Neurocognitive risk markers in pediatric obsessive-compulsive disorder

Juliana Negreiros; Laura Belschner; John R Best; Sarah Lin; Diana Franco Yamin; Yayuk Joffres; Robert R Selles; Fern Jaspers-Fayer; Lynn D Miller; Todd S Woodward; William G Honer; S Evelyn Stewart

doi:10.1111/jcpp.13153

Neurocognitive risk markers in pediatric obsessive-compulsive disorder

J Child Psychol Psychiatry. 2020 May;61(5):605-613. doi: 10.1111/jcpp.13153. Epub 2019 Nov 20.

Authors

Juliana Negreiros^{1

2}, Laura Belschner^{1

2}, John R Best^{1

2}, Sarah Lin^{1

2}, Diana Franco Yamin^{1

2}, Yayuk Joffres^{1

2}, Robert R Selles^{1

2}, Fern Jaspers-Fayer^{1

2}, Lynn D Miller³, Todd S Woodward¹, William G Honer¹, S Evelyn Stewart^{1

2}

Affiliations

¹ Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
² Provincial OCD Program, British Columbia Children's Hospital, Vancouver, BC, Canada.
³ Department of Education and Counselling Psychology and Special Education, University of British Columbia, Vancouver, BC, Canada.

PMID: 31749150
DOI: 10.1111/jcpp.13153

Abstract

Background: Obsessive-compulsive disorder (OCD) has complex genetic underpinnings, particularly in its early-onset form, which places siblings at a 10-fold increased risk of developing the disorder. Examination for neurocognitive markers preceding pediatric OCD onset has not been conducted, although markers have been identified in adult OCD. This study compared neurocognition across groups of OCD-affected youth (n = 87), unaffected siblings of those with early-onset OCD (n = 67), and healthy controls (HC; n = 79).

Methods: A total of 233 participants aged 6-18 years old completed standardized neurocognitive tests of cognitive flexibility, decision making, planning, response inhibition, spatial working memory, attention, recognition nonverbal memory, and intelligence. They were administered the Anxiety Disorders Interview Schedule-Parent version (ADIS-P) and completed self-report anxiety and OCD questionnaires. Linear mixed-effects models tested for differences between groups, adjusting for age, gender, IQ, state anxiety, and ethnicity, and accounting for random effects of family membership.

Results: OCD-affected youth and unaffected siblings performed significantly worse on planning in comparison to HCs (Cohen's d = 0.74; 95% CI = [0.11, 1.36]; Cohen's d = 0.75; 95% CI = [0.12, 1.38], respectively; omnibus group effect p = .007). No other significant between-group differences were identified.

Conclusions: Neurocognitive performance differences between groups identified planning as a preexisting trait marker of pediatric OCD, while no other domain presented as a marker of pediatric OCD. This differs from adult OCD, which is associated with broader cognitive impairments. Investigating longitudinal trajectories and predictive significance of neurocognition in those affected by, and at risk for, early-onset OCD is warranted. Ideally, this will enhance individualized risk stratification and inform future prevention and early intervention strategies.

Keywords: Cognitive; Obsessive-compulsive disorder; biomarker; genetics; pediatrics.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Child
Cognition*
Cognitive Dysfunction / complications*
Cognitive Dysfunction / diagnosis*
Cognitive Dysfunction / prevention & control
Cognitive Dysfunction / therapy
Female
Humans
Male
Obsessive-Compulsive Disorder / complications
Obsessive-Compulsive Disorder / diagnosis*
Obsessive-Compulsive Disorder / psychology*
Obsessive-Compulsive Disorder / therapy
Risk Assessment
Risk Factors

Grants and funding

133715/CIHR/Canada