Categorical and dimensional aspects of co-morbidity in obsessive-compulsive disorder (OCD)

Abstract

Objective: Obsessive-Compulsive Disorder (OCD) defined at the diagnostic level encompasses divergent symptoms and is often associated with other psychiatric problems.The present study examines OCD versus co-morbid symptom patterns in OCD in children and adolescents in order to investigate the presence of diagnostic heterogeneity Subjects and methods: One-hundred and thirteen outpatients with primary OCD participated.The patients' and primary caretakers' responses on semi-structured interviews (child version of Schedule for Affective Disorders and Schizophrenia and the Children's Yale-Brown Obsessive Compulsive Scale) and parents' responses on the Child Behaviour Checklist were used in the study. Psychiatric diagnoses were related to CBCL syndrome scores and CBCL scores were compared with the Swedish normative data.Results: Co-morbid diagnoses were very common and only one out of five patients had only OCD. The most common group was the neuropsychiatric disorders (47%) where tic disorders were most common (27%), especially among boys (40.8%; p= .006, Fisher's exact test). Also anxiety disorders were common (39.8%) as were affective disorders (24.8%) neither with any gender differences. Diagnoses of disruptive disorders were less common (8.8%), almost exclusively of the oppositional kind (ODD) (8.8%). From the dimensional point of view using the CBCL, patients with OCD scored higher than Swedish youngster generally do, and some gender differences were seen in that girls scored higher on anxiety and depression while both girls and boys had high scores on thought problems, attention problems and especially aggressive behaviour. Comorbidities explained from 25-50% of the CBCL sub-syndrome scales, often with both main effects and through complex patterns of interaction with gender, OCD-severity and other co-morbid problems.OCD co-morbidity Conclusions: While co-morbid problems is an important facet of OCD, sub-syndromal levels of symptoms that can be assessed using a dimensional approach, is a large part of the total symptom burden in these youngsters. Our data indicate contributions of different pathways for girls and for boys for several comorbid problems together with OCD-severity.

Obsessive-compulsive symptoms and obsessive-compulsive disorder in adolescents: a population-based study

“…Other studies involving children and adolescents have also observed a higher prevalence of tic disorders in boys. 11,35,38 Conversely, one study has reported a higher frequency of attention deficit hyperactivity disorder in boys, 38 and another has observed more simple phobias, anorexia, compulsive buying, and skin picking in girls. 35 We believe that the small number of boys included in our sample may have affected our results, failing to reveal other significant associations.…”

Mental Health Problems among Korean American Adolescents

“…To our knowledge, there has been no other study with Asian American adolescents that has examined thought problems of Korean American youth. Although the YSR "thought problems scale" has been linked to a number of psychiatric symptoms and disorders, its relationship to obsessive-compulsive behavior (OCB) may be relevant here (Hudziak et al, 2006;Ivarsson, Melin, & Wallin, 2007). Our findings could reflect a greater emphasis among Korean American adolescents than other adolescents on certain behaviors that are similar to OCB (e.g.…”

The Effects of Transcranial Direct Current Stimulation on Obsession-compulsion, Anxiety, and Depression of a Patient Suffering from Obsessive-compulsive Disorder

“…In many research studies, OCD is comorbid with depression and anxiety (Ivarsson, Melin, & Wallin, 2008;Peris et al, 2010). Depression leads to drawback of treatment outcomes for individuals with OCD (Storch et al, 2008).…”

“…Depression leads to drawback of treatment outcomes for individuals with OCD (Storch et al, 2008). Anxiety also is more prevalent than depression in OCD (Ivarsson, Melin, & Wallin, 2008;Langley, Lewin, Bergman, Lee, & Piacentini, 2010). The severity of anxiety will be great if the symptoms of OCD increase .…”