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Somatic Symptoms in Children and Adolescents with Obsessive-Compulsive Disorder: Associations with Clinical Characteristics and Cognitive-Behavioral Therapy Response

Published online by Cambridge University Press:  14 May 2008

Eric A. Storch*
Affiliation:
University of Florida, Gainesville, USA
Lisa J. Merlo
Affiliation:
University of Florida, Gainesville, USA
Mary L. Keeley
Affiliation:
University of Florida, Gainesville, USA
Kristen Grabill
Affiliation:
University of Florida, Gainesville, USA
Vanessa A. Milsom
Affiliation:
University of Florida, Gainesville, USA
Gary R. Geffken
Affiliation:
University of Florida, Gainesville, USA
Emily Ricketts
Affiliation:
University of Florida, Gainesville, USA
Tanya K. Murphy
Affiliation:
University of Florida, Gainesville, USA
Wayne K. Goodman
Affiliation:
University of Florida, Gainesville, USA
*
Reprint requests to Eric A. Storch, Department of Psychiatry, University of Florida, Gainesville, FL 32610, USA. E-mail: estorch@psychiatry.ufl.edu

Abstract

Despite being a core characteristic of anxiety disorders, little data have been reported on somatic symptoms (SSs) in youth with obsessive-compulsive disorder (OCD). Eighty-five children and adolescents with OCD were administered the Children's Yale Brown Obsessive-Compulsive Scale and completed the Children's Depression Inventory and Multidimensional Anxiety Scale for Children. Their parents completed the Child Behavior Checklist and Children's Obsessive-Compulsive Impact Scale. A subset of youth (n = 62) completed a trial of cognitive-behavioral therapy. The frequency of specific SSs was examined in relation to age, gender, OCD symptom severity, child-rated symptoms of depression and anxiety, parent-proxy ratings of internalizing and externalizing problems, and functional impairment. Ninety-six percent of youth experienced at least one SS, with 67% reporting five or more SSs. Child-rated SSs were positively associated with parent-ratings of child SSs, child-rated anxiety and depression, and parent ratings of the children's internalizing problems. Parent-rated SSs were positively related to parent-proxy ratings of internalizing problems and OCD-related impairment, clinician-rated OCD symptom severity, and child-rated generalized anxiety. Total and several specific SSs were reduced following cognitive-behavioral treatment. These results suggest that SSs are prevalent in youth with OCD, are associated with symptom severity, are reduced after participation in cognitive-behavioral therapy, and warrant attention during assessment and treatment.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2008

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References

Abramowitz, J. S. and Deacon, B. J. (2005). Obsessive-Compulsive Disorder: essential phenomenology and overlap with other anxiety disorders. In Abramowitz, J. S. and Houts, A.C. (Eds.), Concepts and Controversies in Obsessive-Compulsive Disorder. New York: Springer Science.CrossRefGoogle Scholar
Achenbach, T. M. (1991). Manual for the Child Behavior Checklist/4-18 and 1991 Profile. Burlington: University of Vermont Department of Psychiatry.Google Scholar
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision). Washington, DC: American Psychiatric Association.Google Scholar
Aschenbrand, S. G., Angelosante, A. G. and Kendall, P.C. (2005). Discriminant validity and clinical utility of the CBCL with anxiety-disordered youth. Journal of Clinical Child and Adolescent Psychology, 34, 735746.CrossRefGoogle ScholarPubMed
Baldwin, J. S. and Dadds, M. R. (2007). Reliability and validity of parent and child versions of the multidimensional anxiety scale for children in community samples. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 252260.Google Scholar
Barbosa, J., Tannock, R. and Manassis, K. (2002). Measuring anxiety: parent-child reporting differences in clinical samples. Depression and Anxiety, 15, 6165.Google Scholar
Bartz, J. A. and Hollander, E. (2006). Is obsessive-compulsive disorder an anxiety disorder? Progress in Neuro-psychopharmacology and Biological Psychiatry, 30, 338352.Google Scholar
Beidel, D. C., Christ, M. G. and Long, P. J. (1991). Somatic complaints in anxious children. Journal of Abnormal Child Psychology, 19, 659670.CrossRefGoogle ScholarPubMed
Bolton, D. (1998). Obsessive-compulsive disorder. In Hersen, M. and Bellack, A. (Eds.), Comprehensive Clinical Psychology (pp. 367391). San Francisco: Pergamon.CrossRefGoogle Scholar
Calvo, R., Lazaro, L., Castro, J., Morer, A. and Toro, J. (2007). Parental psychopathology in child and adolescent obsessive-compulsive disorder. Social Psychiatry and Psychiatric Epidemiology, 42, 647655.Google Scholar
Derisley, J., Libby, S., Clark, S. and Reynolds, S. (2005). Mental health, coping and family-functioning in parents of young people with obsessive-compulsive disorder and with anxiety disorders. British Journal of Clinical Psychology, 44, 439444.CrossRefGoogle ScholarPubMed
Egger, H. L., Angold, A. and Costello, J. (1998). Headaches and psychopathology and children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 951958.Google Scholar
Egger, H. L., Costello, E. J., Erkanli, A. and Angold, A. (1999). Somatic complaints and psychopathology in children and adolescents: stomach aches, musculoskeletal pains, and headaches. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 852860.Google Scholar
Engel, N. A., Rodrigue, J. R. and Geffken, G. R. (1994). Parent-child agreement on ratings of anxiety in children. Psychological Reports, 75, 12511260.Google Scholar
Garber, J., Walker, L. S. and Zeman, J. (1991). Somatization symptoms in a community sample of children and adolescents: further validation of the Children's Somatization Inventory. Psychological Assessment, 3, 588595.Google Scholar
Ginsburg, G. S., Riddle, M. A. and Davies, M. (2006). Somatic symptoms in children and adolescents with anxiety disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 45, 11791187.Google Scholar
Heubeck, B. G. (2000). Cross-cultural generalizability of CBCL syndromes across three continents: from the USA and Holland to Australia. Journal of Abnormal Child Psychology, 28, 439450.CrossRefGoogle ScholarPubMed
Hollander, E. and Zohar, J. (2004). Beyond refractory obsessions and anxiety states: toward remission. Journal of Clinical Psychiatry, 65S, S3S5.Google ScholarPubMed
Ivarsson, T. and Valderhaug, R. (2006). Symptom patterns in children and adolescents with obsessive-compulsive disorder. Behaviour Research and Therapy, 44, 11051116.CrossRefGoogle ScholarPubMed
Kovacs, M. (1992). The Children's Depression Inventory Manual. North Tanawanda, NY: Multi-Health Systems, Inc.Google Scholar
Jolly, J. B., Wherry, J. N., Wiesner, D. C., Reed, D. H., Rule, J. C. and Jolly, J. M. (1994). The mediating role of anxiety in self-reported somatic complaints of depressed adolescents. Journal of Abnormal Child Psychology, 22, 691702.CrossRefGoogle ScholarPubMed
Last, C. G. (1991). Somatic complaints in anxiety disordered children. Journal of Anxiety Disorders, 17, 211221.Google Scholar
Livingston, R., Taylor, J. L. and Crawford, L. (1988). A study of somatic complaints and psychiatric diagnosis in children. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 185187.Google Scholar
Lochenr, C. and Stein, D. J. (2006). Does work on obsessive-compulsive spectrum disorders contribute to understanding the heterogeneity of obsessive-compulsive disorder? Progress in Neuro-psychopharmacology and Biological Psychiatry, 30, 353361.CrossRefGoogle Scholar
Mancini, C., Van Ameringen, M. and Farvolden, P. (2002). Does SSRI augmentation with antidepressants that influence noradrenergic function resolve depression in obsessive-compulsive disorder? Journal of Affective Disorders, 68, 5965.Google Scholar
March, J. S., Parker, J., Sullivan, K., Stallings, P. and Conner, C. K. (1997). The Multidimensional Anxiety Scale for Children (MASC): factor structure, reliability, and validity. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 554565.CrossRefGoogle ScholarPubMed
March, J. S., Sullivan, K. and Parker, J. D. (1999). Test-retest reliability of the Multidimensional Anxiety Scale for Children. Journal of Anxiety Disorders, 13, 349358.Google Scholar
Marks, I. M. (1987). Fears, Phobias, and Rituals: panic, anxiety, and their disorders. New York: Oxford University Press.Google Scholar
Masi, G., Favilla, L., Millepiedi, S. and Mucci, M. (2000). Somatic symptoms in children and adolescents referred for emotional and behavioral disorders. Psychiatry, 63, 140149.Google Scholar
Piacentini, J. C., Bergman, R. L., Keller, M. and McCracken, J. (2003). Functional impairment in children and adolescents with obsessive-compulsive disorder. Journal of Child and Adolescent Psychopharmacology, 13, S61S69.Google Scholar
Piacentini, J. C. and Jaffer, M. (1999). Measuring Functional Impairment in Youngsters With OCD (Manual for the Child OC Impact Scale, COIS). Los Angeles, UCLA: Department of Psychiatry.Google Scholar
Roth-Isigkeit, A., Thyen, U., Stoven, H., Schwarzenberger, J. and Schmucker, P. (2005). Pain among children and adolescents: restrictions in daily living and triggering factors. Pediatrics, 115, 152162.CrossRefGoogle ScholarPubMed
Rynn, M. A., Barber, J. P., Khalid-Khan, S., Siqueland, L., Dembiski, M., McCarthy, K. S. and Gallop, R. (2006). The psychometric properties of the MASC in a pediatric psychiatric sample. Journal of Anxiety Disorders, 20, 139157.Google Scholar
Scahill, L., Riddle, M. A., McSwiggin-Hardin, M., Sharon, I., King, R., Goodman, W. K., Cicchetti, D. and Leckman, J. F. (1997). Children's Yale-Brown obsessive compulsive scale: reliability and validity. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 844852.Google Scholar
Silverman, W. K. and Albano, A. M. (1996). The Anxiety Disorder Interview Schedule for DSM-IV: child and parent versions. San Antonio, TX: The Psychological Corporation.Google Scholar
Storch, E. A., Abramowitz, J. and Goodman, W. K. in press. Does OCD belong with the anxiety disorders in DSM-V? Depression and Anxiety.Google Scholar
Storch, E. A., Geffken, G. R., Merlo, L. J., Mann, G., Duke, D., Munson, M., Adkins, J., Grabill, K. M., Murphy, T. K. and Goodman, W. K. (2007). Family-based cognitive behavioral therapy for pediatric obsessive-compulsive disorder: comparison of intensive and weekly approaches. American Academy of Child and Adolescent Psychiatry, 46, 469478.Google Scholar
Storch, E. A., Murphy, T. K., Geffken, G. R., Soto, O., Sajid, M., Allen, P., Roberti, J. W., Killiany, E. M. and Goodman, W. K. (2004). Psychometric evaluation of the Children's Yale – Brown Obsessive-Compulsive Scale. Psychiatry Research, 129, 9198.CrossRefGoogle ScholarPubMed
Timbremont, B., Braet, C. and Dreessen, L. (2004). Assessing depression in youth: relation between the Children's Depression Inventory and a structured interview. Journal of Clinical Child and Adolescent Psychology, 33, 149157.Google Scholar
Valderhaug, R. and Ivarsson, T. (2005). Functional impairment in clinical samples of Norwegian and Swedish children and adolescent with obsessive compulsive-disorder. European Child and Adolescent Psychiatry, 14, 164173.CrossRefGoogle ScholarPubMed
Yucelen, A. G., Rodopman-Arman, A., Topcuoglu, V., Yazgan, M. Y. and Fisek, G. (2006). Interrater reliability and clinical efficacy of Children's Yale-Brown Obsessive-Compulsive Scale in an outpatient setting. Comprehensive Psychiatry, 47, 4853.Google Scholar
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