[Phenomenology and co-morbidity of childhood onset obsessive compulsive disorder].
OBJECTIVE
The goal of the study was to investigate the contents and comorbidity features of obsessive-compulsive disorder in children and adolescents.


METHODS
55 patients (29 males, 26 females), mainly inpatients selected from university clinics for child and adolescent psychiatry (95%), were investigated. Structured diagnostic interviews were used to interview patients and their parents.


RESULTS
The mean age of onset for obsessive-compulsive disorders was 11.3 years. In males the onset was slightly earlier than among females, but this difference was not significantly significant. Compulsions mostly referred to washing and cleaning, checking, repeating, ordering, and counting. Most frequently, obsessions included thought about contamination, catastrophes, sexuality, and aggression. According to parental reports, the rate of comorbidity was high (lifetime diagnosis: 69%, current diagnosis: 53%), with anxiety, depressive, hyperkinetic, conduct, and eating disorders being the most frequent co-morbid conditions. Obsessive-compulsive symptoms were more intense in those patients who had a greater number of lifetime diagnoses of other psychiatric disorders. Comparing the rates found when structured interviews were carried out according to the study protocol to those for clinicians, clinicians were found to have diagnosed mixed obsessional thoughts and acts (presenting obsessional thoughts, as well as compulsive acts) less frequently.


CONCLUSIONS
The results of this investigation are well in line with those of international studies on obsessive-compulsive disorders. The rates of disorders found were dependent on the diagnostic methods used. A potentially promising approach for further investigation is the sub-typing of patients according to symptom dimensions.
Jans
Thomas
T
Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und Psychotherapie der Julius-Maximilians-Universität Würzburg, Germany.
Wewetzer
Christoph
C
Klampfl
Karin
K
Schulz
Eberhard
E
Herpertz-Dahlmann
Beate
B
Remschmidt
Helmut
H
Warnke
Andreas
A
D000293:Adolescent; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany; D006760:Hospitalization; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis* / Q000453:epidemiology; D010343:Patient Admission; D010552:Personality Assessment; D011446:Prospective Studies