title: Transformation obsessions in paediatric obsessive-compulsive disorder: Clinical characteristics and treatment response to cognitive behaviour therapy.
abstract: OBJECTIVE
  Transformation obsessions denote an under-reported symptom of Obsessive Compulsive Disorder (OCD), characterised by an excessive fear of turning into another person/object or acquiring unwanted characteristics. Relative to other OCD symptoms, little is known about the clinical presentation of transformation obsessions. The study aims to examine the clinical correlates and treatment prognosis of transformation obsessions in a paediatric OCD sample.
  
  
  METHODS
  The sample consisted of 346 youths with a primary diagnosis of OCD. Patients with and without transformation obsessions were compared in terms of demographic and clinical characteristics, and CBT outcomes.
  
  
  RESULTS
  10% of the sample endorsed transformation obsessions. Patients with transformation obsessions were more likely to be boys, to be on augmented medication regimes, and to present with more severe obsessions at assessment. A factor analysis identified four major OCD symptom clusters, with transformation obsessions loading on a 'forbidden thoughts' factor alongside aggressive, sexual, and religious obsessions. No group differences in treatment outcomes were observed.
  
  
  CONCLUSIONS
  Limitations include the cross-sectional and retrospective nature of the study, the representativeness of our sample, and use of concomitant medication, among others.
  
  
  CONCLUSIONS
  The study provides the first empirical evidence regarding phenomenological similarities and differences between paediatric OCD patients presenting with and without transformation obsessions. The findings suggest that transformation obsessions are best conceptualised as related to 'forbidden' obsessions and respond to exposure-based CBT.
authors.affiliation: Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK. Electronic address: Benedetta.Monzani@kcl.ac.uk.
authors.forename: B
authors.initials: B
authors.lastname: Monzani
authors.affiliation: Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK; OCD & Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK.
authors.forename: A
authors.initials: A
authors.lastname: Jassi
authors.affiliation: Psychological Medicine, Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3JH, UK; Institute of Child Health, University College London, London WC1N 1EH, UK.
authors.forename: I
authors.initials: I
authors.lastname: Heyman
authors.affiliation: Department of Psychology, The University of Queensland, Brisbane, 4067 QLD, Australia.
authors.forename: C
authors.initials: C
authors.lastname: Turner
authors.affiliation: OCD & Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK.
authors.forename: C
authors.initials: C
authors.lastname: Volz
authors.affiliation: OCD & Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK; Social, Genetic and Development Centre, Institute of Psychiatry, King's College London, London SE5 8AF, UK.
authors.forename: G
authors.initials: G
authors.lastname: Krebs
mesh_terms: D000293:Adolescent; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000503:physiopathology* / Q000628:therapy*; D012737:Sex Factors; D016896:Treatment Outcome
keywords: Adolescents; Children; Cognitive behaviour therapy; Obsessive compulsive disorder; Transformation obsession