The place of obsessive-compulsive and related disorders in the compulsive-impulsive spectrum: A cluster-analytic study

Leonardo F. Fontenelle, Louise Destrée, Mary Ellen Brierley, Emma M. Thompson, Murat Yücel, Rico Lee, Lucy Albertella, Sam R. Chamberlain

Research output: Contribution to journalArticleResearchpeer-review


Objective: The extent to which obsessive-compulsive and related disorders (OCRDs) are impulsive, compulsive or both requires further investigation. We investigated the existence of compulsive, impulsive, and compulsive-impulsive clusters in an online non-clinical sample and in which groups DSM-5 OCRDs and other related psychopathological symptoms are best placed. Methods: 774 adult participants completed online questionnaires including the Cambridge-Chicago Compulsivity Trait Scale (CHI-T), the Barratt Impulsiveness Scale (BIS-11), and a series of DSM-5 OCRDs symptom severity and other psychopathological measures. We used K-means cluster analysis using CHIT and BIS responses to test three and four factor solutions. Next, we investigated whether different OCRDs and other psychopathological symptoms predicted cluster membership using a multinomial regression model. Results: The best solution identified one “healthy” and three “clinical” clusters (i.e. one predominantly “compulsive” group, one predominantly “impulsive” group, and one “mixed - “compulsive and impulsive group”). A multinomial regression model found obsessive-compulsive, body dysmorphic, and schizotypal symptoms to be associated with the “mixed” and the “compulsive” clusters, and hoarding and emotional symptoms to be related, on a trend level, to the “impulsive” cluster. Additional analysis showed cognitive-perceptual schizotypal symptoms to be associated with the “mixed” but not the “compulsive” group. Conclusions: Our findings suggest that obsessive-compulsive disorder; body dysmorphic disorder and schizotypal symptoms can be mapped across the “compulsive” and “mixed” clusters of the compulsive-impulsive spectrum. Although there was a trend towards hoarding disorder symptoms being associated with the “impulsive” group, trichotillomania and skin picking disorder symptoms did not clearly fit to the demarcated clusters.

Original languageEnglish
Number of pages10
JournalCNS Spectrums
Publication statusAccepted/In press - 2021


  • Body dysmorphic disorder
  • Compulsivity
  • Hoarding disorder
  • Impulsivity
  • Neurodermatitis
  • Obsessive-compulsive disorder
  • Trichotillomania

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