title: Differences in duration of untreated illness, duration, and severity of illness among clinical phenotypes of obsessive-compulsive disorder.
abstract: BACKGROUND
  Obsessive-compulsive disorder (OCD) is a prevalent, disabling, and comorbid condition that is frequently under-recognized and poorly treated. OCD phenotypes may differ in terms of clinical presentation and severity. However, few studies have investigated whether clinical phenotypes differ in terms of latency to treatment (ie, duration of untreated illness[DUI]), duration, and severity of illness. The present study was aimed to quantify the aforementioned variables in a sample of OCD patients.
  
  
  METHODS
  One hundred fourteen outpatients with a Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) diagnosis of OCD were recruited, and their main clinical features were collected. Severity of illness was assessed through the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), and the main phenotypes were identified through the Y-BOCS Symptom Checklist. A one-way analysis of variance (ANOVA) test, followed by a Bonferroni post-hoc test, were performed to compare DUI, duration, and severity of illness across subgroups.
  
  
  RESULTS
  In the whole sample, the mean DUI exceeded 7 years (87.35±11.75 months), accounting for approximately half of the mean duration of illness (172.2±13.36 months). When subjects were categorized into 4 main clinical phenotypes, respectively, aggressive/checking (n=31), contamination/cleaning (n=37), symmetry/ordering (n=32), and multiple phenotypes (n=14), DUI, duration, and severity of illness resulted significantly higher in the aggressive/checking subgroup, compared to other subgroups (F=3.58, p<0.01; F=3.07, p<0.01; F=4.390, p<0.01).
  
  
  CONCLUSIONS
  In a sample of OCD patients, along with a mean latency to treatment of approximately 7 years, regardless of the phenotype, patients had spent half of their duration of illness (DI) without being treated. DUI, duration, and severity of illness resulted significantly higher in the aggressive/checking subgroup.
authors: Dipartimento di Fisiopatologia medico-chirurgica e dei trapianti,Università degli Studi di Milano,Dipartimento di Salute Mentale,Fondazione IRCCS Ca' Granda,Ospedale Maggiore Policlinico,Milano,Italy.
authors: Bernardo
authors: B
authors: Dell'Osso
authors: Dipartimento di Fisiopatologia medico-chirurgica e dei trapianti,Università degli Studi di Milano,Dipartimento di Salute Mentale,Fondazione IRCCS Ca' Granda,Ospedale Maggiore Policlinico,Milano,Italy.
authors: Beatrice
authors: B
authors: Benatti
authors: Dipartimento di Fisiopatologia medico-chirurgica e dei trapianti,Università degli Studi di Milano,Dipartimento di Salute Mentale,Fondazione IRCCS Ca' Granda,Ospedale Maggiore Policlinico,Milano,Italy.
authors: Lucio
authors: L
authors: Oldani
authors: Dipartimento di Fisiopatologia medico-chirurgica e dei trapianti,Università degli Studi di Milano,Dipartimento di Salute Mentale,Fondazione IRCCS Ca' Granda,Ospedale Maggiore Policlinico,Milano,Italy.
authors: Gregorio
authors: G
authors: Spagnolin
authors: Dipartimento di Fisiopatologia medico-chirurgica e dei trapianti,Università degli Studi di Milano,Dipartimento di Salute Mentale,Fondazione IRCCS Ca' Granda,Ospedale Maggiore Policlinico,Milano,Italy.
authors: A Carlo
authors: AC
authors: Altamura
mesh_terms: D000328:Adult; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D009771:Obsessive-Compulsive Disorder / Q000145:classification / Q000523:psychology*; D010641:Phenotype; D011569:Psychiatric Status Rating Scales
keywords: Obsessive compulsive disorder; duration of untreated illness; obsessive compulsive disorder clinical phenotypes