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)

Int J Psychiatry Clin Pract. 2016 Nov;20(4):210-7. doi: 10.1080/13651501.2016.1207087. Epub 2016 Jul 19.

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 (χ(2 )=( )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 (χ(2 )=( )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.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Age of Onset*
  • Europe / epidemiology
  • Female
  • Humans
  • Israel / epidemiology
  • Libya / epidemiology
  • Male
  • Middle Aged
  • North America / epidemiology
  • Obsessive-Compulsive Disorder / epidemiology*
  • Societies, Medical
  • South Africa / epidemiology