Adults with early-onset obsessive-compulsive disorder.
OBJECTIVE
Obsessive-compulsive disorder (OCD) is a clinically heterogeneous disorder with a bimodal age at onset and range of treatment outcomes. This study attempted to ascertain the importance of the age at OCD symptom onset for a better phenotypic precision. Therefore, the authors compared adult OCD patients with an early symptom onset to OCD patients with a later symptom onset.


METHODS
Forty-two adult outpatients with OCD were evaluated with semistructured interviews: 21 with symptom onset before the age of 10 (early-onset group) and 21 with symptom onset after the age of 17 (late-onset group).


RESULTS
Early onset was associated with higher scores on the Yale-Brown Obsessive Compulsive Scale, higher frequencies of tic-like compulsions, higher frequency of sensory phenomena, and a higher rate of comorbid tic disorders. The early-onset group also responded less well to treatment with clomipramine and selective serotonin reuptake inhibitors.


CONCLUSIONS
The results indicate that age at onset may be an important factor in subtyping OCD and that the phenotypic differences found were not restricted to childhood.
Rosario-Campos
M C
MC
Department of Psychiatry, University of São Paulo Medical School, Brazil. maria.rosario-campos@yale.edu
Leckman
J F
JF
Mercadante
M T
MT
Shavitt
R G
RG
Prado
H S
HS
Sada
P
P
Zamignani
D
D
Miguel
E C
EC
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002997:Clomipramine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D002997:Clomipramine; D017367:Selective Serotonin Reuptake Inhibitors