Childhood Obsessive–Compulsive Disorder in the NIMH MECA Study: Parent Versus Child Identification of Cases

doi:10.1016/S0887-6185(00)00048-7

Journal of Anxiety Disorders

Volume 14, Issue 6, November–December 2000, Pages 535-548

https://doi.org/10.1016/S0887-6185(00)00048-7 Get rights and content

Abstract

Because as many as 50% of obsessive–compulsive disorder (OCD) cases have had onset by age 15, interest in its detection in childhood is strong. Clinical experience indicates that children often try to keep their OCD secret and that parental report may give marked underestimates. The authors examined the prevalence of childhood OCD in the NIMH Methods for the Epidemiology of Child and Adolescent Mental Disorders (MECA) Study, a four-site community survey which allowed comparison of both parent and child report of the child's OCD and related symptoms and disorders. OCD cases, based on structured interviews (DISC-2.3 with DSM-III-R criteria) with 1,285 caretaker-child pairs, were identified separately for parent and child (aged 9 through 17) informants from the MECA database. Cases were then examined for demographic characteristics, for obsessive–compulsive symptoms and other diagnoses reported in cases “missed” by one reporter, and for comorbid disorders. Of a total of 35 (2.7%) identified cases, four (0.3%) were identified by the parent and 32 (2.5%) were identified by the child, with only one overlapping case. In general, when OCD cases were “missed” by one reporter, that reporter did not substitute another disorder. These findings support clinical data that children with OCD often hide their illness and underscore the importance of child interviews for its detection.

Section snippets

Method

The NIMH MECA Study was a four-site project used to develop methods for surveys of mental disorder and service utilization in unscreened population-based samples of children and adolescents aged 9 through 17 years. As part of the project, a total of 1,285 pairs of youths and their adult caretakers (90% were the biological mother) were administered a computer-assisted version of the NIMH Diagnostic Interview Schedule for Children (DISC), Version 2.3 Shaffer et al. 1996, Schwab-Stone et al. 1996.

Results

Of the 1,285 pairs of youths and their caretakers, a total of 35 (2.7%) cases were identified in 1991–2 as having OCD based on DSM-III-R criteria. Four (0.3%) OCD cases were identified on the basis of parent report, and 32 (2.5%) were identified by child report, with only one overlapping case in which parent and child reports concurred. Corresponding age-corrected prevalence rates were: total, 1.72%; parent report, 0.02%; child report, 1.62%.

The 35 identified cases consisted of 17 (49%) boys (M

Discussion

The prevalence of OCD in a four-site community-based sample of 1,285 children aged 9 through 17 was examined in terms of parent report and child report. Of a total of 35 (2.7%) identified cases, four (0.3%) were identified by the parent and 32 (2.5%) were identified by the child, with only one overlapping case. While rates based on child report are in general agreement with ECA data for adults (age 18+) (1.5% for 6-month prevalence across five sites [Karno et al., 1988]), rates based on parent

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^☆: Peter S. Jensen was formerly at the Office of the Director, National Institute of Mental Health, Bethesda, Maryland.

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Research paperChildhood Obsessive–Compulsive Disorder in the NIMH MECA Study: Parent Versus Child Identification of Cases☆

Abstract

Section snippets

Method

Results

Discussion

Journal of the American Academy of Child and Adolescent Psychiatry

Journal of the American Academy of Child and Adolescent Psychiatry

Journal of the American Academy of Child and Adolescent Psychiatry

Journal of the American Academy of Child and Adolescent Psychiatry

Journal of the American Academy of Child and Adolescent Psychiatry

Journal of the American Academy of Child and Adolescent Psychiatry

Journal of the American Academy of Child and Adolescent Psychiatry

Journal of the American Academy of Child and Adolescent Psychiatry

Journal of the American Academy of Child and Adolescent Psychiatry

Neurological Clinics of North America

Journal of the American Academy of Child and Adolescent Psychiatry

Journal of the American Academy of Child and Adolescent Psychiatry

Journal of the American Academy of Child and Adolescent Psychiatry

DSM-III disorders in preadolescent childrenPrevalence in a large sample from the general population

Archives of General Psychiatry

Very early onset bipolar disorder. Does it exist?

Age differences in the reliability of the psychiatric interview of the child

Child Development

Research paper
Childhood Obsessive–Compulsive Disorder in the NIMH MECA Study: Parent Versus Child Identification of Cases☆