Course of obsessive-compulsive disorder in children and adolescents: a prospective follow-up study of 23 Danish cases

Abstract

Objective: The course of obsessive-compulsive disorder (OCD) in childhood and adolescence was analyzed.

Method: Twenty-three (88%) of 26 children and adolescents with OCD, all referred to a county child psychiatric clinic as inpatients or outpatients, were longitudinally evaluated every 6 months for obsessive-compulsive symptomatology. At follow-up, 1 1/2 to 5 years after referral (mean follow-up time 3.2 years, SD 1.1), obsessive-compulsive as well as comorbid symptomatology was assessed and compared with that of an age- and sex-matched child psychiatric control group.

Results: Approximately one half of the children and adolescents retained an OCD diagnosis at follow-up. One third of these had an episodic course of the illness, and two thirds had chronic OCD. None in the control group had clinical OCD at follow-up, but three had subclinical obsessive-compulsive symptoms. Thirteen of the probands with OCD received medication (either clomipramine or citalopram) for a period of 1/2 to 2 years (mean 1.4 years). Medication seemed to reduce the severity of OCD in most cases.

Conclusions: This short-term but intensive study supported theories of OCD as an illness with fluctuating severity. Previous findings, that OCD seems to be chronic in approximately half of the cases, were supported by this study.