Early onset obsessive-compulsive disorder with and without tics.
BACKGROUND
Research suggests that obsessive-compulsive disorder (OCD) is not a unitary entity, but rather a highly heterogeneous condition, with complex and variable clinical manifestations.


OBJECTIVE
The aims of this study were to compare clinical and demographic characteristics of OCD patients with early and late age of onset of obsessive-compulsive symptoms (OCS); and to compare the same features in early onset OCD with and without tics. The independent impact of age at onset and presence of tics on comorbidity patterns was investigated.


METHODS
Three hundred and thirty consecutive outpatients meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for OCD were evaluated: 160 patients belonged to the "early onset" group (EOG): before 11 years of age, 75 patients had an "intermediate onset" (IOG), and 95 patients were from the "late onset" group (LOG): after 18 years of age. From the 160 EOG, 60 had comorbidity with tic disorders. The diagnostic instruments used were: the Yale-Brown Obsessive Compulsive Scale and the Dimensional Yale-Brown Obsessive Compulsive Scale (DY-BOCS), Yale Global Tics Severity Scale, and Structured Clinical Interview for DSM-IV Axis I Disorders-patient edition. Statistical tests used were: Mann-Whitney, full Bayesian significance test, and logistic regression.


RESULTS
The EOG had a predominance of males, higher frequency of family history of OCS, higher mean scores on the "aggression/violence" and "miscellaneous" dimensions, and higher mean global DY-BOCS scores. Patients with EOG without tic disorders presented higher mean global DY-BOCS scores and higher mean scores in the "contamination/cleaning" dimension.


CONCLUSIONS
The current results disentangle some of the clinical overlap between early onset OCD with and without tics.
de Mathis
Maria Alice
MA
Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil. alicedemathis@gmail.com
Diniz
Juliana B
JB
Shavitt
Roseli G
RG
Torres
Albina R
AR
Ferrão
Ygor A
YA
Fossaluza
Victor
V
Pereira
Carlos
C
Miguel
Eurípedes
E
do Rosario
Maria Conceicão
MC
D000328:Adult; D017668:Age of Onset; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000150:complications*; D010045:Outpatients; D010552:Personality Assessment; D012720:Severity of Illness Index; D020323:Tics / Q000150:complications*