title: The relationship between adverse childhood experiences and symptom severity, chronicity, and comorbidity in patients with obsessive-compulsive disorder.
abstract: BACKGROUND
  Studies on the relationship between adverse childhood experiences (ACEs) and obsessive-compulsive disorder (OCD) symptom severity are scarce. Available studies leave a considerable degree of uncertainty. The present study examines the relationship between ACEs and symptom severity, chronicity, and comorbidity in a sample of patients with OCD.
  
  
  METHODS
  Baseline data of the Netherlands Obsessive Compulsive Disorder Association (NOCDA) study, in which 382 referred patients with DSM-IV-diagnosed OCD participated, were analyzed. ACEs (physical abuse, sexual abuse, witnessing interparental violence, maternal dysfunction, paternal dysfunction, and early separation from a parent) were measured using a structured interview. Data were collected between September 2005 and November 2009.
  
  
  RESULTS
  None of the ACEs were related to OCD symptom severity or chronicity, nor was there a dose-response relationship between ACEs and OCD severity or chronicity, but results of linear regression analysis revealed that ACEs were related to comorbidity in patients with OCD (P < .001), in particular to comorbid affective disorders (P < .01), substance use disorders (P < .01), and eating disorders (P < .01), but not to comorbid anxiety disorders.
  
  
  CONCLUSIONS
  Results of the study suggest that unlike in other psychiatric disorders, ACEs play no significant role in symptom severity and chronicity of OCD. This study was the first to reveal evidence for a relationship between ACEs and comorbidity in patients with OCD. Conclusions about trauma-relatedness of OCD based on studies finding higher trauma rates or severity among patients with OCD than among healthy controls, should be critically reconsidered, since presence of comorbidity might account for these differences.
authors.affiliation: GGZ Centraal, lokatie Veldwijk, Afdeling Marina de Wolf Centrum, Postbus 1000, 3853 BA, Ermelo, the Netherlands h.visser1@ggzcentraal.nl.
authors.forename: Henny A
authors.initials: HA
authors.lastname: Visser
authors.forename: Agnes
authors.initials: A
authors.lastname: van Minnen
authors.forename: Harold
authors.initials: H
authors.lastname: van Megen
authors.forename: Merijn
authors.initials: M
authors.lastname: Eikelenboom
authors.forename: Adriaan W
authors.initials: AW
authors.lastname: Hoogendoorn
authors.forename: Maarten
authors.initials: M
authors.lastname: Kaarsemaker
authors.forename: Anton J
authors.initials: AJ
authors.lastname: van Balkom
authors.forename: Patricia
authors.initials: P
authors.lastname: van Oppen
mesh_terms: D000328:Adult; D002648:Child; D002649:Child Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D002908:Chronic Disease / Q000453:epidemiology; D015897:Comorbidity; D005195:Family Relations; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology*; D009771:Obsessive-Compulsive Disorder / Q000453:epidemiology / Q000209:etiology*; D012720:Severity of Illness Index