title: A naturalistic study of referred children and adolescents with obsessive-compulsive disorder.
abstract: OBJECTIVE
  To report on clinical features, comorbidity, and response to pharmacotherapy in children and adolescents with obsessive-compulsive disorder (OCD) naturalistically followed and treated with serotonin reuptake inhibitors (SRIs).
  
  
  METHODS
  A consecutive series of 94 patients (65 males, 29 females, age 13.6 +/- 2.8 years), referred in the period January 2001-April 2004, diagnosed with a clinical interview (Diagnostic Interview for Children and Adolescents-Revised), and followed for 10 +/- 6 months, were included in the study.
  
  
  RESULTS
  Contamination obsessions and washing rituals were associated with less impairment than other subtypes of OCD. Aggressive sexual obsessions and checking rituals as well as symmetry obsessions and ordering-repeating rituals were more frequently comorbid with tic disorders. According to the Clinical Global Impressions-Improvement scale (score 1 or 2), 63 subjects (67%) were responders to treatment. Nonresponders were more severely impaired and had a higher number of comorbid disorders, namely, bipolar disorder and conduct disorder (p < .05). Forty-seven patients (50%) received an SRI monotherapy, whereas the other 47 (50%) needed other medications. Patients receiving SRI monotherapy were less severely impaired; had a later onset of OCD; were at a younger age at the visit, had higher rates of depression and anxiety and lower rates of bipolar disorder, attention-deficit/hyperactivity disorder, and conduct disorder (p < .05).
  
  
  CONCLUSIONS
  Long-term naturalistic prospective studies in pediatric patients with OCD might represent an important source of information for everyday care regarding the effectiveness of a treatment over extended periods of time under routine clinical conditions.
authors.affiliation: IRCCS Stella Maris, Scientific Institute Child Neurology and Psychiatry, Calambrone, Pisa (Italy). gabriele.masi@inpe.unipi.it
authors.forename: Gabriele
authors.initials: G
authors.lastname: Masi
authors.forename: Stefania
authors.initials: S
authors.lastname: Millepiedi
authors.forename: Maria
authors.initials: M
authors.lastname: Mucci
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Bertini
authors.forename: Luca
authors.initials: L
authors.lastname: Milantoni
authors.forename: Francesca
authors.initials: F
authors.lastname: Arcangeli
mesh_terms: D000293:Adolescent; D002648:Child; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D011446:Prospective Studies; D012017:Referral and Consultation; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors