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
Randomized Controlled Trial
. 2021 Jul;52(4):883-896.
doi: 10.1016/j.beth.2020.11.001. Epub 2020 Nov 12.

Irritability in Children and Adolescents With OCD

Andrew G Guzick  1 , Daniel A Geller  2 , Brent J Small  3 , Tanya K Murphy  4 , Sabine Wilhelm  2 , Eric A Storch  5
Affiliations
Randomized Controlled Trial

Irritability in Children and Adolescents With OCD

Andrew G Guzick et al. Behav Ther. 2021 Jul.

Abstract

Irritability is a common, impairing transdiagnostic symptom in childhood psychopathology, though it has not been comprehensively studied in pediatric obsessive-compulsive disorder (OCD). Further, the central cognitive behavioral treatment component for OCD, exposure and response prevention therapy (ERP), has been recently proposed as a treatment for irritability. This study aimed to evaluate whether certain clinical characteristics are associated with irritability in pediatric OCD and whether irritability reduces following ERP. Participants were 161 youth (ages 7-17) with OCD and a caregiver participating in a randomized controlled trial of D-cycloserine or pill placebo augmented ERP. Participants completed validated assessments during treatment. Irritability was significantly and positively associated with depressive symptoms, defiance, functional impairment, and family accommodation, but was not associated with pretreatment OCD severity, symptom dimensions, obsessive beliefs. Irritability significantly declined following treatment, with over half of youth with any pretreatment irritability experiencing clinically significant change, though this change was not related to OCD improvement. Results suggest that irritability may be a marker of psychiatric comorbidity, parental accommodation, and impairment in youth with OCD. Implications for the exposure-based treatment of irritability are discussed.

Trial registration: ClinicalTrials.gov NCT00864123.

Keywords: CBT; OCD; disruptive behavior; impairment; youth.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Consort Flow Diagrama a Adjusted from diagram presented in original trial to specify participants included in baseline analyses in this study
See this image and copyright information in PMC

References

    1. Abramowitz JS (2018). Presidential address: are the obsessive-compulsive related disorders related to obsessive-compulsive disorder? A critical look at DSM-5’s new category. Behavior Therapy, 49(1), 1–11. 10.1016/j.beth.2017.06.002 - DOI - PubMed
    1. Achenbach TM, & Rescorla L (2001). Manual for the ASEBA school-age forms & profiles: An integrated system of multi-informant assessment. Burlington, VT: Aseba.
    1. Ale CM, McCarthy DM, Rothschild LM, & Whiteside SP (2015). Components of cognitive behavioral therapy related to outcome in childhood anxiety disorders. Clinical Child and Family Psychology Review, 18(3), 240–251. 10.1007/s10567-015-0184-8 - DOI - PubMed
    1. Althoff RR, Kuny-Slock AV, Verhulst FC, Hudziak JJ, & van der Ende J (2014). Classes of oppositional-defiant behavior: Concurrent and predictive validity. Journal of Child Psychology and Psychiatry, 55(10), 1162–1171. 10.1111/jcpp.12233 - DOI - PMC - PubMed
    1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.

Publication types

Associated data