Incidence of obsessive-compulsive disorder in a community sample of young adolescents.
OBJECTIVE
To investigate the incidence, transition probabilities, and risk factors for obsessive-compulsive disorder (OCD) and subclinical OCD in adolescents.


METHODS
A two-stage epidemiological study originally designed to investigate depression was conducted between 1987 and 1989 in the southeastern United States. For the screening, a self-report depressive symptom questionnaire was administered to a community sample of 3,283 adolescents. In the diagnostic stage, the Schedule for Affective Disorders and Schizophrenia for School-Age Children was administered to 488 mother-child pairs. Baseline screening and diagnostic data from the first year the subject completed an interview and follow-up diagnostic data from subsequent years were used.


RESULTS
The 1-year incidence rates of OCD and subclinical OCD were found to be 0.7% and 8.4%, respectively. Transition probabilities demonstrated a pattern of moving from more severe to less severe categories. Of those with baseline OCD, 17% had the diagnosis of OCD at follow-up; 62% moved to the referent group. Of those with baseline subclinical OCD, 1.5% had OCD at follow-up and 75% moved to the referent group. Black race (odds ratio [OR] = 23.38), age (OR = 4.02), desirable life events (OR = 0.78), undesirable life events (OR = 1.21), and socioeconomic status (OR not estimable) were significant predictors of incident OCD. Age (OR = 2.30), desirable life events (OR = 0.92), and undesirable life events (OR = 1.13) were significantly associated with incident subclinical OCD.


CONCLUSIONS
An initial diagnosis of subclinical OCD was not significantly predictive of a diagnosis of OCD at 1-year follow-up. The overall morbidity remained higher at follow-up in the baseline OCD group than in the baseline subclinical OCD group. The baseline subclinical OCD group was more dysfunctional at follow-up than was the baseline referent group. Further research concerning differences in symptomatology and impairment between OCD and subclinical OCD is warranted.
Valleni-Basile
L A
LA
Department of Epidemiology and Biostatistics, University of South Carolina, Columbia 29208, USA.
Garrison
C Z
CZ
Waller
J L
JL
Addy
C L
CL
McKeown
R E
RE
Jackson
K L
KL
Cuffe
S P
SP
D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008016:Life Change Events; D008297:Male; D008403:Mass Screening; D009771:Obsessive-Compulsive Disorder / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D010552:Personality Assessment; D012307:Risk Factors; D015144:Southeastern United States / Q000453:epidemiology