Childhood, adolescent and adult age at onset and related clinical correlates in obsessive–compulsive disorder: a report from the International College of Obsessive–Compulsive Spectrum Disorders (ICOCS)

Abstract

Objective: Many studies suggest that age at onset (AAO) is an important factor for clinically differentiating patients with juvenile and adult onset of obsessive–compulsive disorder (OCD). The present international study aimed to assess the prevalence of different AAO groups and compare related socio-demographic and clinical features in a large sample of OCD patients.

Methods: A total of 431 OCD outpatients, participating in the ICOCS network, were first categorised in groups with childhood (≤12 years), adolescent (13–17 years) and adult-onset (≥18 years), then in pre-adult and adult onset (≥18 years) and their socio-demographic and clinical features compared.

Results: Twenty-one percent (n = 92) of the sample reported childhood onset, 36% (n = 155) adolescent onset, and 43% (n = 184) adult onset. Patients with adult onset showed a significantly higher proportion of females compared with the other subgroups (χ²=10.9, p< 0.05). Childhood- and adolescent-onset patients had been more frequently treated with cognitive behavioural therapy (CBT), compared to adult-onset patients (χ²=11.5; p < 0.05). The pre-adult- versus adult-onset analysis did not show any additional significant difference.

Conclusions: The present international multicentre study confirms that OCD onset occurs more frequently before adult age, with approximately one out of five patients showing childhood onset. Pre-adult onset was associated with higher rate of CBT, while adult onset was more prevalent in females.

Keywords:

• Age at onset
• cognitive behavioural therapy
• gender
• obsessive–compulsive disorder

Acknowledgements

Authors specifically thank the ECNP Obsessive Compulsive and Related Disorders Network (OCRN) for the support.

Disclosure statement

Bernardo Dell’Osso has the following disclosures: Astra-Zeneca, Speaker’s Bureau, Speaker’s fee; Bristol Myers Squibb, Speaker’s Bureau, Speaker’s fee; Janssen-Cilag, Speaker’s Bureau, Speaker’s fee; Eli Lilly, Speaker’s Bureau, Speaker’s fee; Pfizer, Speaker’s Bureau, Speaker’s fee; GlaxoSmithKline, Speaker’s Bureau, Speaker’s fee; Lundbeck, Speaker’s Bureau, Speaker’s fee; Cyberonics, Speaker’s Bureau, Speaker’s fee; Italfarmaco, Speaker’s Bureau, Speaker’s fee; Roche, Consultant, Honoraria; Merck, Consultant, Honoraria; AstraZeneca, Consultant, Honoraria; BristolMyers Squibb, Consultant, Honoraria; Janssen Cilag, Consultant, Honoraria; Lundbeck, Consultant, Honoraria; Sanofi, Consultant, Honoraria; Eli Lilly, Consultant, Honoraria; Pfizer, Consultant, Honoraria.

Eric Hollander is an associate editor of this journal and has the following disclosures: Sunovion, Speakers Bureau, Speaker’s fee; Shire, Consultant, Consulting fee; Roche, Researcher, Research grant Cunemark, Researcher, Research grant; Brainsway, Researcher, Research grant.

Naomi Fineberg is an associate editor of this journal and has the following disclosures: European College of Neuropsychopharmacology, Researcher, Research support; British Association for Psychopharmacology, Attendance at psychiatric meetings, Financial support; National Institute of Health Research, Researcher, Research support Informa, Associate Editor, Fees; Taylor and Francis, Associate Editor, Royalties. Dan Stein has the following disclosures: Ambrf, Consultant, Research grants and/or consultancy honoraria; Biocodex, Consultant, Research grants and/or consultancy honoraria; Cipla, Consultant, Research grants and/or consultancy honoraria; Lundbeck, Consultant, Research grants and/or consultancy honoraria; Novartis, Consultant, Research grants and/or consultancy honoraria, Servier, Consultant, Research grants and/or consultancy honoraria; Sun, Consultant, Research grants and/or consultancy honoraria; National Responsible Gambling Foundation, Consultant, Research grants and/or consultancy honoraria.

Christine Lochner has the following disclosures: National Research Foundation of South Africa, Research, Research support.

Humberto Nicolini has the following disclosures: Forum Pharmaceuticals, Principal Investigator, Research support.

Michael Van Ameringen has the following disclosures: Astra Zeneca, Consultant, Consulting fee; Biovail, Consultant, Consulting fee; Eli Lilly, Consultant, Consulting fee; Lundbeck, Consultant, Consulting fee; Pfizer, Consultant, Consulting fee; Servier, Consultant, Consulting fee; GlaxoSmith Kline, Speaker, Speaker fee. EGRIS, Principal investigator, Investigator’s fee; ECNP, Ambassador for BG, Support for congresses; Pfizer, Principal investigator, Investigator’s fee; Merck, Principal investigator, Investigator’s fee.

Jon Grant has the following disclosures: research grants from Trichotillomania Learning Center, NIMH, National Center for Responsible Gaming, Brainsway, Forest, and Psyadon Pharmaceuticals. He receives yearly compensation from Springer Publishing for acting as Editor-in-Chief of the Journal of Gambling Studies and has received royalties from Oxford University Press, American Psychiatric Publishing, Inc., Norton Press, Johns Hopkins Press, and McGraw Hill.

Joseph Zohar has the following disclosures: he received grant/research support from Lundbeck, Servier, Brainsway and Pfizer, has served as a consultant or on advisory boards for Servier, Pfizer, Abbott, Lilly, Actelion, AstraZeneca and Roche and has served on speakers’ bureaus for Lundbeck, Roch, Lilly Servier, Pfizer and Abbott.

Jose M. Menchon has the following disclosures: AB Biotics, Consultant, Honoraria; Medtronic, Speaker, Honoraria.