Obsessive-compulsive symptoms are associated with psychiatric comorbidities, behavioral and clinical problems: a population-based study of Brazilian school children

Pediatric-onset obsessive-compulsive disorder (OCD) is underdiagnosed, and many affected children are untreated. The present study seeks to evaluate the presence and the clinical impact of OCD and obsessive-compulsive symptoms (OCS) in a large sample of school-age children. In Phase I, we performed an initial screening using the Family History Screen (FHS). In Phase II, we identified an ""at-risk"" sample, as well as a randomly selected group of children. A total of 2,512 children (6-12 years old) were assessed using the FHS, the Development and Well-Being Assessment (DAWBA), the Strengths and Difficulties Questionnaire (SDQ), and the Child Behavior Checklist (CBCL). Data analyses included descriptive and multivariate analytical techniques. 2,512 children (mean age: 8.86 +/- A 1.84 years; 55.0 % male) were categorized into one of the three diagnostic groups: OCD (n = 77), OCS (n = 488), and unaffected controls (n = 1,947). There were no significant socio-demographic differences (age, gender, socioeconomic status) across groups. The OCS group resembled the OCD on overall impairment, including school problems and delinquent behaviors. However, the OCD group did have significantly higher rates of several comorbid psychiatric disorders, including separation anxiety, generalized anxiety, and major depressive disorder, than OCS or unaffected controls. Moreover, the OCD group also scored higher than the SDQ, as well as on each of CBCL items rated by the parent. Our findings suggest that there is a psychopathological continuum between OCS and OCD in school-aged children. The presence of OCS is associated with functional impairment, which needs further investigation in longitudinal studies.

Palavras-chave

Child and adolescent psychiatry, Comorbidities, Epidemiology, Obsessive-compulsive disorder, School-aged children

URI

https://observatorio.fm.usp.br/handle/OPI/13506

Referências

Abramowitz JS, 2004, CLIN PSYCHOL REV, V34, P206
Achenbach T. M., 1991, INTEGRATIVE GUIDE 19
Agresti A., 2002, CATEGORICAL DATA ANA
Alvarenga PG, 2012, IACAPAP TXB CHILD AD
American Academy of Child and Adolescent Psychiatry (AACAP), 2012, J AM ACAD CHILD ADOL, V51, P98
Bordin IA, 2013, CAD SAUDE PUBLICA, V29, P13, DOI 10.1590/S0102-311X2013000100004
Grisham JR, 2010, PSYCHIAT RES, V175, P256, DOI 10.1016/j.psychres.2009.01.028
Essau CA, 2000, J ANXIETY DISORD, V14, P263, DOI 10.1016/S0887-6185(99)00039-0
Lebowitz ER, 2011, DEPRESS ANXIETY, V28, P899, DOI 10.1002/da.20858
Goodman R, 2000, J CHILD PSYCHOL PSYC, V41, P645, DOI 10.1111/j.1469-7610.2000.tb02345.x
Kessler RC, 2005, ARCH GEN PSYCHIAT, V62, P593, DOI 10.1001/archpsyc.62.6.593
Fullana MA, 2010, J AFFECT DISORDERS, V124, P291, DOI 10.1016/j.jad.2009.11.020
Fullana MA, 2009, AM J PSYCHIAT, V166, P329, DOI [10.1176/appi.ajp.2008.08071006, 10.1176/appi.ajp.2008/08071006]
Goodman A, 2012, SOC PSYCH PSYCH EPID, V47, P1321, DOI 10.1007/s00127-011-0440-2
Termine C, 2006, BRAIN DEV-JPN, V28, P69, DOI 10.1016/j.braindev.2005.04.006
Black DW, 2008, CNS SPECTRUMS, V13, P54
Goodman R, 1997, J CHILD PSYCHOL PSYC, V38, P581, DOI 10.1111/j.1469-7610.1997.tb01545.x
Geller DA, 2006, PSYCHIAT CLIN N AM, V29, P353, DOI 10.1016/j.psc.2006.02.012
Kim MS, 2009, J INT NEUROPSYCH SOC, V15, P286, DOI 10.1017/S1355617709090213
Bedard MJ, 2009, ARCH CLIN NEUROPSYCH, V24, P585, DOI 10.1093/arclin/acp052
Canals J, 2012, J ANXIETY DISORD, V26, P746, DOI 10.1016/j.janxdis.2012.06.003
Fleitlich-Bilyk B, 2004, J AM ACAD CHILD PSY, V43, P727, DOI 10.1097/01.chi.0000120021.14101.ca
Apter A, 1996, J AM ACAD CHILD PSY, V35, P907, DOI 10.1097/00004583-199607000-00016
Heyman I, 2001, BRIT J PSYCHIAT, V179, P324, DOI 10.1192/bjp.179.4.324
Ruscio AM, 2010, MOL PSYCHIATR, V15, P53, DOI 10.1038/mp.2008.94
Fontenelle LF, 2006, PROG NEURO-PSYCHOPH, V30, P327, DOI 10.1016/j.pnpbp.2005.11.001
Moraes END, 2011, REV BRAS PSIQUIATR, V33, P287, DOI 10.1590/S1516-44462011000300013
Blom RM, 2011, DEPRESS ANXIETY, V28, P870, DOI 10.1002/da.20853
McGuire JF, 2013, PSYCHIAT RES, V209, P589, DOI 10.1016/j.psychres.2013.04.003
Rajender G, 2011, ACTA PSYCHIAT SCAND, V124, P152, DOI 10.1111/j.1600-0447.2011.01733.x
ZOHAR AH, 1992, J AM ACAD CHILD PSY, V31, P1057, DOI 10.1097/00004583-199211000-00010
VALLENIBASILE LA, 1994, J AM ACAD CHILD PSY, V33, P782, DOI 10.1097/00004583-199407000-00002
de Mathis MA, 2013, EUR NEUROPSYCHOPHARM, V23, P594, DOI 10.1016/j.euroneuro.2012.08.006
Milne BJ, 2009, AM J MED GENET B, V150B, P41, DOI 10.1002/ajmg.b.30764
Mahfouz AA, 2009, INT J PSYCHIAT MED, V39, P169, DOI 10.2190/PM.39.2.e
Association American Psychiatric, 1994, DIAGN STAT MAN MENT
Bolstad WM, 2007, INTRO BAYESIAN STAT
Bruijn C, 2010, PSYCHOL MED, V40, P989
Shams Giti, 2011, Acta Med Iran, V49, P680
FLAMENT M, 1990, Encephale, V16, P311
FLAMENT MF, 1988, J AM ACAD CHILD PSY, V27, P764, DOI 10.1097/00004583-198811000-00018
Jannuzzi PM, 1996, REV ADM SAO PAULO, V31, P82
Rosario-Campos MC, 2008, RECENT TRENDS DEV AD, P83
Salum GA, 2014, INT J METHO IN PRESS
Siegel C, 1988, NONPARAMETRIC STAT B
Vivan AD, 2013, REV BRAS PSIQUIATR, V18, P111
Voltas N, 2013, CHILD PSYCHIAT HUM D, V28, P377
Yandell BS, 1997, PRACTICAL DATA ANAL

Coleções

Artigos e Materiais de Revistas Científicas - FM/MPS
Artigos e Materiais de Revistas Científicas - HC/IPq
Artigos e Materiais de Revistas Científicas - LIM/21

Página do item completo