A discrimination based on autogenous versus reactive obsessions in obsessive-compulsive disorder and related clinical manifestations

Introduction: Although putative subtypes of obsessive-compulsive disorder (OCD) have been gradually more recognized, there is no generally accepted subtype discrimination. It has been suggested that autogenous and reactive obsessions stem from different cognitive process. This study aimed to assess existence of gender, age at onset of illness, and comorbidity differences in OCD patients suffering from autogenous and reactive obsessions. Methods: The medical records of 177 OCD patients were evaluated retrospectively for gender, age at onset, comorbid diagnoses, and predisposing life events. Obsessions and compulsions were coded according to theYale-Brown Obsessive-Compulsive Scale. All patients were grouped as the patients with autogenous (autogenous group [AG] n=32), reactive (reactive group [RG] n=77) and mixed obsessions (mixed group [MG] n=68). Results: AG patients were significantly more likely to be male, compared with the RG and MG patients. They also had significantly later onset of illness. Dissociative disorders were less common among AG patients compared with the other groups. Conclusion: Results suggest that the discrimination between autogenous and reactive obsessions are not only based on their development and maintenance mechanism through different cognitive process but that there also clinical manifestations of this discrimination.