A study of phenomenology, psychiatric co-morbidities, social and adaptive functioning in children and adolescents with OCD

•Contamination and aggressive obsessions were the commonest obsessions.•Doubts, scary thoughts of terrible happening were the most distressing obsessions.•Repeated washing, cleaning and checking were the commonest compulsions.•Washing hands, rewriting and checking are the most distressing compulsion.•Co-morbidity of anxiety, depression and dissociative disorder is rather common.

ObjectiveTo study the phenomenology, social, adaptive and global functioning of children and adolescents with OCD.BackgroundStudies have shown varying prevalence of paediatric OCD ranging from 1% to 4%. Childhood-onset OCD have some important differences in sex distribution, presentation, co-morbidities and insight.Materials and methods25 subjects (6 to ≤18 years) with a DSM-IV-TR diagnosis of OCD were included in this study. Subjects were evaluated using K-SADS-PL, Children's Y-BOCS, HoNOSCA, C-GAS and VABS-II.ResultsThe mean age of the sample was 14.9 ± 2.2 years. Obsession of contamination was commonest (68%) followed by aggressive obsession (60%); commonest compulsions were washing and cleaning (72%) followed by checking (56%). Most distressing obsessions were obsession of doubt about their decision (28%), having horrible thoughts about their family being hurt (20%) and thought that something terrible is going to happen and it will be their fault (16%). Most subjects rate spending far too much time in washing hands (60%) as most distressing compulsion, followed by rewriting and checking compulsions (both 12%). 76% subjects have co-morbid psychiatric diagnosis. Anxiety disorders (24%), depression (16%), and dissociative disorder (16%) were common co-morbidities. Mean C-GAS score of the sample was 53.2 ± 9.9. 44% of subjects had below average adaptive functioning.ConclusionsThe study shows that, most frequent obsessions and compulsions may be different from most distressing ones and this finding might have clinical implication. Most of the children and adolescent with OCD have co-morbidities. Children also had problems in adaptive functioning.