Irritability in Children and Adolescents With OCD☆
Section snippets
procedures
This study was a secondary analysis from a randomized controlled trial of D-cycloserine or pill placebo augmented ERP (Storch et al., 2016). The institutional review boards at each participating site (Massachusetts General Hospital and University of South Florida) approved the trial. Written parental consent and child assent were obtained at an initial screening visit at which the Schedule for Affective Disorders and Schizophrenia for School-Age Children–Present and Lifetime Version (K-SADS-PL;
sample characteristics
Two-hundred and six parent-child dyads consented to participate in the study, with 161 being eligible for pretreatment analyses. Of those, 142 were randomized to D-cycloserine or pill placebo plus ERP and were included in treatment outcome analyses with CY-BOCS as a dependent variable. Follow-up irritability measures were not completed with the first 29 children who were randomized; thus, analyses using the irritability measure as an outcome included 113 participants. No significant differences
Discussion
The goal of this study was to investigate irritability in the clinical presentation and treatment of youth with OCD. Results replicate the broader literature (e.g., Brandes et al., 2019, Copeland et al., 2013, Evans et al., 2019, Shimshoni et al., 2020), finding that irritability was significantly associated with greater functional impairment, depressive symptoms, and defiant behavior, and extend these findings to youth with OCD. It was also found that families accommodated obsessive-compulsive
Conclusions
This study was the first to investigate irritability among children and adolescents with OCD. In line with the broader literature, irritable youth with OCD appear to experience more severe depressive symptoms, defiant behaviors, and functional impairment, supporting irritability as a marker of greater negative affectivity and psychopathology. Families also described more accommodation among irritable youth, highlighting the importance of caregiver involvement in CBT for this population.
Conflict of Interest Statement
Dr. Geller has received grant or research support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development subcontract with Duke Clinical Research Center Pediatric Trials Network, the National Institute of Mental Health, Biohaven Pharmaceuticals, Boehringer Ingelheim, Eli Lilly and Co., Forest Pharmaceuticals, GlaxoSmithKline, the International OCD Foundation, Neurocrine Biosciences, Nuvelution Pharma, Peace of Mind Foundation, Pfizer, Solvay, Syneos Health, Teva
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Cited by (8)
Whom are you mad at? Anger and revenge in obsessive-compulsive symptoms during adolescence
2022, Journal of Obsessive-Compulsive and Related DisordersCitation Excerpt :Suppressed anger was associated with doubting/checking and obsessing when depression was excluded from the model, but these relations disappeared when we accounted for depressive symptoms, in line with the results by Cludius et al. (2021) who found that anger suppression was higher in OC patients than controls without controlling for depression. Moreover, the relation between trait anger and the OC dimensions appears to be different from the findings of another study conducted on children and adolescents with OCD, showing no significant correlations between irritability and OC symptoms’ severity (Guzick et al., 2021), although irritability and anger cannot be considered interchangeable constructs. The full regression model, that included all anger and interpersonal motivations factors, confirmed the findings of the previous analyses such that trait anger was uniquely associated with all the OC symptom types.
Phasic Versus Tonic Irritability and Associations with Family Accommodation Among Youth with Selective Mutism: A Latent Profile Analysis
2024, Research on Child and Adolescent PsychopathologyFamily Accommodation in Pediatric Obsessive–Compulsive Disorder: Investigating Prevalence and Clinical Correlates in the NordLOTS Study
2023, Child Psychiatry and Human DevelopmentTourettic OCD: Current understanding and treatment challenges of a unique endophenotype
2022, Frontiers in Psychiatry
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We gratefully acknowledge the contributions of the following individuals to the original trial: Susan Sprich, Ph.D., Aude Henin, Ph.D., Jamie Micco, Ph.D., Joseph McGuire, Ph.D., P Jane Mutch, Ph.D., Monica Wu, Ph.D., Robert Selles, Ph.D., Adam B Lewin, Ph.D., ABPP, Allison Kennel, ARNP, Nicole McBride, Ph.D., Alyssa Faro, Ph.D., Kelsey Ramsay, Ashley Brown, Andrew MIttelman, Abigail Stark, Ph.D., Allison Cooperman, Angelina Gomez, Chelsea Ale, Ph.D., Kathleen Trainor, Ph.D., Cary Jordan, Ph.D., Christine Cooper-Vince, Ph.D., Anne Chosak, Ph.D., Noah Berman, Ph.D., Marco Grados, MD, Gary Geffken, Ph.D., Rebecca Betensky, Ph.D., Barbara Coffey, MD, Martin Franklin, Ph.D., Jennifer Britton, Ph.D., David Greenblatt, MD, and David Pauls, Ph.D. This study was funded by grants 1R01MH093381 (Dr. Storch) and 5R01MH093402 (Dr. Geller) from the National Institute of Mental Health (NIMH). The NIMH had no involvement in the study design, data collection, analysis and interpretation of data, the writing of this report, or in the decision to submit this article for publication. clinicaltrials.govIdentifier: NCT00864123.