Symptom profiles and executive function in childhood obsessive-compulsive disorder

- Three obsessive-compulsive symptom dimension subgroups were identified in children and adolescents with OCD.
- Each subgroup mapped onto one of the symptom dimensions of harm/sexual, symmetry/hoarding, or contamination/cleaning.
- The subgroups differed with respect to parent-reported working memory, and several basic clinical characteristics.
- The subgroups did not differ with respect to performance-based executive functions.
- Symptom dimensions were not associated with executive functions in children and adolescents with OCD.

Obsessive-compulsive disorder (OCD) often becomes manifest in childhood. It has been suggested that the symptom heterogeneity of the disorder could mask subgroups associated with executive function (EF) impairment. Though supported in adult studies, this is scarcely investigated in children. The aims of the present study were to: (i) investigate OCD symptom subgroups using an empirically supported and age-appropriate definition of symptom dimensions (SD) as well as latent profile analysis (LPA); (ii) compare the identified subgroups with respect to EFs, demographic, and clinical descriptives; and (iii) explore the associations between SDs and EFs. The study included 50 pediatric OCD patients and 50 matched controls. Patients were assessed with the Children's Yale-Brown Obsessive-Compulsive Scale from which three SD factor scores were generated. Participants were assessed with EF tasks from which latent variables measuring working memory, set shifting and response inhibition were derived. Parents rated executive function behaviors in their children. Three subgroups were identified, each predominantly characterized by one of the SDs. Subgroups differed with respect to parent-rated working memory and several demographic and basic clinical characteristics. The findings suggest the presence of clinically relevant child and adolescent OCD SD subgroups, but do not support the relevance of EFs in distinguishing SDs.