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Immune Dysfunction in Obsessive-Compulsive Disorder: From Risk Factors to Multisystem Involvement

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Abstract

Immune dysfunction has been proposed as an important component of the pathophysiology of obsessive-compulsive disorder (OCD), motivating innovative research hypotheses with potential clinical interest. In this chapter, we will review published evidence supporting a model for immune dysfunction in OCD as multifactorial, constitutive, and environmental, contributing to illness development, clinical presentation, and multisystem impact. The fact that OCD patients present comorbidity with several systemic illnesses, including auto-immune disorders, and that the majority of recognized risk factors, such as perinatal complications, traumatic life events or childhood infections, induce inflammation, motivated the development of studies trying to achieve a deeper comprehension regarding the association between inflammation and OCD. While case-control studies demonstrated an increase in different inflammatory and oxidative markers, studies evaluating genetic determinants suggested that immunogenetic risk may also be a source of vulnerability for OCD. Lastly, animal models have been contributing to a deeper understanding of the biological mechanisms underlying immune changes in OCD, focusing on the role of microglia and central nervous system (CNS) infections. Thus, similarly to other psychiatric illnesses, systemic dysregulation of the immune system is an important mechanism in OCD pathophysiology, reflecting genetic variability, environmental insults, or the behavioral and socioeconomic impact of the disorder. A better comprehension of immune dysfunction in OCD may ultimately promote the development of novel prevention, diagnosis, and treatment techniques, potentially leading to improved care and quality of life for these patients.

Keywords

  • Obsessive-compulsive disorder
  • Immune-psychiatry
  • Infection
  • Childhood trauma
  • Autoimmunity
  • Immune dysfunction

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Fig. 17.1

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Maia, A., Barahona-Corrêa, B., Oliveira-Maia, A.J., Oliveira, J. (2021). Immune Dysfunction in Obsessive-Compulsive Disorder: From Risk Factors to Multisystem Involvement. In: Berk, M., Leboyer, M., Sommer, I.E. (eds) Immuno-Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-030-71229-7_17

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