Abstract
Objectives
The goal of this study was to determine childhood clinical predictors of quality of life (QoL) in early adulthood in children with obsessive–compulsive disorder (OCD).
Methods
A longitudinal cohort study was conducted with 36 (out of 62 eligible) children with OCD, interviewed once at childhood baseline (mean age 12.1 ± 2.1, range 8.0–15.8), and again in early adulthood after an average follow-up interval of 9 years. QoL was measured in adulthood with the longitudinal interval follow-up evaluation range of impaired functioning tool (LIFE-RIFT).
Results
Forty-two percent of children experienced a remission of OCD symptoms by early adulthood. OCD appeared to most strongly impair the interpersonal relationships and work domains of QoL. QoL and severity of OCD and anxiety symptoms were significantly associated in early adulthood. Primary hoarding symptoms in childhood predicted poor QoL in adulthood. Increased symptoms in the forbidden thoughts dimension in both childhood and adulthood were associated with improved adulthood QoL.
Conclusions
Children for whom OCD symptoms remitted by adulthood showed no evidence of residual impairment in QoL, whereas children whose OCD symptoms failed to remit by adulthood showed at most mild impairment in QoL. Hoarding symptoms in childhood appear to portend not only the persistence of OCD symptoms but also poorer QoL in early adulthood.
Similar content being viewed by others
References
Karno M, Golding JM, Sorenson SB, Burnam MA (1988) The epidemiology of obsessive–compulsive disorder in five US communities. Arch Gen Psychiatry 45:1094–1099
Valleni-Basile LA, Garrison CZ, Jackson KL, Waller JL, McKeown RE, Addy CL, Cuffe SP (1994) Frequency of obsessive–compulsive disorder in a community sample of young adolescents. J Am Acad Child Adolesc Psychiatry 33:782–791
Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry 62:593–602
Freeman JB, Choate-Summers ML, Moore PS, Garcia AM, Sapyta JJ, Leonard HL, Franklin ME (2007) Cognitive behavioral treatment for young children with obsessive–compulsive disorder. Biol Psychiatry 61:337–343
Lack CW, Storch EA, Keeley ML, Geffken GR, Ricketts ED, Murphy TK, Goodman WK (2009) Quality of life in children and adolescents with obsessive–compulsive disorder: base rates, parent-child agreement, and clinical correlates. Soc Psychiatry Psychiatr Epidemiol 44:935–942
Murray C, Lopez A (1996) The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Harvard University Press, Cambridge
Koran LM (2000) Quality of life in obsessive–compulsive disorder. Psychiatr Clin North Am 23:509–517
Moritz S (2008) A review on quality of life and depression in obsessive–compulsive disorder. CNS Spectr 13:16–22
Moritz S, Rufer M, Fricke S, Karow A, Morfeld M, Jelinek L, Jacobsen D (2005) Quality of life in obsessive–compulsive disorder before and after treatment. Compr Psychiatry 46:453–459
Pediatric OCD Treatment Study (POTS) Team (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 292:1969–1976
Stewart S, Geller D, Jenike M, Pauls D, Shaw D, Mullin B, Faraone S (2004) Long-term outcome of pediatric obsessive–compulsive disorder: a meta-analysis and qualitative review of the literature. Acta Psychiatr Scand 110:4–13
Bloch MH, Craiglow BG, Landeros-Weisenberger A, Dombrowski PA, Panza KE, Peterson BS, Leckman JF (2009) Predictors of early adult outcomes in pediatric-onset obsessive–compulsive disorder. Pediatrics 124:1085–1093
Mataix-Cols D, Rauch SL, Manzo PA, Jenike MA, Baer L (1999) Use of factor-analyzed symptom dimensions to predict outcome with serotonin reuptake inhibitors and placebo in the treatment of obsessive–compulsive disorder. Am J Psychiatry 156:1409–1416
Mataix-Cols D, Marks IM, Greist JH, Kobak KA, Baer L (2002) Obsessive–compulsive symptom dimensions as predictors of compliance with and response to behaviour therapy: results from a controlled trial. Psychother Psychosom 71:255–262
Mataix-Cols D, Nakatani E, Micali N, Heyman I (2008) Structure of obsessive–compulsive symptoms in pediatric OCD. J Am Acad Child Adolesc Psychiatry 47:773–778
Bloch MH, Landeros-Weisenberger A, Kelmendi B, Coric V, Bracken MB, Leckman JF (2006) A systematic review: antipsychotic augmentation with treatment refractory obsessive–compulsive disorder. Mol Psychiatry 11:622–632
March JS, Franklin ME, Leonard H, Garcia A, Moore P, Freeman J, Foa E (2007) Tics moderate treatment outcome with sertraline but not cognitive-behavior therapy in pediatric obsessive–compulsive disorder. Biol Psychiatry 61:344–347
Leckman JF, Sholomskas D, Thompson WD, Belanger A, Weissman MM (1982) Best estimate of lifetime psychiatric diagnosis: a methodological study. Arch Gen Psychiatry 39:879–883
Pauls DL, Alsobrook JP 2nd, Goodman W, Rasmussen S, Leckman JF (1995) A family study of obsessive–compulsive disorder. Am J Psychiatry 152:76–84
Leckman JF, Riddle MA, Hardin MT, Ort SI, Swartz KL, Stevenson J, Cohen DJ (1989) The Yale Global Tic Severity Scale: initial testing of a clinician-rated scale of tic severity. J Am Acad Child Adolesc Psychiatry 28:566–573
Scahill L, Riddle MA, McSwiggin-Hardin M, Ort SI, King RA, Goodman WK, Cicchetti D, Leckman JF (1997) Children’s Yale-Brown Obsessive Compulsive Scale: reliability and validity. J Am Acad Child Adolesc Psychiatry 36:844–852
Poznanski EO, Cook SC, Carroll BJ (1979) A depression rating scale for children. Pediatrics 64:442–450
Leckman JF, Grice DE, Boardman J, Zhang H, Vitale A, Bondi C, Alsobrook J, Peterson BS, Cohen DJ, Rasmussen SA, Goodman WK, McDougle CJ, Pauls DL (1997) Symptoms of obsessive–compulsive disorder. Am J Psychiatry 154:911–917
Rosario-Campos MC, Miguel EC, Quatrano S, Chacon P, Ferrao Y, Findley D, Katsovich L, Scahill L, King RA, Woody SR, Tolin D, Hollander E, Kano Y, Leckman JF (2006) The Dimensional Yale-Brown Obsessive–Compulsive Scale (DY-BOCS): an instrument for assessing obsessive–compulsive symptom dimensions. Mol Psychiatry 11:495–504
Leon AC, Solomon DA, Mueller TI, Turvey CL, Endicott J, Keller MB (1999) The range of impaired functioning tool (LIFE-RIFT): a brief measure of functional impairment. Psychol Med 29:869–878
Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, Heninger GR, Charney DS (1989) The Yale-Brown Obsessive Compulsive Scale I. Development, use, and reliability. Arch Gen Psychiatry 46:1006–1011
Bloch MH, Landeros-Weisenberger A, Rosario MC, Pittenger C, Leckman JF (2008) Meta-analysis of the symptom structure of obsessive–compulsive disorder. Am J Psychiatry 165:1532–1542
Abramowitz JS (1997) Effectiveness of psychological and pharmacological treatments for obsessive–compulsive disorder: a quantitative review. J Consult Clin Psychol 65:44–52
Saxena S, Maidment KM, Vapnik T, Golden G, Rishwain T, Rosen RM, Tarlow G, Bystritsky A (2002) Obsessive–compulsive hoarding: symptom severity and response to multimodal treatment. J Clin Psychiatry 63:21–27
Masi G, Millepiedi S, Mucci M, Bertini N, Milantoni L, Arcangeli F (2005) A naturalistic study of referred children and adolescents with obsessive–compulsive disorder. J Am Acad Child Adolesc Psychiatry 44:673–681
Mataix-Cols D, Rosario-Campos MC, Leckman JF (2005) A multidimensional model of obsessive–compulsive disorder. Am J Psychiatry 162:228–238
Rufer M, Fricke S, Moritz S, Kloss M, Hand I (2006) Symptom dimensions in obsessive–compulsive disorder: prediction of cognitive-behavior therapy outcome. Acta Psychiatr Scand 113:440–446
Saxena S, Brody AL, Maidment KM, Baxter LR Jr (2007) Paroxetine treatment of compulsive hoarding. J Psychiatr Res 41:481–487
Stein DJ, Andersen EW, Overo KF (2007) Response of symptom dimensions in obsessive–compulsive disorder to treatment with citalopram or placebo. Rev Bras Psiquiatr 29:303–307
Delorme R, Bille A, Betancur C, Mathieu F, Chabane N, Mouren-Simeoni MC, Leboyer M (2006) Exploratory analysis of obsessive compulsive symptom dimensions in children and adolescents: a prospective follow-up study. BMC Psychiatry 6:1
McKay D, Piacentini J, Greisberg S, Graae F, Jaffer M, Miller J (2006) The structure of childhood obsessions and compulsions: dimensions in an outpatient sample. Behav Res Ther 44:137–146
Stewart SE, Rosario MC, Brown TA, Carter AS, Leckman JF, Sukhodolsky D, Katsovitch L, King R, Geller D, Pauls DL (2007) Principal components analysis of obsessive–compulsive disorder symptoms in children and adolescents. Biol Psychiatry 61:285–291
Eisen JL, Greenberg BD, Mancebo M, Pinto A, Rasmussen S, Marsland R, Orphanides A, Dyck I, Stout R (2006) OCD Subtypes. American Psychiatric Association, Toronto
Nestadt G, Samuels J, Riddle M, Bienvenu OJ 3rd, Liang KY, LaBuda M, Walkup J, Grados M, Hoehn-Saric R (2000) A family study of obsessive–compulsive disorder. Arch Gen Psychiatry 57:358–363
Landeros-Weisenberger A, Bloch MH, Kelmendi B, Wegner R, Nudel J, Dombrowski P, Pittenger C, Krystal JH, Goodman WK, Leckman JF, Coric V (2009) Dimensional predictors of response to SRI pharmacotherapy in obsessive–compulsive disorder. J Affect Disord 121:175–179
Acknowledgments
The authors acknowledge the National Institute of Mental Health support of the Yale Child Study Center Research Training Program (MHB, JFL), K05MH076273 (JFL), K02MH074677 (BSP), R01MH068318 (BSP), the National Institutes of Health Loan Repayment Program (MHB), the support of the Tourette’s Syndrome Association Inc. (JFL, MHB), the APIRE/Eli Lilly Psychiatric Research Fellowship (MHB), the AACAP/Eli Lilly Pilot Research Award (MHB), the Trichotillomania Learning Center Research Award (MHB), NARSAD Young Investigator Award (MHB) and the APA/NIMH PMRTP Program (ALW)
Conflict of interest statement
The authors have no conflicts of interest to disclose.
Author information
Authors and Affiliations
Corresponding author
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Palermo, S.D., Bloch, M.H., Craiglow, B. et al. Predictors of early adulthood quality of life in children with obsessive–compulsive disorder. Soc Psychiatry Psychiatr Epidemiol 46, 291–297 (2011). https://doi.org/10.1007/s00127-010-0194-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00127-010-0194-2