated more on the underlying processes. That is, we felt that the fact that a patient has obsessions, compulsions, and recurring disturbing thoughts and behaviors that are difficult to control is more important than the specific nature of his or her symptoms. Over time, however, a number of researchers, including James Leckman, MD, at Yale, have introduced the idea that subtypes that are determined by content may actually have biologic importance and may be determined in part genetically. Currently, we do consider different clinical subtypes of OCD.
