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Predictors of early adulthood quality of life in children with obsessive–compulsive disorder

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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.

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References

  1. 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

    PubMed  CAS  Google Scholar 

  2. 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

    Article  PubMed  CAS  Google Scholar 

  3. 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

    Article  PubMed  Google Scholar 

  4. 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

    Article  PubMed  Google Scholar 

  5. 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

    Google Scholar 

  6. 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

    Google Scholar 

  7. Koran LM (2000) Quality of life in obsessive–compulsive disorder. Psychiatr Clin North Am 23:509–517

    Article  PubMed  CAS  Google Scholar 

  8. Moritz S (2008) A review on quality of life and depression in obsessive–compulsive disorder. CNS Spectr 13:16–22

    PubMed  Google Scholar 

  9. 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

    Article  PubMed  Google Scholar 

  10. 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

  11. 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

    Article  PubMed  CAS  Google Scholar 

  12. 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

    Article  PubMed  Google Scholar 

  13. 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

    PubMed  CAS  Google Scholar 

  14. 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

    Article  PubMed  Google Scholar 

  15. 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

    Article  PubMed  Google Scholar 

  16. 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

    Article  PubMed  CAS  Google Scholar 

  17. 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

    Article  PubMed  Google Scholar 

  18. 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

    PubMed  CAS  Google Scholar 

  19. 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

    PubMed  CAS  Google Scholar 

  20. 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

    Article  PubMed  CAS  Google Scholar 

  21. 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

    Article  PubMed  CAS  Google Scholar 

  22. Poznanski EO, Cook SC, Carroll BJ (1979) A depression rating scale for children. Pediatrics 64:442–450

    PubMed  CAS  Google Scholar 

  23. 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

    PubMed  CAS  Google Scholar 

  24. 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

    Article  PubMed  CAS  Google Scholar 

  25. 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

    Article  PubMed  CAS  Google Scholar 

  26. 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

    PubMed  CAS  Google Scholar 

  27. 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

    Article  PubMed  Google Scholar 

  28. Abramowitz JS (1997) Effectiveness of psychological and pharmacological treatments for obsessive–compulsive disorder: a quantitative review. J Consult Clin Psychol 65:44–52

    Article  PubMed  CAS  Google Scholar 

  29. 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

    PubMed  Google Scholar 

  30. 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

    Article  PubMed  Google Scholar 

  31. Mataix-Cols D, Rosario-Campos MC, Leckman JF (2005) A multidimensional model of obsessive–compulsive disorder. Am J Psychiatry 162:228–238

    Article  PubMed  Google Scholar 

  32. 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

    Article  PubMed  CAS  Google Scholar 

  33. Saxena S, Brody AL, Maidment KM, Baxter LR Jr (2007) Paroxetine treatment of compulsive hoarding. J Psychiatr Res 41:481–487

    Article  PubMed  Google Scholar 

  34. 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

    Article  PubMed  Google Scholar 

  35. 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

    Article  PubMed  Google Scholar 

  36. 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

    Article  PubMed  Google Scholar 

  37. 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

    Article  PubMed  Google Scholar 

  38. 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

    Google Scholar 

  39. 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

    Article  PubMed  CAS  Google Scholar 

  40. 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

    Google Scholar 

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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)

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The authors have no conflicts of interest to disclose.

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Correspondence to Michael H. Bloch.

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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

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