Clinical Profile and Outcome in a Large Sample of Children and Adolescents with Obsessive-compulsive Disorder: A Chart Review from a Tertiary Care Center in India

Overview

Journal Indian J Psychiatry

Specialty Psychiatry

Date 2018 Sep 1

PMID 30166677

Citations 4

Authors

K Deepthi

John Vijay Sagar Kommu

M Smitha

Y C Janardhan Reddy

Affiliations

Soon will be listed here.

Abstract

Background: Obsessive-compulsive disorder (OCD) is a common psychiatric illness in children and adolescents. Till date, the sample sizes in the Indian studies have been relatively small.

Methodology: The present study is a retrospective chart review of a large sample of children and adolescents diagnosed with OCD in a tertiary care center.

Objectives: The objectives of this study were to characterize the clinical profile and to evaluate outcome of OCD in children and adolescents.

Results: Fear of contamination and washing/cleaning compulsions were the most common presenting symptoms. Most of the patients were male with two-thirds having a comorbid disorder. Major depressive disorder was the most common comorbid disorder. The rates of attention deficit hyperactivity disorder, disruptive behavioral disorders, and tic disorders were low when compared to Western studies. One-third of the patients received adequate trial of serotonin reuptake inhibitors and 36% received cognitive behavior therapy. Fifty-four percent of patients had a poor outcome with hospitalization, longer duration of illness, earlier onset of OC symptoms, and family history of OCD being the predictors of poor outcome.

Conclusion: The present study of a large sample of patients with juvenile OCD highlights the low rate of comorbid disruptive behavior disorders as reported in the earlier Indian studies and a favorable short-term outcome in approximately 56% of the patients.

Citing Articles

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References

Stewart S, Geller D, Jenike M, Pauls D, Shaw D, Mullin B . 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. DOI: 10.1111/j.1600-0447.2004.00302.x. View

Thomsen P . Obsessive-compulsive disorder in children and adolescents: predictors in childhood for long-term phenomenological course. Acta Psychiatr Scand. 1995; 92(4):255-9. DOI: 10.1111/j.1600-0447.1995.tb09579.x. View

Palermo S, Bloch M, Craiglow B, Landeros-Weisenberger A, Dombrowski P, Panza K . Predictors of early adulthood quality of life in children with obsessive-compulsive disorder. Soc Psychiatry Psychiatr Epidemiol. 2010; 46(4):291-7. PMC: 3645906. DOI: 10.1007/s00127-010-0194-2. View

Bellino S, Patria L, Ziero S, Bogetto F . Clinical picture of obsessive-compulsive disorder with poor insight: a regression model. Psychiatry Res. 2005; 136(2-3):223-31. DOI: 10.1016/j.psychres.2004.04.015. View

Storch E, Larson M, Muroff J, Caporino N, Geller D, Reid J . Predictors of functional impairment in pediatric obsessive-compulsive disorder. J Anxiety Disord. 2010; 24(2):275-83. DOI: 10.1016/j.janxdis.2009.12.004. View

Subramaniam M, Abdin E, Vaingankar J, Chong S . Obsessive--compulsive disorder: prevalence, correlates, help-seeking and quality of life in a multiracial Asian population. Soc Psychiatry Psychiatr Epidemiol. 2012; 47(12):2035-43. DOI: 10.1007/s00127-012-0507-8. View

Pauls D, Alsobrook 2nd J, Goodman W, Rasmussen S, Leckman J . A family study of obsessive-compulsive disorder. Am J Psychiatry. 1995; 152(1):76-84. DOI: 10.1176/ajp.152.1.76. View

Douglass H, Moffitt T, 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):1424-31. DOI: 10.1097/00004583-199511000-00008. View

Ortiz A, Morer A, Moreno E, Plana M, Cordovilla C, Lazaro L . Clinical significance of psychiatric comorbidity in children and adolescents with obsessive-compulsive disorder: subtyping a complex disorder. Eur Arch Psychiatry Clin Neurosci. 2015; 266(3):199-208. DOI: 10.1007/s00406-015-0642-9. View

10.

Hollingsworth C, Tanguay P, Grossman L, PABST P . Long-term outcome of obsessive-compulsive disorder in childhood. J Am Acad Child Psychiatry. 1980; 19(1):134-44. DOI: 10.1016/s0002-7138(09)60658-0. View

11.

do Rosario-Campos M, Leckman J, Curi M, Quatrano S, Katsovitch L, Miguel E . A family study of early-onset obsessive-compulsive disorder. Am J Med Genet B Neuropsychiatr Genet. 2005; 136B(1):92-7. DOI: 10.1002/ajmg.b.30149. View

12.

Masi G, Millepiedi S, Perugi G, Pfanner C, Berloffa S, Pari C . A naturalistic exploratory study of the impact of demographic, phenotypic and comorbid features in pediatric obsessive-compulsive disorder. Psychopathology. 2010; 43(2):69-78. DOI: 10.1159/000274175. View

13.

Jaisoorya T, Reddy Y, Thennarasu K, Beena K, Beena M, Jose D . An epidemological study of obsessive compulsive disorder in adolescents from India. Compr Psychiatry. 2015; 61:106-14. DOI: 10.1016/j.comppsych.2015.05.003. View

14.

Catapano F, Perris F, Fabrazzo M, Cioffi V, Giacco D, De Santis V . Obsessive-compulsive disorder with poor insight: a three-year prospective study. Prog Neuropsychopharmacol Biol Psychiatry. 2009; 34(2):323-30. DOI: 10.1016/j.pnpbp.2009.12.007. View

15.

Garrison C, Jackson K, Waller J, McKeown R, Addy C, Cuffe S . Frequency of obsessive-compulsive disorder in a community sample of young adolescents. J Am Acad Child Adolesc Psychiatry. 1994; 33(6):782-91. DOI: 10.1097/00004583-199407000-00002. View

16.

Bolton D, Luckie M, Steinberg D . Long-term course of obsessive-compulsive disorder treated in adolescence. J Am Acad Child Adolesc Psychiatry. 1995; 34(11):1441-50. DOI: 10.1097/00004583-199511000-00010. View

17.

Goodman W, Price L, Rasmussen S, Mazure C, Fleischmann R, Hill C . The Yale-Brown Obsessive Compulsive Scale. I. Development, use, and reliability. Arch Gen Psychiatry. 1989; 46(11):1006-11. DOI: 10.1001/archpsyc.1989.01810110048007. View

18.

Mancuso E, Faro A, Joshi G, Geller D . Treatment of pediatric obsessive-compulsive disorder: a review. J Child Adolesc Psychopharmacol. 2010; 20(4):299-308. DOI: 10.1089/cap.2010.0040. View

19.

Leonard H, Swedo S, Lenane M, Rettew D, Hamburger S, Bartko J . A 2- to 7-year follow-up study of 54 obsessive-compulsive children and adolescents. Arch Gen Psychiatry. 1993; 50(6):429-39. DOI: 10.1001/archpsyc.1993.01820180023003. View

20.

Nakatani E, Krebs G, Micali N, Turner C, Heyman I, Mataix-Cols D . Children with very early onset obsessive-compulsive disorder: clinical features and treatment outcome. J Child Psychol Psychiatry. 2011; 52(12):1261-8. DOI: 10.1111/j.1469-7610.2011.02434.x. View