Abstract
This paper describes the phenomenological features of early childhood onset obsessive compulsive disorder (OCD; defined as children meeting DSM-IV criteria for OCD with age of onset <8 years). Fifty-eight children (ages 4–8) were included in the sample. OCD and comorbid diagnoses were determined by structured interview, and OCD severity was measured using the Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS). Mean age of OCD onset was almost five, and mean age of presentation was between 6 and 7. Mean symptom severity was in the moderately severe range. Comorbidity and family history of OCD were common. Contamination and aggressive/catastrophic obsessions and washing and checking compulsions were endorsed most frequently. Results indicate that early childhood onset OCD may have a lower boy to girl ratio and lower rates of depressive disorders, but may be similar to later childhood onset OCD in terms of OCD symptom presentation and severity.
Similar content being viewed by others
References
Chabane, N., Delorme, R., Millet, B., Mouren, M. C., Leboyer, M., & Pauls, D. (2005). Early-onset obsessive–compulsive disorder: a subgroup with a specific clinical and familial pattern? Journal of Child Psychology and Psychiatry and Allied Disciplines, 46(8), 881–887.
Chambers, W. (1985). The assessment of affective disorders in children and adolescents by semistructured interview: test–retest reliability of the schedule for affective disorders and Schizophrenia for school-age children, present episode version. Archives of General Psychiatry, 42(7), 696–702.
Chowdhury, U., Frampton, I., & Heyman, I. (2004). Clinical characteristics of young people referred to an obsessive compulsive disorder clinic in the United Kingdom. Clinical Child Psychology and Psychiatry, 9(3), 395–401.
Costello, E. J., Mustillo, S., Erkanli, A., Keeler, G., & Angold, A. (2003). Prevalence and development of psychiatric disorders in childhood and adolescence. Archives of General Psychiatry, 60, 837–844.
Delorme, R., Golmard, J., Chabane, N., Millet, B., Krebs, M., Mouren-Simeoni, M. C., et al. (2005). Admixture analysis of age at onset in obsessive–compulsive disorder. Psychological Medicine, 35, 237–243.
Eischstedt, J. A., & Arnold, S. L. (2001). Childhood-onset obsessive–compulsive disorder: a tic-related subtype of OCD? Clinical Child Review, 21(1), 137–158.
Francis, G., & Gragg, R. (1996). Childhood obsessive compulsive disorder. Thousand Oaks, CA: Sage.
Freeman, J., Garcia, A., Fucci, C., Karitani, M., Miller, L., & Leonard, H. L. (2003). Family-based treatment of early-onset obsessive–compulsive disorder. Journal of Child and Adolescent Psychopharmacology, 13(Supplement 1), S71–S80, 79–88.
Freeman, J. B., Garcia, A. M., Coyne, L., Ale, C. M., Przeworski, A., Compton, S., et al. (2008). Treating OCD in young children: results from a randomized, controlled trial pilot study. Journal of the American Academy of Child and Adolescent Psychiatry, in press.
Geller, D. A., Biederman, J., Faraone, S., Agranat, A., Cradock, K., Hagermoser, L., et al. (2001a). Developmental aspects of obsessive compulsive disorder: findings in children, adolescents, and adults. Journal of Nervous and Mental Disease, 189(7), 471–477.
Geller, D. A., Biederman, J., Faraone, S., Spencer, T., Doyle, R., Mullin, B., et al. (2004). Re-examining comorbidity of obsessive compulsive and attention-deficit hyperactivity disorder using an empirically derived taxonomy. European Child and Adolescent Psychiatry, 13(2), 83–91.
Geller, D. A., Biederman, J., Faraone, S. V., Bellordre, C. A., Kim, G. S., Hagermoser, L., et al. (2001b). Disentangling chronological age from age of onset in children and adolescents with obsessive–compulsive disorder. International Journal of Neuropsychopharmacology, 4, 169–178.
Geller, D. A., Biederman, J., Griffin, S., Jones, J., & Lefkowitz, T. R. (1996). Comorbidity of juvenile obsessive–compulsive disorder with disruptive behavior disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 35(12), 1637–1646.
Geller, D. A., Biederman, J., Jones, J., Park, K., Schwartz, S., Shapiro, S., et al. (1998). Is juvenile obsessive–compulsive disorder a developmental subtype of the disorder? A review of the pediatric literature. Journal of the American Academy of Child and Adolescent Psychiatry, 37(4), 420–427.
Hanna, G. L. (1995). Demographic and clinical features of obsessive–compulsive disorder in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 34(1), 19–27.
Himle, M. B., Woods, D. W., Conelea, C. A., Bauer, C. C., & Rice, K. A. (2007). Investigating the effects of tic suppression on premonitory urge ratings in children and adolescents with Tourette’s syndrome. Behaviour Research and Therapy, 45(12), 2964–2976.
Hollingsworth, C. E., Tanguay, P. E., Grossman, L., & Pabst, P. (1980). Long-term outcome of obsessive–compulsive disorder in childhood. Journal of the American Academy of Child Psychiatry, 19, 134–144.
Kaufman, J., Birmaher, B., Brent, D. A., Rao, U., Flynn, C., Moreci, P., et al. (1997). Schedule for affective disorders and schizophrenia for school-age children–present and lifetime version (K-SADS-PL): initial reliability and validity data. Journal of the American Academy of Child & Adolescent Psychiatry, 36, 980–988.
Last, C. G., Perrin, S. M. H., & Kazdin, A. E. (1992). DSM-III-R anxiety disorders in children: sociodemographic and clinical characteristics. Journal of the American Academy of Child and Adolescent Psychiatry, 31(6), 1070–1076.
Leckman, J. F., McDougle, C. J., Pauls, D. L., Peterson, B. S., Grice, D. E., King, R. A., et al. (2000). Tic-related versus non-tic-related obsessive–compulsive disorder. In Obsessive–compulsive disorder: Contemporary issues in treatment (pp 43–68). Mahwah, NJ, US: Erlbaum.
Lenane, M. C., Swedo, S. E., Leonard, H. L., Pauls, D., Sceery, W., & Rapoport, J. L. (1990). Psychiatric disorders in first degree relatives of children and adolescents with obsessive compulsive disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 29(3), 407–412.
Leonard, H. L., Lenane, M. C., Swedo, S. E., Rettew, D. C., Gershon, E. S., & Rapoport, J. L. (1992). Tics and Tourette’s disorder: a 2- to 7-year follow up of 54 obsessive–compulsive children. American Journal of Psychiatry, 149(9), 1244–1251.
Mansueto, C. S. (2005). Tic or compulsion?: it’s tourettic OCD. Behavioral Modification, 29, 784–799.
Masi, G., Millepiedi, S., Mucci, M., Bertini, N., Milantoni, L., & Arcangeli, F. (2005). A naturalistic study of referred children and adolescents with obsessive–compulsive disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 44(7), 673–681.
Masi, G., Millepiedi, S., Mucci, M., Bertini, N., Pfanner, C., & Arcangeli, F. (2006). Cormorbidity of obsessive–compulsive disorder and attention-deficit/hyperactivity disorder in referred children and adolescents. Comprehensive Psychiatry, 47, 42–47.
Millet, B., Kochman, F., Gallarda, T., Krebs, M., Demonfaucon, F., Barrot, I., et al. (2004). Phenomenological and comorbid features associated in obsessive–compulsive disorder: influence of age of onset. Journal of Affective Disorders, 79, 241–246.
Nestadt, G., Samuels, J., Riddle, M., Bienvenu, O. J., Liang, K. Y., LaBuda, M., et al. (2000). A family study of obsessive–compulsive disorder. Archives of General Psychiatry, 57, 358–363.
Pauls, D., Alsobrook, J. P., Goodman, W. K., Rasmussen, S. A., & Leckman, J. F. (1995). A family study of obsessive–compulsive disorder. American Journal of Psychiatry, 152(1), 76–84.
Rettew, D. C., Swedo, S. E., Leonard, H. L., Lenane, M. C., & Rapoport, J. L. (1992). Obsessions and compulsions across time in 79 children and adolescents with obsessive–compulsive disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 1050–1056.
Riddle, M. A., Scahill, L., King, R. A., Hardin, M. T., Towbin, K. E., Ort, S. I., et al. (1990). Obsessive compulsive disorder in children and adolescents: phenomenology and family history. Journal of the American Academy of Child and Adolescent Psychiatry, 19(5), 766–772.
Rosario-Campos, M. C., Leckman, J. F., Curi, M., Quatrano, S., Katsovitch, L., Miguel, E. C., et al. (2005). A family study of early-onset obsessive compulsive disorder. American Journal of Genetics, 136B, 92–97.
Rosario-Campos, M. C., Leckman, J. F., Mercadante, M. T., Shavitt, R., Prado, H. S., Sada, P., et al. (2001). Adults with early-onset obsessive–compulsive disorder. American Journal of Psychiatry, 158(11), 1899–1903.
Scahill, L., Kano, Y., King, R. A., Carlson, A., Peller, A., LeBrun, U., et al. (2003). Influence of age and tic disorders on obsessive–compulsive disorder in a pediatric sample. Journal of Child and Adolescent Psychopharmacology, 13(Supplement 1), S7–S17.
Scahill, L., Riddle, M. A., McSwiggan-Hardin, M., Ort, S. I., King, R. A., Goodman, W. K., et al. (1997). Children’s Yale-Brown Obsessive–Compulsive Scale: reliability and validity. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 844–852.
Secord, P., & Peevers, B. (1974). The development and attribution of person concepts. In T. Mischel (Ed.), Understanding other persons (pp. 117–142). Oxford: Blackwell.
Selman, R. (1980). The growth of interpersonal understanding. New York: Academic.
Silverman, W. K., & Albano, A. M. (1996). Anxiety disorders interview schedule for DSM-IV. San Antonio: The Psychological Corporation.
Silverman, W., & Eisen, A. (1992). Age differences in the reliability of parent and child reports of child anxious symptomatology using a structured interview. Journal of the American Academy of Child Psychiatry, 31(1), 117–124.
Silverman, W., & Nelles, W. (1988). The Anxiety Disorders Interview Schedule for Children. Journal of the American Academy of Child and Adolescent Psychiatry, 27(6), 772–778.
Silverman, W., & Rabian, B. (1995). Test-retest reliability of the DSM-III-R childhood anxiety disorders symptoms using the Anxiety Disorders Interview Schedule for Children. Journal of Anxiety Disorders, 9(2), 139-150.
Sobin, C., Blundell, M. L., & Karayiorgou, M. (2000). Phenotypic differences in early- and late-onset obsessive–compulsive disorder. Comprehensive Psychiatry, 41(5), 373–379.
Storch, E. A., Murphy, T. K., Adkins, J. W., Lewin, A. B., Geffken, G. R., Johns, N. B., et al. (2006). The Children’s Yale-Brown Obsessive–Compulsive scale: psychometric properties of child-and parent-report formats. Journal of Anxiety Disorders, 20(8), 1–16.
Swedo, S. E., Rapoport, J. L., Leonard, H. L., Lenane, M., & Cheslow, D. (1989). Obsessive compulsive disorders in children and adolescents: clinical phenomenology of 70 consecutive cases. Archives of General Psychiatry, 46, 335–343.
Weinberg, C. R. (1993). Toward a clearer definition of confounding. American Journal of Epidemiology, 137, 1–8.
Wood, J. J., Piacentini, J. C., Bergman, R. L., McCracken, J., & Barrios, V. (2002). Concurrent validity of the anxiety disorders section of the anxiety disorders interview schedule for DSM-IV: child and parent versions. Journal of Clinical Child and Adolescent Psychology, 31(3), 335–342.
Woods, D. W., Piacentini, J., Himle, M. B., & Chang, S. (2005). Premonitory Urge for Tics Scale (PUTS): initial psychometric results and examination of the premonitory urge phenomenon in youths with tic disorders. Journal of Developmental & Behavioral Pediatrics, 26(6), 397–403.
Yucelen, A. G., Rodopman-Arman, A., Topcuoglu, V., Yazgan, M. Y., & Fisek, G. (2006). Interrater reliability and clinical efficacy of Children’s Yale-Brown Obsessive–Compulsive Scale in an outpatient setting. Comprehensive Psychiatry, 47, 48–53.
Zohar, A. H. (1999). The epidemiology of obsessive–compulsive disorder in children and adolescents. Child and Adolescent Psychiatric Clinics of North America, 8(3), 445–461.
Acknowledgements
This study was supported in part by a grant from the National Institute of Mental Health (R21 MH079217). This paper is dedicated to the memory of Henrietta Leonard, M.D.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Garcia, A.M., Freeman, J.B., Himle, M.B. et al. Phenomenology of Early Childhood Onset Obsessive Compulsive Disorder. J Psychopathol Behav Assess 31, 104–111 (2009). https://doi.org/10.1007/s10862-008-9094-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10862-008-9094-0