Pediatric obsessive–compulsive disorder: Symptom patterns and confirmatory factor analysis

• Most OCD participants reported multiple obsessions and compulsions.
• Most common obsessions were aggressive and contamination.
• Most common compulsions were checking and washing/cleaning.
• CFA supported the four-factor model of CY-BOCS in this sample.
• CY-BOCS dimensions will help define homogeneous OCD subtypes.

Pediatric obsessive–compulsive disorder (OCD) is a clinically heterogeneous disorder. This study evaluates patterns of obsessions and compulsions in pediatric OCD and assesses symptom dimensions in OCD based on the Children's Yale–Brown Obsessive–Compulsive Scale (CY-BOCS) using confirmatory factor analysis (CFA). Participants were 77 youths (ages 5–18) with OCD [22 with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and 55 with non-PANDAS OCD]. All participants were administered Anxiety Disorders Interview Schedule for DSM-IV and CY-BOCS. CFA was run to test a four-factor model with the following CY-BOCS factors: ordering/repeating, contamination/cleaning, hoarding, and forbidden thoughts. The most common obsessions were aggressive and contamination and most common compulsions were checking and washing/cleaning. Eighty-eight percent of participants reported multiple current obsessions and compulsions. CFA results supported the fit of the hypothesized factor model to the data within this sample. Defining OCD dimensions will guide investigations of etiology and help predict and monitor response to treatments.