A Study Protocol in BMCPsychiatry discusses the OCDTWIN project of recruiting monozygotic twin pairs to understand the environmental risk factors in the causal pathway to obsessive compulsive disorder, some of which could become actionable targets.
], is still actively recruiting at a rate of approximately 3,000 new twins per year, providing a sustained source of potential study participants. Data collection will continue for at least the next two years. If we secure additional funds, we aim to continue recruiting participants beyond the planned 50 pairs, thus increasing statistical power. The study is currently limited to Swedish residents and to participants who are 16 years or older.
While the primary aim of OCDTWIN is the identification of environmental risk factors that are in the causal pathway to OCD, we will collect a wide range of exposures from birth , childhood , and up to the time of participation in the study . While the interpretation of results regarding early exposures will be relatively straightforward because these exposures will precede the onset of OCD symptoms, the interpretation of results based on more recent exposures will be more challenging.
There are additional challenges associated with the discordant MZ twin design. Our approach assumes that MZ twins are genetically identical. However, post-zygotic mutations are known to occur and can be specific to one twin in a pair [], which could explain OCD discordance in some pairs. On the other hand, this will provide a unique opportunity for genetic discovery. Another potential challenge is twin chorionicity, which is often unknown for adult twins.
The project is expected to generate many scientific outputs. All resulting papers will be deposited in preprint repositories to ensure immediate access to the scientific community. We will publish the results in specialized peer-reviewed journals that allow open access formats.
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