Early Onset Obsessive-Compulsive Disorder With and Without Tics

ABSTRACTIntroduction: Research suggests that obsessive-compulsive disorder (OCD) is not a unitary entity, but rather a highly heterogeneous condition, with complex and variable clinical manifestations.Objective: The aims of this study were to compare clinical and demographic characteristics of OCD patients with early and late age of onset of obsessive-compulsive symptoms (OCS); and to compare the same features in early onset OCD with and without tics. The independent impact of age at onset and presence of tics on comorbidity patterns was investigated.Methods: Three hundred and thirty consecutive outpatients meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for OCD were evaluated: 160 patients belonged to the “early onset” group (EOG): before 11 years of age, 75 patients hadResults: The EOG had a predominance of males, higher frequency of family history of OCS, higher mean scores on the “aggression/violence” and “miscellaneous” dimensions, and higher mean global DY-BOCS scores. Patients with EOG without tic disorders presented higher mean global DY-BOCS scores and higher mean scores in the “contamination/cleaning” dimension.Conclusion: The current results disentangle some of the clinical overlap between early onset OCD with and without tics.

Download Full-text

Early onset obsessive–compulsive disorder: the biological and clinical phenotype

CNS Spectrums ◽

10.1017/s1092852921000122 ◽

2021 ◽

pp. 1-7

Author(s):

Giacomo Grassi ◽

Chiara Cecchelli ◽

Gloria Mazzocato ◽

Luisa Vignozzi

Keyword(s):

Mental Disorders ◽

Obsessive Compulsive Disorder ◽

Early Onset ◽

Neurodevelopmental Disorder ◽

Age At Onset ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Diagnostic And Statistical Manual ◽

Clinical Profiles ◽

Made In

Abstract Moving from a behavioral-based to a biological-based classification of mental disorders is a crucial step toward a precision-medicine approach in psychiatry. In the last decade, a big effort has been made in order to stratify genetic, immunological, neurobiological, cognitive, and clinical profiles of patients. Making the case of obsessive–compulsive disorder (OCD), a lot have been made in this direction. Indeed, while the Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnosis of OCD aimed to delineate a homogeneous group of patients, it is now clear that OCD is instead an heterogeneous disorders both in terms of neural networks, immunological, genetic, and clinical profiles. In this view, a convergent amount of literature, in the last years, indicated that OCD patients with an early age at onset seem to have a specific clinical and biological profile, suggesting it as a neurodevelopmental disorder. Also, these patients tend to have a worse outcome respect to adult-onset patients and there is growing evidence that early-interventions could potentially improve their prognosis. Therefore, the aim of the present paper is to review the current available genetic, immunological, neurobiological, cognitive, and clinical data in favor of a more biologically precise subtype of OCD: the early-onset subtype. We also briefly resume current available recommendations for the clinical management of this specific population.

Download Full-text

Admixture analysis of age at onset in obsessive–compulsive disorder

Psychological Medicine ◽

10.1017/s0033291704003253 ◽

2005 ◽

Vol 35 (2) ◽

pp. 237-243 ◽

Cited By ~ 81

Author(s):

RICHARD DELORME ◽

JEAN-LOUIS GOLMARD ◽

NADIA CHABANE ◽

BRUNO MILLET ◽

MARIE-ODILE KREBS ◽

...

Keyword(s):

Obsessive Compulsive Disorder ◽

Late Onset ◽

Age At Onset ◽

Admixture Analysis ◽

Obsessive Compulsive ◽

General Anxiety Disorder ◽

General Anxiety ◽

Compulsive Disorder ◽

History Of ◽

Best Fitting

Background. Age at onset (AAO) has been useful to explore the clinical, neurobiological and genetic heterogeneity of obsessive–compulsive disorder (OCD). However, none of the various thresholds of AAO used in previous studies have been validated, and it remains an unproven notion that AAO is a marker for different subtypes of OCD. If AAO is a clinical indicator of different biological subtypes, then subgroups based on distinct AAOs should have separate normal distributions as well as different clinical characteristics.Method. Admixture analysis was used to determine the best-fitting model for the observed AAO of 161 OCD patients.Results. The observed distribution of AAO in OCD is a mixture of two Gaussian distributions with mean ages of 11·1±4·1 and 23·5±11·1 years. The first distribution, defined by early-onset OCD, had increased frequency of Tourette's syndrome and increased family history of OCD. The second distribution, defined by late-onset OCD, showed elevated prevalence of general anxiety disorder and major depressive disorder.Conclusions. These results, based on a statistically validated AAO cut-off and those of previous studies on AAO in OCD, suggest that AAO is a crucial phenotypic characteristic in understanding the genetic basis of this disorder.

Download Full-text

The Immediate Effect of COVID-19 Pandemic on Children and Adolescents with Obsessive Compulsive Disorder

10.21203/rs.3.rs-54132/v4 ◽

2020 ◽

Author(s):

Judith Becker Nissen ◽

David Højgaard ◽

Per Hove Thomsen

Keyword(s):

Depressive Symptoms ◽

Family History ◽

Psychiatric Disorders ◽

Obsessive Compulsive Disorder ◽

Age Of Onset ◽

Close Contact ◽

Clinical Group ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

History Of

Abstract Background Obsessive compulsive disorder (OCD) is a distressing psychiatric disorder. Traumas may trigger or aggravate OCD symptoms. COVID-19 pandemic has coursed a global crisis and has been associated with onset of psychiatric disorders in adults. Little is known about children/adolescents with OCD. The present study aimed to examine how children/adolescents with OCD react towards COVID-19 crisis. Methods A questionnaire was distributed to two separate groups of children/adolescents. One group was a clinical group newly diagnosed at a specialized OCD clinic. All the children/adolescents had a current close contact to a therapist or doctor. The other group was a survey group identified through the Danish OCD Association. Most of these children/adolescents were diagnosed years ago, and their primary treatment was completed. For the clinical group, data from patient files was available. Results In both groups, but most pronounced in the survey group, participants experienced a worsening of their OCD, anxiety, and depressive symptoms. The aggravation of OCD correlated with the worsening of anxiety, depressive symptoms, and the extent of avoidance behavior. For both groups, OCD aggressive symptoms predicted a significant worsening. Poor baseline insight showed a trend to predict a symptom worsening. The worsening was most pronounced in children with early age of onset and a family history of attention deficit hyperactivity disorder. Conclusions To our knowledge, this is one of the first studies examining the effect of COVID-19 in children/adolescents with OCD. The effect was examined in two separate populations strengthening the findings. The study points towards an influence of the OCD phenotype, baseline insight suggesting a continued vulnerability, and a family history of psychiatric disorders. Trial registration The study is approved by the Danish Data Protection Agency (1-16-02-147-20) registered 1 st of April 2020. Oral and written information was given to parents and patients and written consent from patients over 15 years and parents were received.

Download Full-text

Association analysis between a VNTR intron 8 polymorphism of the dopamine transporter gene (SLC6A3) and obsessive- compulsive disorder in a Brazilian sample

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2007000600002 ◽

2007 ◽

Vol 65 (4a) ◽

pp. 936-941 ◽

Cited By ~ 7

Author(s):

Karen Miguita ◽

Quirino Cordeiro ◽

Jacqueline Siqueira-Roberto ◽

Roseli Gedanke Shavitt ◽

José Carlos Ramos Castillo ◽

...

Keyword(s):

Dopamine Transporter ◽

Obsessive Compulsive Disorder ◽

Age At Onset ◽

Tic Disorders ◽

Transporter Gene ◽

Obsessive Compulsive ◽

Dopamine Transporter Gene ◽

Brazilian Sample ◽

Compulsive Disorder ◽

Co Morbidity

Family, twin and segregation analysis have provided evidences that genetic factors are implicated in the susceptibility for obsessive-compulsive disorder (OCD). Several lines of research suggest that the dopaminergic system may be involved in the pathophysiology of OCD. Thus, the aim of the present study was to investigate a possible association between a polymorphism located in intron 8 of the dopamine transporter gene (SLC6A3) and OCD in a Brazilian sample composed by 208 patients and 865 healthy controls. No statistically differences were observed in allelic and genotype distributions between cases and controls. No association was also observed when the sample was divided according to specific phenotypic features such as gender, presence of tic disorders co-morbidity and age at onset of obsessive-compulsive symptoms (OCS). Our results suggest that the intron 8 VNTR of the SLC6A3 investigated in this study is not related to the susceptibility for OCD in our Brazilian sample.

Download Full-text

Gender-Divergent Aetiological Factors in Obsessive-Compulsive Disorder

The British Journal of Psychiatry ◽

10.1192/bjp.158.2.260 ◽

1991 ◽

Vol 158 (2) ◽

pp. 260-263 ◽

Cited By ~ 97

Author(s):

Homa F. Noshirvani ◽

Yiannis Kasvikis ◽

Isaac M. Marks ◽

Fivos Tsakiris ◽

William O. Monteiro

Keyword(s):

Obsessive Compulsive Disorder ◽

Early Onset ◽

Late Onset ◽

Low Fertility ◽

Onset Age ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

History Of ◽

Low Rate

Among 307 adults with OCD, early onset (age 5–15 years) was more common in men and later onset (age 26–35 years) in women. Early onset was associated with more checking, and late onset with more washing. More women than men had a history of treated depression; 12% of the women but none of the men had a history of anorexia. More women than men were married. Gender-divergent features may reflect differential aetiological factors. Our sample resembled others in the literature in its slight overall female preponderance, low rate of marriage and low fertility, onset mainly before age 35 years, chronicity, and common present and past depression.

Download Full-text

Gender-related clinical differences in obsessive-compulsive disorder

European Psychiatry ◽

10.1016/s0924-9338(99)00224-2 ◽

1999 ◽

Vol 14 (8) ◽

pp. 434-441 ◽

Cited By ~ 127

Author(s):

F. Bogetto ◽

S. Venturello ◽

U. Albert ◽

G. Maina ◽

L. Ravizza

Keyword(s):

Obsessive Compulsive Disorder ◽

Clinical Features ◽

Age At Onset ◽

Obsessive Compulsive ◽

Course Of Illness ◽

Compulsive Disorder ◽

History Of ◽

Axis I ◽

Dsm Iv ◽

Chronic Course

SummaryThe purpose of the present study was to investigate the gender-related differences of clinical features in a sample of obsessive-compulsive (OCD) patients. One hundred and sixty outpatients with a principal diagnosis of obsessive-compulsive disorder (DSM-IV, Y-BOCS = 16) were admitted. Patients were evaluated with a semi-structured interview covering the following areas: socio-demographic data, Axis I diagnoses (DSM-IV), OCD clinical features (age at onset of OC symptoms and disorder, type of onset, life events and type of course). For statistical analysis the sample was subdivided in two groups according to gender. We found an earlier age at onset of OC symptoms and disorder in males; an insidious onset and a chronic course of illness were also observed in that group of patients. Females more frequently showed an acute onset of OCD and an episodic course of illness; they also reported more frequently a stressful event in the year preceding OCD onset. A history of anxiety disorders with onset preceding OCD and hypomanic episodes occurring after OCD onset was significantly more common among males, while females showed more frequently a history of eating disorders. We found three gender-related features of OCD: males show an earlier age at onset with a lower impact of precipitant events in triggering the disorder; OCD seems to occur in a relative high proportion of males who already have phobias and/or tic disorders; and a surfeit of chronic course of the illness in males in comparison with females.

Download Full-text

The Immediate Effect of COVID-19 Pandemic on Children and Adolescents with Obsessive Compulsive Disorder

10.21203/rs.3.rs-54132/v3 ◽

2020 ◽

Author(s):

Judith Becker Nissen ◽

David Højgaard ◽

Per Hove Thomsen

Keyword(s):

Depressive Symptoms ◽

Family History ◽

Psychiatric Disorders ◽

Obsessive Compulsive Disorder ◽

Age Of Onset ◽

Close Contact ◽

Clinical Group ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

History Of

Abstract Background Obsessive compulsive disorder (OCD) is a distressing psychiatric disorder. Traumas may trigger or aggravate OCD symptoms. COVID-19 pandemic has coursed a global crisis and has been associated with onset of psychiatric disorders in adults. Little is known about children/adolescents with OCD. The present study aimed to examine how children/adolescents with OCD react towards COVID-19 crisis. Methods A questionnaire was distributed to two separate groups of children/adolescents. One group was a clinical group newly diagnosed at a specialized OCD clinic. All the children/adolescents had a current close contact to a therapist or doctor. The other group was a survey group identified through the Danish OCD Association. Most of these children/adolescents were diagnosed years ago, and their primary treatment was completed. For the clinical group, data from patient files was available. Results In both groups, but most pronounced in the survey group, participants experienced a worsening of their OCD, anxiety, and depressive symptoms. The aggravation of OCD correlated with the worsening of anxiety, depressive symptoms, and the extent of avoidance behavior. For both groups, OCD aggressive symptoms predicted a significant worsening. Poor baseline insight showed a trend to predict a symptom worsening. The worsening was most pronounced in children with early age of onset and a family history of attention deficit hyperactivity disorder.Conclusions To our knowledge, this is one of the first studies examining the effect of COVID-19 in children/adolescents with OCD. The effect was examined in two separate populations strengthening the findings. The study points towards an influence of the OCD phenotype, baseline insight suggesting a continued vulnerability, and a family history of psychiatric disorders. Trial registration The study is approved by the Danish Data Protection Agency (1-16-02-147-20) registered 1st of April 2020. Oral and written information was given to parents and patients and written consent from patients over 15 years and parents were received.

Download Full-text

Obsessive-Compulsive Disorder

Anxiety Disorders in Adults ◽

10.1093/oso/9780195369250.003.0010 ◽

2009 ◽

Author(s):

Vladan Starcevic, MD, PhD

Keyword(s):

Anxiety Disorders ◽

Obsessive Compulsive Disorder ◽

Clinical Features ◽

Age Of Onset ◽

Clinical Manifestations ◽

Severity Of Illness ◽

Repetitive Behaviors ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Close Relationship

As its name implies, the main characteristics of obsessive-compulsive disorder (OCD) are obsessions and/or compulsions. Different types of obsessions and compulsions make OCD a heterogeneous condition. Also, OCD exists on a continuum from mild cases to those with extremely severe and incapacitating manifestations generally not seen in other anxiety disorders. Clinical manifestations of OCD are striking and leave few people who observe them unimpressed. This is arguably due to the seriousness with which persons with OCD take their own obsessions and compulsions along with concurrent realization that these same obsessions and compulsions are senseless and should be gotten rid of. Indeed, there are few other examples in psychopathology where insight and deficiency of insight stand together, and where espousing and fighting the absurd are so intertwined. For all these reasons, OCD is often portrayed as a puzzling or intriguing disorder; in addition, it often represents a treatment challenge. Obsessive-compulsive disorder is probably the least controversial condition within the anxiety disorders because its clinical features are well described and relatively easily recognized and because hardly anyone doubts its existence as a psychopathological entity. What is controversial about OCD, however, is where it belongs and how it should be classified. This is a consequence of a number of features of OCD that make it look different from other anxiety disorders and of the close relationship that OCD has with some conditions outside of the realm of anxiety disorders. Listed below are a number of key questions about OCD…. 1. In view of its different clinical features and the vastly different severity of these features, should OCD be considered a unitary condition or divided into subtypes? 2. If OCD is to be divided into subtypes, on the basis of what criteria should it be done? Types of obsessions and compulsions, reasons for performing compulsions, severity of illness, degree of insight, age of onset, or something else? 3. Should neutralizing responses other than compulsions be given a more prominent role in the description and conceptualization of OCD? 4. How does insight contribute to the conceptualization of OCD? 5. What are the core features of OCD? Is OCD primarily an affective disorder, is it characterized by a primary disturbance in thinking, or is it essentially a disorder of repetitive behaviors?

Download Full-text

A single nucleotide polymorphism in SLC1A1 gene is associated with age of onset of obsessive-compulsive disorder

European Psychiatry ◽

10.1016/j.eurpsy.2014.02.006 ◽

2014 ◽

Vol 29 (5) ◽

pp. 301-303 ◽

Cited By ~ 5

Author(s):

S. Dallaspezia ◽

M. Mazza ◽

C. Lorenzi ◽

F. Benedetti ◽

E. Smeraldi

Keyword(s):

Gene Expression ◽

Single Nucleotide Polymorphism ◽

Obsessive Compulsive Disorder ◽

Age Of Onset ◽

Age At Onset ◽

Functional Polymorphism ◽

Nucleotide Polymorphism ◽

Obsessive Compulsive ◽

Single Nucleotide ◽

Compulsive Disorder

AbstractDifferent genetic polymorphisms in the SLC1A1 have been shown to be associated with obsessive-compulsive disorder. Rs301430 is a T/C functional polymorphism affecting the gene expression and extrasynaptic glutamate concentration.We observed that Rs301430 influence age at onset in obsessive-compulsive disorder.

Download Full-text