title: The influence of age at onset and duration of illness on long-term outcome in patients with obsessive-compulsive disorder: a report from the International College of Obsessive Compulsive Spectrum Disorders (ICOCS).
abstract: Several studies reported a negative effect of early onset and long duration of illness on long-term outcome in psychiatric disorders, including Obsessive-Compulsive Disorder (OCD). OCD is a prevalent, comorbid and disabling condition, associated with reduced quality of life and overall well-being for affected patients and related caregivers. The present multicenter naturalistic study sought to assess the influence of early onset and duration of illness on long-term outcome in a sample of 376 OCD out-patients worldwide, as part of the "International College of Obsessive-Compulsive Spectrum Disorders" (ICOCS) network. Binary logistic regressions were performed with age at the onset and duration of illness, as continuous independent variables, on a series of different outcome dependent variables, including lifetime number of hospitalizations and suicide attempts, poly-therapy and psychiatric comorbidity. Correlations in terms of disability (SDS) were analyzed as well. Results showed that a longer duration of illness (but not earlier age of onset) was associated with hospitalization (odds ratio=1.03, p=0.01), earlier age at onset with CBT (odds ratio=0.94, p<0.001) and both a later age at onset (odds ratio=1.05, p=0.02) and a shorter duration of illness (odds ratio=0.93, p=0.02) with panic disorder comorbidity. In addition, earlier age at onset inversely correlated with higher social disability (r=-0.12, p=0.048) and longer duration of illness directly correlated with higher disability in work, social and family life (r=0.14, p=0.017; r=0.13, p=0.035; r=0.14, p=0.02). The findings from the present large, multicenter study indicate early onset and long duration of illness as overall negative predictors of long-term outcome in OCD.
authors.affiliation: Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda, Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan 20122, Italy. bernardo.dellosso@unimi.it
authors.forename: Bernardo
authors.initials: B
authors.lastname: Dell'Osso
authors.forename: Beatrice
authors.initials: B
authors.lastname: Benatti
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Buoli
authors.forename: A Carlo
authors.initials: AC
authors.lastname: Altamura
authors.forename: Donatella
authors.initials: D
authors.lastname: Marazziti
authors.forename: Eric
authors.initials: E
authors.lastname: Hollander
authors.forename: Naomi
authors.initials: N
authors.lastname: Fineberg
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
authors.forename: Stefano
authors.initials: S
authors.lastname: Pallanti
authors.forename: Humberto
authors.initials: H
authors.lastname: Nicolini
authors.forename: Michael
authors.initials: M
authors.lastname: Van Ameringen
authors.forename: Christine
authors.initials: C
authors.lastname: Lochner
authors.forename: Georgi
authors.initials: G
authors.lastname: Hranov
authors.forename: Oguz
authors.initials: O
authors.lastname: Karamustafalioglu
authors.forename: Luchezar
authors.initials: L
authors.lastname: Hranov
authors.forename: Jose M
authors.initials: JM
authors.lastname: Menchon
authors.forename: Joseph
authors.initials: J
authors.lastname: Zohar
mesh_terms: D000328:Adult; D017668:Age of Onset; D000375:Aging; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy; D015897:Comorbidity; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy; D012074:Remission Induction; D012189:Retrospective Studies; D012955:Societies, Medical
keywords: Duration of illness; Early onset; Long-term outcome; Obsessive compulsive disorder (OCD)