Trans-cultural aspects of obsessive-compulsive disorder: A description of a Brazilian sample and a systematic review of international clinical studies

Little is known about the extent and the mechanisms through which culture may affect the clinical manifestations of obsessive-compulsive disorder (OCD). In this study, our objective was to identify culture-related symptomatological patterns in OCD. We described the socio-demographic and phenomenological characteristics of 101 adult patients with OCD seen at an university clinic for anxiety and depressive disorders in Rio de Janeiro, Brazil, and compared them with those reported in 15 clinical samples from North and Latin America, Europe, Africa, and Asia identified through a systematic review in MEDLINE, PsychINFO, and LILACS. Patients with OCD were almost universally characterized by: (1) a predominance of females, (2) a relatively early age of onset, and (3) a preponderance of mixed obsessions and compulsions. In contrast, a predominance of aggressive and religious obsessions was found only in Brazilian and Middle Eastern samples, respectively. The core features of OCD are probably relatively independent of cultural variations. The sole exception to this rule seems to be the content of the obsessions, in which cultural factors may play a significant role.