Skip to main content

Advertisement

Log in

Variations in Symptom Prevalence and Clinical Correlates in Younger Versus Older Youth with Obsessive–Compulsive Disorder

  • Original Article
  • Published:
Child Psychiatry & Human Development Aims and scope Submit manuscript

Abstract

Few studies have examined the phenomenology of obsessive–compulsive disorder (OCD) in younger children. A sample of 292 treatment seeking youth with a primary diagnosis of OCD was divided into the young child (3–9 years old) and older child (10–18 years old) groups. Overall OCD severity did not differ between groups. However, older youth demonstrated stronger intensity of obsessive and compulsive symptoms, while younger children were rated as having less resistance and control of compulsions. Older youth exhibited increased occurrence of comorbid depression, and an increased occurrence of sexual, magical thinking, and somatic obsessions, as well as, checking, counting and magical thinking compulsions. Conversely, the group of younger children exhibited significantly poorer insight, increased incidence of hoarding compulsions, higher rates of comorbid attention deficit/hyperactivity disorder, disruptive behavior, and parent-rated anxiety, and more frequently exhibited hoarding compulsions. These differences suggest domains to consider when screening for OCD among younger/older pediatric cohorts.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn

  2. Ruscio AM, Stein DJ, Chiu WT, Kessler RC (2010) The epidemiology of obsessive–compulsive disorder in the National Comorbidity Survey Replication. Mol Psychiatry 15:53–63

    Article  PubMed Central  PubMed  Google Scholar 

  3. Piacentini J, Bergman RL, Keller M, McCracken J (2003) Functional impairment in children and adolescents with obsessive–compulsive disorder. J Child Adolesc Psychopharmacol 13(Suppl 1):S61–S69

    Article  PubMed  Google Scholar 

  4. Sukhodolsky DG, do Rosario-Campos MC, Scahill L, Katsovich L, Pauls DL, Peterson BS et al (2005) Adaptive, emotional, and family functioning of children with obsessive–compulsive disorder and comorbid attention deficit hyperactivity disorder. Am J Psychiatry 162:1125–1132

    Article  PubMed Central  PubMed  Google Scholar 

  5. Valderhaug R, Ivarsson T (2005) Functional impairment in clinical samples of Norwegian and Swedish children and adolescents with obsessive–compulsive disorder. Eur Child Adolesc Psychiatry 14:164–173

    Article  PubMed  Google Scholar 

  6. Geller D, Biederman J, Jones J, Park K, Schwartz S, Shapiro S et al (1998) Is juvenile obsessive–compulsive disorder a developmental subtype of the disorder? A review of the pediatric literature. J Am Acad Child Adolesc Psychiatry 37:420–427

    Article  PubMed  Google Scholar 

  7. Tukel R, Ertekin E, Batmaz S, Alyanak F, Sozen A, Aslantas B et al (2005) Influence of age of onset on clinical features in obsessive–compulsive disorder. Depress Anxiety 21:112–117

    Article  PubMed  Google Scholar 

  8. Geller DA (2006) Obsessive–compulsive and spectrum disorders in children and adolescents. Psychiatr Clin N Am 29:353–370

    Article  Google Scholar 

  9. do Rosario-Campos MC, Leckman JF, Curi M, Quatrano S, Katsovitch L, Miguel EC et al (2005) A family study of early-onset obsessive–compulsive disorder. Am J Med Genet B Neuropsychiatr Genet 136B:92–97

    Article  PubMed  Google Scholar 

  10. 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 Central  PubMed  Google Scholar 

  11. Geller DA, Biederman J, Faraone S, Agranat A, Cradock K, Hagermoser L et al (2001) Developmental aspects of obsessive compulsive disorder: findings in children, adolescents, and adults. J Nerv Ment Dis 189:471–477

    Article  PubMed  Google Scholar 

  12. Stewart SE, Rosario MC, Brown TA, Carter AS, Leckman JF, Sukhodolsky D et al (2007) Principal components analysis of obsessive–compulsive disorder symptoms in children and adolescents. Biol Psychiatry 61:285–291

    Article  PubMed  Google Scholar 

  13. Biederman J, Mick E, Faraone SV (2000) Age-dependent decline of symptoms of attention deficit hyperactivity disorder: impact of remission definition and symptom type. Am J Psychiatry 157:816–818

    Article  PubMed  Google Scholar 

  14. Rohde P, Lewinsohn PM, Klein DN, Seeley JR, Gau JM (2013) Key characteristics of major depressive disorder occurring in childhood, adolescence, emerging adulthood, and adulthood. Clin Psychol Sci 1:41–53

    Article  Google Scholar 

  15. Ryan ND, Puig-Antich J, Ambrosini P, Rabinovich H, Robinson D, Nelson B et al (1987) The clinical picture of major depression in children and adolescents. Arch Gen Psychiatry 44:854–861

    Article  PubMed  Google Scholar 

  16. Farrell L, Barrett P, Piacentini J (2006) Obsessive–compulsive disorder across the developmental trajectory: clinical correlates in children, adolescents and adults. Behav Change 23:103–120

    Article  Google Scholar 

  17. Mancebo MC, Garcia AM, Pinto A, Freeman JB, Przeworski A, Stout R et al (2008) Juvenile-onset OCD: clinical features in children, adolescents and adults. Acta Psychiatr Scand 118:149–159

    Article  PubMed Central  PubMed  Google Scholar 

  18. Nakatani E, Krebs G, Micali N, Turner C, Heyman I, Mataix-Cols D (2011) Children with very early onset obsessive–compulsive disorder: clinical features and treatment outcome. J Child Psychol Psychiatry 52:1261–1268

    Article  PubMed  Google Scholar 

  19. Lewin AB, Bergman RL, Peris TS, Chang S, McCracken JT, Piacentini J (2010) Correlates of insight among youth with obsessive–compulsive disorder. J Child Psychol Psychiatry 51:603–611

    Article  PubMed Central  PubMed  Google Scholar 

  20. de Mathis MA, do Rosario MC, Diniz JB, Torres AR, Shavitt RG, Ferrao YA et al (2008) Obsessive–compulsive disorder: influence of age at onset on comorbidity patterns. Eur Psychiatry 23:187–194

    Article  PubMed  Google Scholar 

  21. Storch EA, Caporino NE, Morgan JR, Lewin AB, Rojas A, Brauer L et al (2011) Preliminary investigation of web-camera delivered cognitive-behavioral therapy for youth with obsessive–compulsive disorder. Psychiatry Res 189:407–412

    Article  PubMed  Google Scholar 

  22. Lewin AB, Park JM, Jones AM, Crawford EA, DeNadai AS, Menzel J et al (2014) Family-based exposure and response prevention therapy for preschool-aged children with obsessive-compulsive disorder: a pilot randomized controlled trial. Behaviour Research and Therapy (in press)

  23. Storch EA, Jones AM, Lack CW, Ale CM, Sulkowski ML, Lewin AB et al (2012) Rage attacks in pediatric obsessive–compulsive disorder: phenomenology and clinical correlates. J Am Acad Child Adolesc Psychiatry 51:582–592

    Article  PubMed  Google Scholar 

  24. Lewin AB, Larson MJ, Park JM, McGuire JH, Murphy TK, Storch EA (2014) Neuropsychological functioning in youth with obsessive compulsive disorder: an examination of executive function and memory impairment. Psychiatry Res (in press)

  25. Scahill L, Riddle MA, McSwiggin-Hardin M, Ort SI, King RA, Goodman WK et al (1997) Children’s Yale-Brown Obsessive Compulsive Scale: reliability and validity. J Am Acad Child Adolesc Psychiatry 36:844–852

    Article  PubMed  Google Scholar 

  26. Storch EA, Murphy TK, Geffken GR, Bagner DM, Soto O, Sajid M et al (2005) Factor analytic study of the Children’s Yale-Brown Obsessive–Compulsive Scale. J Clin Child Adolesc Psychol 34:312–319

    Article  PubMed  Google Scholar 

  27. Gallant J, Storch EA, Merlo LJ, Ricketts ED, Geffken GR, Goodman WK et al (2008) Convergent and discriminant validity of the Children’s Yale-Brown Obsessive Compulsive Scale-Symptom Checklist. J Anxiety Disord 22:1369–1376

    Article  PubMed  Google Scholar 

  28. Storch EA, Murphy TK, Geffken GR, Soto O, Sajid M, Allen P et al (2004) Psychometric evaluation of the Children’s Yale-Brown Obsessive–Compulsive Scale. Psychiatry Res 129:91–98

    Article  PubMed  Google Scholar 

  29. Lewin AB, Piacentini J, De Nadai AS, Jones AM, Peris TS, Geffken GR et al (2014) Defining clinical severity in pediatric obsessive–compulsive disorder. Psychol Assess (in press)

  30. Lewin AB, Piacentini J (2010) Evidence-based assessment of child obsessive compulsive disorder: recommendations for clinical practice and treatment research. Child Youth Care For 39:73–89

    Article  Google Scholar 

  31. Guy W (1976) Clinical global impressions: ECDEU assessment manual for psychopharmacology, revised. Rockville, MD, National Institute of Mental Health (pp 218–222)

  32. Storch EA, Lewin AB, De Nadai AS, Murphy TK (2010) Defining treatment response and remission in obsessive–compulsive disorder: a signal detection analysis of the Children’s Yale-Brown Obsessive Compulsive Scale. J Am Acad Child Adolesc Psychiatry 49:708–717

    PubMed  Google Scholar 

  33. Zaider TI, Heimberg RG, Fresco DM, Schneier FR, Liebowitz MR (2003) Evaluation of the Clinical Global Impression Scale among individuals with social anxiety disorder. Psychol Med 33:611–622

    Article  PubMed  Google Scholar 

  34. Calvocoressi L, Lewis B, Harris M, Trufan SJ, Goodman WK, McDougle CJ et al (1995) Family accommodation in obsessive–compulsive disorder. Am J Psychiatry 152:441–443

    PubMed  Google Scholar 

  35. Caporino NE, Morgan J, Beckstead J, Phares V, Murphy TK, Storch EA (2012) A structural equation analysis of family accommodation in pediatric obsessive–compulsive disorder. J Abnorm Child Psychol 40:133–143

    Article  PubMed  Google Scholar 

  36. Peris TS, Bergman RL, Langley A, Chang S, McCracken JT, Piacentini J (2008) Correlates of accommodation of pediatric obsessive-compulsive disorder: parent, child, and family characteristics. J Am Acad Child Adolesc Psychiatry 47:1173–1181

    Article  PubMed Central  PubMed  Google Scholar 

  37. Storch EA, Geffken GR, Merlo LJ, Jacob ML, Murphy TK, Goodman WK et al (2007) Family accommodation in pediatric obsessive–compulsive disorder. J Clin Child Adolesc Psychol 36:207–216

    Article  PubMed  Google Scholar 

  38. March JS, Parker JD, Sullivan K, Stallings P, Conners CK (1997) The Multidimensional Anxiety Scale for Children (MASC): factor structure, reliability, and validity. J Am Acad Child Adolesc Psychiatry 36:554–565

    Article  PubMed  Google Scholar 

  39. Baldwin JS, Dadds MR (2007) Reliability and validity of parent and child versions of the multidimensional anxiety scale for children in community samples. J Am Acad Child Adolesc Psychiatry 46:252–260

    Article  PubMed  Google Scholar 

  40. Whiteside SP (2009) Adapting the Sheehan disability scale to assess child and parent impairment related to childhood anxiety disorders. J Clin Child Adolesc Psychol 38:721–730

    Article  PubMed  Google Scholar 

  41. Silverman WK, Albano AM (1996) The Anxiety Disorders Interview Schedule for DSM-IV: child and parent versions. Psychological Corporation, San Antonio

    Google Scholar 

  42. Silverman WK, Saavedra LM, Pina AA (2001) 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 40:937–944

    Article  PubMed  Google Scholar 

  43. Wood JJ, Piacentini JC, Bergman RL, McCracken J, Barrios V (2002) Concurrent validity of the anxiety disorders section of the Anxiety Disorders Interview Schedule for DSM-IV: child and parent versions. J Clin Child Adolesc Psychol 31:335–342

    Article  PubMed  Google Scholar 

  44. 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

    Article  PubMed  Google Scholar 

  45. Costello EJ, Mustillo S, Erkanli A, Keeler G, Angold A (2003) Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry 60:837–844

    Article  PubMed  Google Scholar 

  46. Lewinsohn PM, Clarke GN, Seeley JR, Rohde P (1994) Major depression in community adolescents: age at onset, episode duration, and time to recurrence. J Am Acad Child Adolesc Psychiatry 33:809–818

    Article  PubMed  Google Scholar 

  47. Baker SM, Gentry JW (1996) Kids as collectors: a phenomenological study of first and fifth graders. Adv Consum Res 23:132–137

    Google Scholar 

  48. Storch EA, Rahman O, Park JM, Reid J, Murphy TK, Lewin AB (2011) Compulsive hoarding in children. J Clin Psychol 67:507–516

    Article  PubMed  Google Scholar 

  49. Zohar AH, Felz L (2001) Ritualistic behavior in young children. J Abnorm Child Psychol 29:121–128

    Article  PubMed  Google Scholar 

  50. Nordsletten AE, Mataix-Cols D (2012) Hoarding versus collecting: where does pathology diverge from play? Clin Psychol Rev 32:165–176

    Article  PubMed  Google Scholar 

  51. Reardon LE, Leen-Feldner EW, Hayward C (2009) A critical review of the empirical literature on the relation between anxiety and puberty. Clin Psychol Rev 29:1–23

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Adam B. Lewin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Selles, R.R., Storch, E.A. & Lewin, A.B. Variations in Symptom Prevalence and Clinical Correlates in Younger Versus Older Youth with Obsessive–Compulsive Disorder. Child Psychiatry Hum Dev 45, 666–674 (2014). https://doi.org/10.1007/s10578-014-0435-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10578-014-0435-9

Keywords

Navigation