Clinical Features, Psychiatric Comorbidities and Treatments in Childhood OCD in terms of OCD Severity, Age and Gender
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DOI:
https://doi.org/10.58600/eurjther2200Keywords:
Child, Adolescent, Obsessive-Compulsive Disorder, Comorbidity, PsychopharmacotherapyAbstract
Objective: The aim of this study was to investigate the clinical features, psychiatric comorbidities, and treatments of childhood obsessive-compulsive disorder (OCD), with consideration given to OCD severity, gender and age.
Method: The study included 104 children and adolescents between the ages of 6 and 17 who were diagnosed with OCD and followed up in Child and Adolescent Psychiatry outpatient clinics between 2016 and 2023. The study examined the sociodemographic characteristics, clinical features, comorbid psychiatric disorders, and treatment approaches of children and adolescents with OCD.
Results: The sample had a mean age of 13.1 ± 2.7 years, and the mean age at onset of OCD was 11.9 ± 2.7 years (range: 5-17 years). Those with mild OCD had a significantly lower mean age at presentation and onset of OCD compared to those with moderate and severe OCD (p=0.012, p=0.02, respectively). Patients with severe OCD had longer illness duration (p=0.009) and outpatient follow-up (p=0.004) compared to those with moderate OCD. Boys had significantly higher rates of family history of psychiatric disorders (p=0.006), attention-deficit/hyperactivity disorder/oppositional defiant disorder (p=0.003), and tic disorder (p=0.035) comorbidity rates than girls, while girls had higher rates of anxiety disorders (p=0.022) comorbidity. The study found that repeating and counting compulsions were more common in adolescents than in preadolescents (p=0.003, all).
Conclusion: These results suggest that clinical presentation and comorbidity may vary with disease severity, gender and age, in children and adolescents with OCD. Early intervention is crucial to prevent clinical progression, worsening, and mental health sequelae.
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References
Schuyler M, Geller DA (2023) Childhood Obsessive-Compulsive Disorder. Psychiatric Clinics. 46(1):89-106. https://doi.org/10.1016/j.psc.2022.10.002
American Psychiatric Association, DSM-5 Task Force (2013) Diagnostic and statistical manual of mental disorders: DSM-5™ (5th ed.). American Psychiatric Publishing, Inc. https://doi.org/10.1176/appi.books.9780890425596
Marras A, Fineberg N, Pallanti S (2016) Obsessive compulsive and related disorders: comparing DSM-5 and ICD-11. CNS spectrums. 21(4):324-33. https://doi.org/10.1017/S1092852916000110
Geller DA (2006) Obsessive-compulsive and spectrum disorders in children and adolescents. Psychiatric Clinics. 29(2):353-70. https://doi.org/10.1016/j.psc.2006.02.012
Geller D, Biederman J, Faraone SV, Frazier J, Coffey BJ, Kim G, Bellordre CA (2000)
Clinical correlates of obsessive compulsive disorder in children and adolescents referred to specialized and non-specialized clinical settings. Depression and Anxiety. 11(4):163-8. https://doi.org/10.1002/1520-6394(2000)11:4<163::AID-DA3>3.0.CO;2-3
Van Grootheest DS, Cath DC, Beekman AT, Boomsma DI (2005) Twin studies on obsessive-compulsive disorder: a review. Twin Research and Human Genetics. 8(5):450-8. https://doi.org/10.1375/183242705774310060
Gerald Nestadt, MD, MPH; Jack Samuels, PhD; Mark Riddle, MD; O. Joseph Bienvenu III, MD; Kung-Yee Liang, PhD; Michele LaBuda, PhD; John Walkup, MD; Marco Grados, MD; Rudolf Hoehn-Saric, MD (2000) A family study of obsessive-compulsive disorder. Archives of general psychiatry. 57(4):358-63. https://doi.org/10.1001/archpsyc.57.4.358
Taylor S (2011) Early versus late onset obsessive-compulsive disorder: evidence for distinct subtypes. Clinical psychology review. 31(7):1083-100. https://doi.org/10.1016/j.cpr.2011.06.007
Sharma E, Sharma LP, Balachander S, Lin B, Manohar H, Khanna P, Lu C, Garg K, Thomas TL, Au ACL, Selles RR, Højgaard DRMA, Skarphedinsson G, Stewart SE (2021) Comorbidities in obsessive-compulsive disorder across the lifespan: a systematic review and meta-analysis. Frontiers in psychiatry. 12:703701. https://doi.org/10.3389/fpsyt.2021.703701
Vivan AdS, Rodrigues L, Wendt G, Bicca MG, Braga DT, Cordioli AV (2013) Obsessive-compulsive symptoms and obsessive-compulsive disorder in adolescents: a population-based study. Brazilian Journal of Psychiatry. 36:111-8. https://doi.org/10.1590/1516-4446-2013-1113
Peris TS, Rozenman M, Bergman RL, Chang S, O'Neill J, Piacentini J (2017) Developmental and clinical predictors of comorbidity for youth with obsessive compulsive disorder. Journal of psychiatric research. 93:72-8. https://doi.org/10.1016/j.jpsychires.2017.05.002
Pittenger C (2023) The Pharmacological Treatment of Obsessive-Compulsive Disorder. Psychiatric Clinics. 46(1):107-19. https://doi.org/10.1016/j.psc.2022.11.005
Team POTSP (2004) Cognitive-behavior therapy, sertraline, and their combination for children and adolescents with obsessive-compulsive disorder: the Pediatric OCD Treatment Study (POTS) randomized controlled trial. Jama. 292(16):1969-76. https://doi.org/10.1001/jama.292.16.1969
Zai G, Barta C, Cath D, Eapen V, Geller D, Grünblatt E (2019) New insights and perspectives on the genetics of obsessive-compulsive disorder. Psychiatric genetics. 29(5):142-51. https://doi.org/10.1097/YPG.0000000000000230
Hollander E, Stein DJ, Fineberg NA, Marteau F, Legault M (2010) Quality of life outcomes in patients with obsessive-compulsive disorder: relationship to treatment response and symptom relapse. The Journal of clinical psychiatry. 71(6):16465. https://doi.org/10.4088/JCP.09m05911blu
Fineberg NA, Dell'Osso B, Albert U, Maina G, Geller D, Carmi L, Sireau N, Walitza S, Grassi G, Pallanti S, Hollander E, Brakoulias V, Menchon JM, Marazziti D, Ioannidis K, Apergis-Schoute A, Stein DJ, Cath DC, Veltman DJ, Van Ameringen M, Fontenelle LF, Shavitt RG, Costa D, Diniz JB, Zohar J (2019) Early intervention for obsessive compulsive disorder: an expert consensus statement. European Neuropsychopharmacology. 29(4):549-65. https://doi.org/10.1016/j.euroneuro.2019.02.002
Guy, W. (1976). ECDEU Assessment Manual for Psychopharmacology, Revised. US Department of Health, Education, and Welfare Publication (ADM). Rockville, MD: National Institute of Mental Health, 76-338.
Dalsgaard S, Thorsteinsson E, Trabjerg BB, Schullehner J, Plana-Ripoll O, Brikell I, Wimberley T, Thygesen M, Madsen KB, Timmerman A, Schendel D, McGrath JJ, Mortensen PB, Pedersen CB (2020) Incidence rates and cumulative incidences of the full spectrum of diagnosed mental disorders in childhood and adolescence. JAMA psychiatry. 77(2):155-64. https://doi.org/10.1001/jamapsychiatry.2019.3523
Mathis MA, Alvarenga Pd, Funaro G, Torresan RC, Moraes I, Torres AR, Zilberman ML, Hounie AG (2011) Gender differences in obsessive-compulsive disorder: a literature review. Brazilian Journal of Psychiatry. 33:390-9. https://doi.org/10.1590/s1516-44462011000400014
Hanna GL, Himle JA, Curtis GC, Gillespie BW (2005) A family study of obsessive-compulsive disorder with pediatric probands. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics. 134(1):13-9. https://doi.org/10.1002/ajmg.b.30138
Storch EA, Larson MJ, Merlo LJ, Keeley ML, Jacob ML, Geffken GR, Murphy TK& Goodman WK (2008) Comorbidity of pediatric obsessive-compulsive disorder and anxiety disorders: impact on symptom severity and impairment. Journal of Psychopathology and Behavioral Assessment. 30:111-20. https://doi.org/10.1007/s10862-007-9057-x
Storch EA, Merlo LJ, Larson MJ, Geffken GR, Lehmkuhl HD, Jacob ML, Murphy TK, Goodman WK (2008) Impact of comorbidity on cognitive-behavioral therapy response in pediatric obsessive-compulsive disorder. Journal of the American Academy of Child & Adolescent Psychiatry. 47(5):583-92. https://doi.org/10.1097/CHI.0b013e31816774b1
Sukhodolsky DG, do Rosario-Campos MC, Scahill L, Katsovich L, Pauls DL, Peterson BS, King RA, Lombroso PJ, Findley DB, Leckman JF (2005) Adaptive, emotional, and family functioning of children with obsessive-compulsive disorder and comorbid attention deficit hyperactivity disorder. American Journal of Psychiatry. 162(6):1125-32. https://doi.org/10.1176/appi.ajp.162.6.1125
Mancebo MC, Boisseau CL, Garnaat SL, Eisen JL, Greenberg BD, Sibrava NJ, Stout RL, Rasmussen SA (2014) Long-term course of pediatric obsessive-compulsive disorder: 3 years of prospective follow-up. Comprehensive Psychiatry. 55(7):1498-504. https://doi.org/10.1016/j.comppsych.2014.04.010
Farrell L, Barrett P, Piacentini J (2006) Obsessive-compulsive disorder across the developmental trajectory: clinical correlates in children, adolescents and adults. Behavior Change. 23(2):103-20. https://doi.org/10.1375/bech.23.2.103
Kenyon KM, Eaton WO (2015) Age at child obsessive-compulsive disorder onset and its relation to gender, symptom severity, and family functioning. Archives of Scientific Psychology. 3(1):150. https://doi.org/10.1037/arc0000022
Alvarenga PG, Cesar RC, Leckman JF, Moriyama TS, Torres AR, Bloch MH, Coughlin CG, Hoexter MQ, Manfro GG, Polanczyk GV, Miguel EC, do Rosario MC (2015) Obsessive-compulsive symptom dimensions in a population-based, cross-sectional sample of school-aged children. Journal of psychiatric research. 62:108-14 https://doi.org/10.1016/j.jpsychires.2015.01.018
Mathes BM, Morabito DM, Schmidt NB (2019) Epidemiological and clinical gender differences in OCD. Current psychiatry reports. 21:1-7 https://doi.org/10.1007/s11920-019-1015-2
Ivarsson T, Melin K, Wallin L (2008) Categorical and dimensional aspects of co-morbidity in obsessive-compulsive disorder (OCD). European child & adolescent psychiatry. 17:20-31 https://doi.org/10.1007/s00787-007-0626-z
Narayanaswamy JC, Viswanath B, Cherian AV, Math SB, Kandavel T, Reddy YJ (2012) Impact of age of onset of illness on clinical phenotype in OCD. Psychiatry research. 200(2-3):554-9. https://doi.org/10.1016/j.psychres.2012.03.037
Geller DA, Biederman J, Faraone S, Agranat A, Cradock K, Hagermoser L, Kim G, Frazier J, Coffey BJ (2001) Developmental aspects of obsessive compulsive disorder: findings in children, adolescents, and adults. The Journal of nervous and mental disease. 189(7):471-7. https://doi.org/10.1097/00005053-200107000-00009
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