Developmental and clinical predictors of comorbidity for youth with obsessive compulsive disorder☆
Section snippets
Participants
The full sample consisted of 322 youths presenting for services at a university-based program specializing in the treatment of child and adolescent OCD, anxiety, and tic disorders. The program provides both clinical and research services to youth with these conditions, and it is the primary treatment center in the region, with a catchment area of over 18 million people. Clinical services include an outpatient treatment clinic offering weekly evidence-based intervention using cognitive behavior
Results
Overall Rates of Comorbidity. The number of comorbid diagnoses in this sample ranged from zero to six (M = 1.15, SD = 1.16), with the percentage of youth meeting one (35%), two (18%), three (9%), four (3%), five (1%), and six (<1%) comorbid diagnoses decreasing as the number of comorbidities increased. As expected, the total number of comorbid diagnoses demonstrated small positive correlations with higher levels of OCD symptom severity on the CYBOCS (r = 0.14, p = 0.012) and CGI-S (r = 0.23, p
Discussion
This study examined patterns of comorbidity among a large sample of youth with primary OCD. Overall, age differences emerged such that older youth met criteria for a higher number of co-occurring disorders. As expected, adolescents in particular were more likely to have a co-occurring internalizing disorder compared to their younger counterparts. Somewhat surprisingly, adolescents were also more likely to have a comorbid externalizing disorder compared to either children or pre-adolescents.
References (53)
- et al.
Obsessive–compulsive disorder: influence of age at onset on comorbidity patterns
Eur. Psychiatry
(2008) - et al.
Comorbidity of juvenile obsessive-compulsive disorder with disruptive behavior disorders
J. Am. Acad. Child Adolesc. Psychiatry
(1996) Demographic and clinical features of obsessive-compulsive disorder in children and adolescents
J. Am. Acad. Child Adolesc. Psychiatry
(1995)- et al.
Prevalence, incidence, and comorbidity of clinically diagnosed obsessive–compulsive disorder in Taiwan: a national population-based study
Psychiatry Res.
(2014) - et al.
Preventive child health care findings on early childhood predict peer-group social status in early adolescence
J. Adolesc. Health
(2012) - et al.
Obsessive-compulsive disorder in childhood
J. Anxiety Disord.
(1989) - et al.
Comparison of clinical features among youth with tic disorders, obsessive–compulsive disorder (OCD), and both conditions
Psychiatry Res.
(2010) - et al.
Major depressive disorder in older adolescents: prevalence, risk factors, and clinical implications
Clin. Psychol. Rev.
(1998) - et al.
Comorbidity of obsessive-compulsive disorder and attention-deficit/hyperactivity disorder in referred children and adolescents
Compr. Psychiatry
(2006) - et al.
Lifetime prevalence of mental disorders in U.S. adolescents: results from the national comorbidity survey replication–adolescent supplement (NCS-A)
J. Am. Acad. Child Adolesc. Psychiatry
(2010)
Phenomenological and comorbid features associated in obsessive–compulsive disorder: influence of age of onset
J. Affect. Disord.
Controlled comparison of family cognitive behavioral therapy and psychoeducation/relaxation training for child obsessive-compulsive disorder
J. Am. Acad. Child Adolesc. Psychiatry
Obsessive compulsive disorder in children and adolescents: phenomenology and family history
J. Am. Acad. Child Adolesc. Psychiatry
Children's yale-brown obsessive compulsive scale: reliability and validity
J. Am. Acad. Child Adolesc. Psychiatry
Test-retest reliability of anxiety symptoms and diagnoses with the anxiety disorders interview Schedule for DSM-IV: child and parent versions
J. Am. Acad. Child Adolesc. Psychiatry
Psychometric evaluation of the Children's yale–brown obsessive-compulsive scale
Psychiatry Res.
Clinical features of children and adolescents with obsessive-compulsive disorder and hoarding symptoms
Compr. Psychiatry
Impact of comorbidity on cognitive-behavioral therapy response in pediatric obsessive-compulsive disorder
J. Am. Acad. Child Adolesc. Psychiatry
Depression in youth with obsessive-compulsive disorder: clinical phenomenology and correlates
Psychiatry Res.
Correlates of comorbid depression, anxiety and helplessness with obsessive–compulsive disorder in Chinese adolescents
J. Affect. Disord.
Psychopathology in children and adolescents with Tourette's syndrome: a controlled study
Brain Dev.
Adaptive interventions in child and adolescent mental health
J. Clin. Child Adolesc. Psychol.
Diagnostic and Statistical Manual of Mental Disorders
Diagnostic and Statistical Manual of Mental Disorders
Diagnostic and Statistical Manual of Mental Disorders
Mapping evidence-based treatments for children and adolescents: application of the distillation and matching model to 615 treatments from 322 randomized trials
J. Consult. Clin. Psychol.
Cited by (41)
The clinical presentation of major depressive disorder in youth with co-occurring obsessive-compulsive disorder
2024, Journal of Affective DisordersObsessive-compulsive disorder in youth and young adults with depression: Clinical characteristics of comorbid presentations
2023, Journal of Obsessive-Compulsive and Related DisordersA network perspective on cognitive function and obsessive-compulsive related symptoms
2023, Journal of Affective DisordersObsessive-Compulsive Disorder: Diagnosis, Clinical Features, Nosology, and Epidemiology
2023, Psychiatric Clinics of North AmericaCitation Excerpt :In adults, 60% to 90% of those with lifetime OCD meet lifetime criteria for at least one other mental disorder, with anxiety and depressive disorders being most common.21,22 In youth, 50% have co-occurring anxiety or depressive disorders and around 15% meet criteria for an externalizing condition (eg, oppositional defiant disorder).23 Rates of comorbidity varies, with higher rates generally found in clinical samples.22
Just let me check: The role of individual differences in self-reported anxiety and obsessive-compulsive features on subjective, behavioural, and physiological indices during a checking task
2022, International Journal of PsychophysiologyCitation Excerpt :Obsessive-compulsive disorder (OCD) and anxiety disorders are categorised in separate chapters of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, American Psychiatric Association, 2013). However, high comorbidity rates and symptom overlap may suggest shared underlying processes (Peris et al., 2017). For instance, both anxiety and OCD are characterised by safety behaviours including checking and reassurance seeking (American Psychiatric Association [APA], 2013).
Intervention cost-effectiveness for pediatric anxiety and OCD: A systematic review and integrated database model
2022, Journal of Affective Disorders
- ☆
This research was supported by grants from the International Obsessive Compulsive Foundation (Peris, Piacentini), NARSAD (Bergman, Peris); NIMH K23 MH085058 (Peris); R01 MH58549 (Piacentini); R01MH081864 (O'Neill, Piacentini, dual PIs); R34MH095885 (Chang) and T32 MH073517 (Piacentini). We gratefully acknowledge the contributions of the children, families, and program staff who have made this work possible.