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Children with Obsessive-Compulsive Symptomology in the General Population

Different Subtypes?

Zijlmans, Josjan MSc*; Marhe, Reshmi PhD*; van der Ende, Jan PhD; Verhulst, Frank C. MD, PhD; Popma, Arne MD, PhD*,‡; Tiemeier, Henning MD, PhD†,§; van den Heuvel, Odile A. MD, PhD‖,¶,**

Journal of Developmental & Behavioral Pediatrics: September 2017 - Volume 38 - Issue 7 - p 476–482
doi: 10.1097/DBP.0000000000000467
Original Articles
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Objective: Obsessive-compulsive disorder (OCD) is a moderately prevalent neurodevelopmental disorder, and many children suffer from subclinical obsessive-compulsive (OC) symptoms. The disorder is heterogeneous and has high comorbidity rates. In early disease stages of psychiatric disorders, symptoms are typically hard to attribute exclusively to specific disorders. The authors investigated whether profiles of neuropsychiatric symptoms can be distinguished within a large population-based study of school-aged children (7–10 years) scoring high on OC symptoms.

Methods: OC symptoms and comorbid symptoms common in pediatric OCD were assessed: symptoms of attention-deficit hyperactivity disorder, oppositional defiant disorder, autism, and anxiety. Latent profile analysis was performed on the subgroup of children scoring high on OC symptoms (high-OC sample, n = 209, i.e., 4.5% of total sample, n = 4632) using the z scores of the measures of comorbid symptoms as indicators.

Results: Three distinguishable profiles were found within the high-OC sample. The first subgroup (“OC-specific”; 81.3%, 3.7% of total sample) had only OC-specific problems, the second subgroup (“Comorbid OC”; 11.0%, 0.5% of total sample) had high scores on all measures of comorbid symptomology, and the third subgroup (“Autistic OC”; 7.7%, 0.3%, of total sample) scored especially high on autism.

Conclusion: The findings show that profiles based on neuropsychiatric symptoms can be distinguished within a population-based sample of school-aged children scoring high on obsessive-compulsive symptoms. These profiles may be useful in establishing patterns of symptom course during development. Longitudinal follow-up is necessary to ascertain whether at a later age these subgroups still differ in their symptom profile and neuropsychiatric trajectory.

*Department of Child and Adolescent Psychiatry, VU University Medical Center, Amsterdam, the Netherlands;

Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, the Netherlands;

Department of Criminal Law and Criminology, Leiden University, Leiden, the Netherlands;

§Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands;

Departments of Psychiatry,

Anatomy and Neurosciences, VU University Medical Center, Amsterdam, the Netherlands;

**The OCD Team, Haukeland University Hospital, Bergen, Norway.

Address for reprints: Josjan Zijlmans, MSc, Meibergdreef 5, 1105 AZ Amsterdam, the Netherlands (Psychiatry Building AMC/De Bascule); e-mail: j.zijlmans@vumc.nl.

The work of H. Tiemeier was supported by the Gravitation program of the Dutch Ministry of Education, Culture, and Science and the Netherlands Organization for Scientific Research (NWO Grant 024.001.003, The Consortium on Individual Development).

Disclosure: The authors declare no conflict of interest.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Received November 10, 2016

Accepted May 02, 2017

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.