Demographic and clinical characteristics of adolescents in Hawaii with obsessive-compulsive disorder.
BACKGROUND
A high prevalence rate of obsessive-compulsive disorder (OCD) among Hawaiian adolescents, particularly Native Hawaiians, has been reported. Because Native Hawaiian and other Polynesian youth are at an increased risk for rheumatic fever, caused by an autoimmune response to group A beta-hemolytic streptococci, we hypothesized that the genetic and environmental risk factors for streptococcal infections and their autoimmune sequelae potentially may be associated with the presence of OCD and may partially explain this high OCD prevalence.


OBJECTIVE
To describe, among the adolescents in Hawaii diagnosed as having OCD through a previous study, OCD prevalence by ethnicity, household crowding and other measures of socioeconomic status, various measures of physical health and health-seeking behavior, and comorbid psychopathologic features.


METHODS
Six hundred nineteen adolescents from 5 high schools in the state of Hawaii were interviewed from April 15, 1993, to May 7, 1996. Interview instruments included the Diagnostic Interview Schedule for Children and other measurements of psychopathology. Obsessive-compulsive disorder diagnoses, based on current and past 6-month symptoms elicited via structured interview of the adolescents, were reported.


RESULTS
Relative to other ethnicities, Native Hawaiians had a 2-fold higher risk (odds ratio = 2.03) for OCD. Degree of Polynesian ancestry correlated positively with OCD prevalence. Obsessive-compulsive disorder prevalence also correlated positively with crowding in the household; measures of physical illness; and measures of depression, anxiety, aggression, and illicit substance use.


CONCLUSIONS
The characteristics of OCD in this sample suggest the need to consider the possibility of a streptococcal origin and the need for further studies to clarify the genetic and environmental risk factors for OCD in Hawaiian and other Polynesian youth.
Guerrero
Anthony P S
AP
The Native Hawaiian Mental Health Research Development Program of the Department of Psychiatry, University of Hawaii John A. Burns School of Medicine, Honolulu 96813, USA. guerroA@dop.hawaii.edu
Hishinuma
Earl S
ES
Andrade
Naleen N
NN
Bell
Cathy K
CK
Kurahara
David K
DK
Lee
Terry G
TG
Turner
Helen
H
Andrus
Jason
J
Yuen
Noelle Y C
NY
Stokes
Alexander J
AJ
D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology / Q000523:psychology*; D000328:Adult; D000374:Aggression / Q000523:psychology; D001007:Anxiety / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D007406:Interview, Psychological; D016015:Logistic Models; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000453:epidemiology* / Q000208:ethnology; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D010865:Pilot Projects; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000208:ethnology