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OCD, PTSD symptoms overlap

Findings published in Psychiatry Research revealed significant overlap between self-reported PTSD and obsessive-compulsive disorder symptoms.

“Numerous case studies have documented the co-occurrence of these disorders following exposure to a traumatic event,” C. Laurel Franklin, PhD, and Amanda M. Raines, PhD, of the Southeast Louisiana Veterans Health Care System in New Orleans and the Tulane University School of Medicine, wrote. “One possibility for the high degree of co-occurrence between these two disorders is symptom similarity.”

Franklin and Raines examined symptom endorsement and overlap between OCD and PTSD in 117 trauma-exposed veterans.

At a VA hospital, participants were administered self-report assessments — such as the Dimensional Obsessive-Compulsive Scale (DOCS) and the PTSD Checklist for DSM-5 (PCL-5) — as part of a routine clinical care. For analysis, the researchers first examined rates of PTSD, OCD and co-occurring PTSD/OCD using clinical cut scores on self-report measures, then calculated a series of correlations for the PCL-5 total score, DOCS total score and DOCS subscale scores, and lastly paired DOCS and PCL-5 items for similarity in item content.

Based on self-report assessment of clinical cut scores, the results showed that 81% of veterans met for probable PTSD and 74% met for OCD. Chi square analyses also revealed frequent overlap of endorsement across items with similar content, according to the findings.

Using Pearson product-moment correlation, Franklin and Raines found a strong positive association between PCL-5 and DOCS total scores (r = 0.6; P < .001), which remained significant after controlling for self-report depressive symptom severity (r = 0.48; P < .001). In addition, they reported links between PCL-5 total scores and DOCS subscales scores: contamination concerns (r = 0.32; P = .002); responsibility for harm (r = 0.55; P < .001); unacceptable thoughts (r = 0.71; P < .001); and symmetry concerns (r = 0.42; P < .001).

“To our knowledge, this study is the first to explore symptom overlap using an outpatient sample of veterans and self-report scales that more accurately assess the constructs of interest,” Franklin and Raines wrote. “Given the significant overlap, caution should be used when using self-report solely to assess PTSD and OCD particularly in traumatized samples.” – by Savannah Demko

Disclosure: The authors report no relevant financial disclosures.