Abstract
Twenty-eight adult males and 19 females with childhood obsessive-compulsive disorder (OCD) were followed-up in young adulthood, six to 22 years after their first referral, and their social outcome was described. The overall, social outcome was illustrated with The Global Assessment Scale (GAS). Ten patients (21.2%) had a poor outcome with GAS-scores under 50; 19 patients (40.4%) had a GAS-score between 50 and 70; and 18 (38.3%) of the patients had a good prognosis with GAS-scores over 70. Childhood OCD-patients were more socially isolated in adulthood than a non-OCD psychiatric comparison group and an age and sex standardised group from the normal population: more still lived with their parents, and fewer had partnerships. Seventeen percent had been granted disability pension, which was significantly different from the normal population, but not from that of the psychiatric comparison group. Age of onset of OCD, social background factors, and symptomatology in childhood did not seem to predict the social outcome. OCD at follow-up was strongly associated with a poor outcome.
Résumé
Les troubles obsessifs-compulsifs chez les enfants et les adolescents. Une étude de suivi de 6 à 22 ans du devenir social.
28 hommes adultes et 19 femmes avec des troubles obsessifs-compulsifs de l'enfant (OCD) furent suivis en tant que jeunes adultes de 6 à 22 ans après leur première consultation et leur devenir social fut décrit. Le devenir social global fut apprécié par le Global Assessment Scale (GAS). 10 patients (21.2%) avaient un devenir pauvre avec un GAS score en dessous de 50; 19 patients (40.4%) avaient un score GAS au-dessus de 70. Les patients ayant des TOC depuis l'enfance étaient plus isolés socialement en tant qu'adultes que le groupe de comparaison psychiatrique non OCD ainsi qu'avec un groupe standardisé, en fonction de l'âge et du sexe, d'une population normale: davantage vivent encore chez leur parents et peu ont des partenaires. 70% avaient une allocation handicapée, ce qui était significativement différente de la population normale, mais de celle du groupe de comparaison psychiatrique. L'âge du début de l'OCD, les facteurs d'environnement social et la Symptomatologie dans l'enfance ne semblent pas prédire le devenir social. L'OCD est ainsi fortement associé avec un devenir pauvre.
Zusammenfassung
28 männliche und 19 weibliche Erwachsene mit Zwangsstörungen im Kindesalter wurden im jungen Erwachsenenalter 6 bis 22 Jahre nach der Erstvorstellung nachuntersucht und ihre soziale Entwicklung evaluiert. Die Global Assessment Scale (GAS) wurde zur Evaluation des all-gemeinen Sozialprognose herangezogen. 10 Patienten (21.2%) hatten eine schlechte soziale Entwicklung genommen mit GAS-Werten unter 50; 19 Patienten (40.4%) hatten einen GAS-Wert zwischen 50 und 70; 18 (28.3%) der Patienten hatten eine gute Prognose mit GAS-Wer-ten über 70. Die Patienten mit Zwangsstörungen im Kindesalter waren im Erwachsenenalter stärker sozial isoliert als eine psychiatrische Kontrollgruppe und eine nach Alter und Geschlecht parallelisierte Gruppe aus der Normalbevölkerung: aus der Patientengruppe lebten mehr noch bei ihren Eltern, und weniger hatten Partnerschaften. 17% waren berentet worden, was sich signifikant von der Normalbevölkerung unterschied, jedoch nicht von der psychiatrischen Kontrollgruppe. Das Alter zu Beginn der Zwangsstörung, soziale Hintergrundfaktoren und die Symptomatologie im Kindesalter schienen keinen Einfluß auf die Sozialprognose zu haben. Das Fortbestehen der Zwangsstörung zum Katamnesezeitpunkt war stark mit einer schlechten Prognose assoziiert.
Similar content being viewed by others
References
Allsopp, M. & Verduyn, C. (1990). Adolescents with obsessive-compulsive disorder: a case note review of consecutive patients referred to a provincial regional adolescent psychiatry unit.Journal of Adolescence, 13, 157–169.
American Psychiatric Association. (1980).Diagnostic and Statistical Manual of Mental Disorders (3rd ed.). Washington DC: APA.
Armitage, P. & Berry, G. (1987).Statistical methods in medical research (2nd ed.). Victoria, Australia: Blackwell Scinetific Publications.
Berg, C.J., Rapoport, J.L., Whitaker, A., Davies, M., Leonard, H.L., Swedo, S.E., Braiman, S. & Lenane, M. (1989). Childhood obsessive-compulsive disorder: A two-year prospective follow-up of a community sample.Journal of the American Academy of Child and Adolescent Psychiatry, 28, 528–533.
Black, A. (1974). The natural history of obsessional neurosis. In Beech, H.R. (ed).Obsessional states. (pp. 19–54). London: Methuen and Co.
Denmark's Statistics (1992 a).Statistical ten-year review. Copenhagen: Denmark's Statistics.
Denmark's Statistics (1992 b).Living conditions in Denmark. Compendium of Statistics 1992. Aarhus: Denmark's Statistics, Socialforskningsinstituttet.
Endicott, J., Spitzer, R.L., Fleiss, J.L. & Cohen, J. (1976). The Global Assessment Scale. A procedure for measuring overall severity of psychiatric disturbance.Archives of General Psychiatry, 33, 766–771.
Flament, M.F., Whitaker, A., Rapoport, J.L., Davies, M., Berg, C., Kalikow, K., Sceery, W. & Shaffer, D. (1988). Obsessive-compulsive disorder in adolescence. An epidemiological study.Journal of the American Academy of Child and Adolescent Psychiatry, 21, 764–771.
Flament, M.F., Koby, E., Rapoport, J.L., Berg, C.J., Zahn, T., Cox, C., Denckla, M. & Lenane, M. (1990). Childhood obsessive-compulsive disorder: A prospective follow-up study.Journal of Child Psychology and Psychiatry, 31, 363–380.
Goodman, W.K., Lawrence, H.P., R_asmussen, S.A., Mazure, C., Fleischmann, R.L., Hill, C.L., Heninger, G.R. & Charney, D.S. (1989a). The YaleBrown Obsessive-Compulsive scale. I. Development, use, and reliability.Archives of General Psychiatry, 46, 1006–1011.
Goodman, W.K., Lawrence, H.P., Rasmussen, S.A., Mazure, C., Delgado, P., Heninger, G.R. & Charney, D.S. (1989b). The Yale-Brown Obsessive-Compulsive scale. II. Validity.Archives of General Psychiatry, 46, 1012–1016.
Goodwin, D.W., Guze, S.B. & Robins, E. (1969). Followup studies in obsessional neurosis.Archives of General Psychiatry, 20, 182–187.
Hansen, E.J. (1984).Social groups in Denmark (in Danish). Copenhagen: Socialforskningsinstituttet.
Hollingsworth, C.E., Tangnay, P.E., Grossmann, L. & Pabst, P. (1980). Long-term outcome of obsessive compulsive disorder in childhood.Journal of the American Academy of Child Psychiatry, 19, 134–144.
Ingram, I.M. (1961). Obsessional illness in mental hospital patients.Journal of Mental Science, 107, 382–402.
Institute of Psychiatric Demography.Annuals 1970–1992. Aarhus: Institute of Psychiatric Demography.
Kringlen, E. (1965). Obsessional neurotics: a long-term follow-up.British Journal of Psychiatry, 111, 709–722.
Leonard, H.L., Swedo, S.E., Lenane, M.C., Rettew, D.C., Hamburger, S.D., Bartko, J.J. & Rapoport, J.L. (1993). A two to seven year follow-up study of 54 obsessive compulsive children and adolescents.Archives of General Psychiatry, 50, 429–439.
Munk-Jørgensen, P., Kastrup, M. & Mortensen, P.B. (1993). The Danish psychiatric register as a tool in epidemiology.Acta Psychiatrica Scandinavica, suppl 370, 27–32.
Nie, N.H., Hull, C.H., Jenkins, J.G., Steinbrenner, K. & Bent, D.H. (1975).SPSS: Statistical Package for the social sciences. 2nd edition. New York: McGraw-Hill.
Schaffer, D., Gould, M.S., Brasic, J., Ambrosini, P., Fisher, P., Bird, H. & Aluwahlia, S. (1983). A children's global assessment scale (CGAS).Archives of General Psychiatry, 40, 1228–1231.
Spitzer, R.L., Williams, J.B.W., Gibbon, M. & First, M. (1987).Structured Clinical Interview for DSM-3-R personality disorders (SCID-II). New York: Biometrics Research, New York State Psychiatric Institute.
Steinhausen, H.C. (1987). Global assessment of childhood psychopathology.Journal of the American Academy of Child and Adolescent Psychiatry, 26, 203–206.
Thomsen, P.H. (1994). Obsessive-compulsive disorder in children and adolescents. A 6–22 year follow-up study. Clinical descriptions.European Child ani Adolescent Psychiatry, 3, 82–96
Thomsen, P.H. & Jensen, J. (1991). Latent class analysis of organic aspects of obsessive-compulsive disorder in children and adolescents.Acta Psychiatrica Scandinavica, 84, 391–395.
Thomsen, P.H. & Jensen, J. (1994). Obsessive-compulsive disorder. Admission patterns and diagnostic stability. A registerbased study.Acta Psychiatrica Scandinavica, 90, 19–24.
Thomsen, P.H. & Mikkelsen, H.U. (1991). Children and adolescents with obsessive-compulsive disorder The demographic and diagnostic characteristics of 61 Danish patients.Ada Psychiatrica Scandinavica, 83, 262–266.
Thomsen, P.H. & Mikkelsen, H.U. (1993). Development of personality disorders in children and adolescents with obsessive-compulsive disorder. A 6-to 22-year follow-up study.Ada Psychiatrica Scandinavia, 87, 456–462.
Warren, W. (1960). Some relationships between the psychiatry of children and of adults.Journal of Mental Science, 106, 815–826.
Wechsler, D. (1974).Manual for the Wechsler Intelligent Scale for Children (Revised). New York: The Pychological Corporation.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Thomsen, P.H. Obsessive-compulsive disorder in children and adolescents. A 6–22 year follow-up study of social outcome. European Child & Adolescent Psychiatry 4, 112–122 (1995). https://doi.org/10.1007/BF01977739
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01977739