Clinical correlates of functional impairment in children and adolescents with obsessive–compulsive disorder

• We investigated clinical correlates of functional impairment among youth with OCD.
• Parent-rated impairment correlated with internalizing and OCD symptoms.
• Child-rated impairment correlated with anxiety symptoms but not with OCD symptoms.
• Depressive symptoms were the only significant predictors of parent-rated impairment.
• Anxiety symptoms and subjective well-being predicted child impairment ratings.

Pediatric obsessive–compulsive disorder (OCD) is associated with functional impairment across multiple domains, although little information exists regarding clinical correlates of impairment. It has been suggested that subjective well-being (SWB) be considered in assessment of functional impairment related to various chronic health conditions, although SWB has not yet been examined in youth with OCD. Participants were 65 youth (ages 6–17 years) with a primary diagnosis of OCD recruited from a specialty clinic. Youth and their caregiver were administered the children's Yale–Brown obsessive compulsive scale. Youth completed the children's OCD impact scale-revised, children's depression inventory 2 self-report, multidimensional anxiety scale for children, Student's life satisfaction scale, and positive and negative affect scale for children; parents completed the child behavior checklist and children's OCD impact scale-revised. Results suggested that parent-rated impairment was positively associated with internalizing symptoms and obsessive–compulsive symptom severity, while child-rated impairment was positively associated with child-rated anxiety symptoms but not obsessive–compulsive symptom severity. Subjective well-being was negatively correlated with both parent- and child-rated impairment. Increasing anxiety symptoms and decreasing SWB predicted child-rated impairment. Increasing scores on the CBCL withdrawn/depressed subscale predicted parent-rated impairment above and beyond obsessive–compulsive symptom severity, while SWB did not.