CHILDHOOD, ADOLESCENT AND ADULT AGE AT ONSET AND RELATED CLINICAL CORRELATES IN OBSESSIVE-COMPULSIVE DISORDER: A REPORT FROM THE INTERNATIONAL COLLEGE OF OBSESSIVE-COMPULSIVE DISORDERS (ICOCS)

ObjectiveMany studies suggest that age at onset of obsessive-compulsive disorder (OCD) is an important factor in subtyping OCD (1). In fact, significant differences in clinical profile and comorbidity patterns have been observed between "juvenile-onset" and "adult-onset" OCD (2). Aim of the present study was to compare the prevalence and the socio-demographic and clinical patterns of OCD patients with "childhood-onset" (≤12 years), "adolescent-onset" (12-18 years), and "adult-onset" (≥18 years) in a large international sample.MethodsThe sample included 431 OCD out-patients of either gender and any age attending to different psychiatric departments worldwide participating to the “international college of obsessive-compulsive spectrum disorders” (ICOCS) network. The records of patients diagnosed with OCD and followed in the Psychiatric departments of the ICOCS network were collected and included in a common web-database and their main demographic and clinical variables were analyzed and Chi-squared and ANOVA analysis were performed to compare the three subgroups.ResultsTwenty-one percent (n=92) of the sample was represented by patients with childhood onset, while 36% (n=155) of the sample showed an adolescent onset and 43% (n=184) showed an adult onset. Patients with adult onset showed a significant female prevalence compared to the other two subgroups (χ2=10.92, p<0.05; 28% of females in the adult onset subgroup vs 11% in childhood onset and 18% in adolescent onset subgroup) and showed a significantly lower prevalence of patients receiving cognitive behavioural therapy (CBT) compared to the other two subgroups (χ2=14.5, p<0.01; 28% in adult onset subgroup were not under CBT vs 10% of the childhood onset and 19% of the adolescent onset subgroup). No significant differences among the three onset subgroups were found in terms of Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores nor in terms of psychopharmacological treatments and presence of comorbidity patterns.ConclusionsPresent naturalistic study suggests that more than 50% of the sample showed an onset during childhood or adolescence. Furthermore, there was a female prevalence in the subgroup of OCD patients with adult onset, as previously shown in recent studies (2) and a less frequent use of CBT in the same subgroup. Further research is required to better understand the clinical features of OCD with different age at onset.