Symptom profiles in pediatric obsessive-compulsive disorder (OCD): The effects of comorbid grooming conditions

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Abstract

This study sought to examine possible differences in phenomenological features and/or symptom severity of children diagnosed with obsessive-compulsive disorder (OCD) and a comorbid grooming condition (i.e., skin picking and trichotillomania). A total of 202 children receiving a primary diagnosis of OCD were classified into two distinct groups: (1) OCD alone (n = 154) and (2) OCD plus a comorbid grooming condition (OCD + grooming; n = 48). Analyses revealed that those children presenting with a comorbid grooming condition demonstrated different symptom profiles than those with OCD alone. In addition, parents of these children were more likely to report the presence of tactile/sensory sensitivity than those in the OCD alone group. However, no differences were found with respect to symptom severity via self-report (e.g., OCI) or semi-structured interview (e.g., CY-BOCS). Possible clinical and treatment implications, future areas of research, and limitations to the present study are discussed.

Section snippets

Participants

The sample consisted of children and adolescents (hereafter referred to as children) referred to the Pediatric Anxiety Research Clinic (PARC), located in Providence, RI and affiliated with the Warren Alpert School of Medicine at Brown University, through newspaper advertisements, community outreach, and clinic referrals. Children (and their families) was recruited through several of the PARC's ongoing research studies evaluating the phenomenology and treatment of childhood anxiety disorders

OCD symptoms

Chi-square analyses examined differences with respect to the frequency of OCD symptom dimensions across the two groups (Table 2). Children in the OCD + grooming group were more likely to experience contamination (χ2(1) = 4.62, P = .03), aggressive (χ2(1) = 3.68, P = .05), sexual (χ2(1) = 4.83, P = .03), somatic (χ2(1) = 7.75, P < .01), and religious obsessions (χ2(1) = 6.08, P = .01), as well as washing (χ2(1) = 5.82, P = .01), checking (χ2(1) = 6.49, P = .01), repeating (χ2(1) = 13.21, P < .01), counting (χ2(1) = 9.05, P < .01),

Discussion

To our knowledge, this is the first study to examine possible differences in symptom profiles and other phenomenological characteristics among children presenting with OCD alone and those presenting with OCD and a comorbid grooming behavior (e.g., OCD + grooming). Results suggest that those children presenting with a comorbid grooming behavior demonstrated different symptom profiles than those with OCD alone. In particular, these children reported more obsessions and compulsions than those with

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