Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2009 Oct;124(4):1085-93.
doi: 10.1542/peds.2009-0015. Epub 2009 Sep 28.

Predictors of early adult outcomes in pediatric-onset obsessive-compulsive disorder

Michael H Bloch  1 , Brittany G Craiglow, Angeli Landeros-Weisenberger, Philip A Dombrowski, Kaitlyn E Panza, Bradley S Peterson, James F Leckman
Affiliations
Comparative Study

Predictors of early adult outcomes in pediatric-onset obsessive-compulsive disorder

Michael H Bloch et al. Pediatrics. 2009 Oct.

Abstract

Objective: The aim of this study was to determine the childhood clinical predictors of early adult outcomes in pediatric-onset obsessive-compulsive disorder (OCD) and to assess whether dimensional subtypes of OCD and the presence of comorbid tic symptoms influence long-term outcomes.

Methods: We conducted a longitudinal cohort study in which 45 of 62 eligible children with OCD were reassessed an average of 9 years later, in early adulthood. Main outcome measures included expert-rated, obsessive-compulsive (OC) symptom severity and time to remission of OC symptoms. Baseline clinical characteristics were evaluated in terms of their influence on OCD severity in adulthood and time to remission of OC symptoms.

Results: Forty-four percent of subjects were determined to have subclinical OC symptoms at the follow-up evaluation. The absence of a comorbid tic disorder and the presence of prominent hoarding symptoms were associated with the persistence of OCD symptoms. Female gender, earlier age at childhood assessment, later age of OCD onset, more-severe childhood OCD symptoms, and comorbid oppositional defiant disorder also were associated with persistence of OCD symptoms into adulthood.

Conclusions: These results confirm that a significant proportion of treated children with OCD experience remission by adulthood. The presence of comorbid tics heralds a positive outcome, whereas primary hoarding symptoms are associated with persistent OCD.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Survival curves comparing patients with OCD with and without comorbid CTD (red curve indicates patients with comorbid CTD; black curve, patients without CTD; circles, censored observations). Proportions of patients with OCD who experienced remission are indicated on the y-axis, and time since childhood baseline assessment is displayed on the x-axis. Patients with OCD with comorbid CTD experienced decreased time to remission of OC symptoms ( χ12=6.0; P = .02).
FIGURE 2
FIGURE 2
Survival curves comparing patients with OCD according to primary symptom dimension (red curve indicates symmetry; green curve, cleaning; black curve, forbidden thoughts; blue curve, hoarding; circles, censored observations). Proportions of patients with OCD who experienced remission are displayed on the y-axis, and time since childhood baseline assessment is displayed on the x-axis. OCD symptom dimensions were associated with differences in the likelihood of remission at trend levels ( χ32=6.6; P = .09). Primary hoarding symptoms were associated with a significantly decreased likelihood of remission ( χ12=5.4; P = .02), compared with nonhoarding OCD symptoms.
See this image and copyright information in PMC

References

    1. Douglass HM, Moffitt TE, Dar R, McGee R, Silva P. Obsessive-compulsive disorder in a birth cohort of 18-year-olds: prevalence and predictors. J Am Acad Child Adolesc Psychiatry. 1995;34(11):1424–1431. - PubMed
    1. Flament MF, Whitaker A, Rapoport JL, et al. Obsessive compulsive disorder in adolescence: an epidemiological study. J Am Acad Child Adolesc Psychiatry. 1988;27(6):764–771. - PubMed
    1. Narrow WE, Rae DS, Robins LN, Regier DA. Revised prevalence estimates of mental disorders in the United States: using a clinical significance criterion to reconcile 2 surveys’ estimates. Arch Gen Psychiatry. 2002;59(2):115–123. - PubMed
    1. Stewart SE, Geller DA, Jenike M, Pauls D, Shaw D, Mullin B, et al. Long-term outcome of pediatric obsessive-compulsive disorder: a meta-analysis and qualitative review of the literature. Acta Psychiatr Scand. 2004;110(1):4–13. - PubMed
    1. Leckman JF, Grice DE, Barr LC, de Vries AL, Martin C, Cohen DJ, et al. Tic-related vs. non-tic-related obsessive compulsive disorder. Anxiety. 1994;1(5):208–215. - PubMed

Publication types

MeSH terms