title: Impact of Gender, Age at Onset, and Lifetime Tic Disorders on the Clinical Presentation and Comorbidity Pattern of Obsessive-Compulsive Disorder in Children and Adolescents.
abstract: BACKGROUND
  Obsessive-compulsive disorder (OCD) is a heterogeneous disorder; therefore, there is a need for identifying more homogeneous subtypes. This study aimed to examine the clinical characteristics and comorbidity pattern of a large sample of pediatric OCD subjects, and to examine the impact of gender, age at onset, and lifetime tic disorders on the clinical presentation and comorbidity pattern.
  
  
  METHODS
  A total of 110 children and adolescents diagnosed with OCD were assessed using the Kiddle Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL) for psychiatric comorbidity, and a clinical data form was filled out. The cutoff for differentiating prepubertal from adolescent onset was 11 years of age.
  
  
  RESULTS
  A total of 83.6% of the subjects had at least one comorbid psychiatric disorder. Oppositional defiant disorder and contamination/somatic obsessions were significantly higher in males (p=0.036 and p=0.03, respectively) than in females. Depressive disorders and religious obsessions were significantly higher in the adolescent-onset group (p=0.02, p=0.05, respectively) whereas disruptive behavior disorders were higher in the prepubertal-onset group (p=0.037). Disruptive behavior disorders were significantly more frequent in the tic (+) group than in tic (-) group (p=0.021).
  
  
  CONCLUSIONS
  There were differences in the comorbidity pattern and clinical expression between genders and between prepubertal and adolescent-onset cases. Findings of this study supported the introduction of tic-related OCD as a specifier in Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5), and the necessity of a detailed assessment of other psychiatric disorders in youth with OCD.
authors.affiliation: Department of Child and Adolescent Psychiatry, Bakırkoy State and Research Hospital for Mental Health and Neurologic Disorders , Istanbul, Turkey .
authors.forename: Canan
authors.initials: C
authors.lastname: Tanidir
authors.affiliation: Department of Child and Adolescent Psychiatry, Bakırkoy State and Research Hospital for Mental Health and Neurologic Disorders , Istanbul, Turkey .
authors.forename: Hilal
authors.initials: H
authors.lastname: Adaletli
authors.affiliation: Department of Child and Adolescent Psychiatry, Bakırkoy State and Research Hospital for Mental Health and Neurologic Disorders , Istanbul, Turkey .
authors.forename: Hatice
authors.initials: H
authors.lastname: Gunes
authors.affiliation: Department of Child and Adolescent Psychiatry, Bakırkoy State and Research Hospital for Mental Health and Neurologic Disorders , Istanbul, Turkey .
authors.forename: Ali Guven
authors.initials: AG
authors.lastname: Kilicoglu
authors.affiliation: Department of Child and Adolescent Psychiatry, Bakırkoy State and Research Hospital for Mental Health and Neurologic Disorders , Istanbul, Turkey .
authors.forename: Caner
authors.initials: C
authors.lastname: Mutlu
authors.affiliation: Department of Child and Adolescent Psychiatry, Bakırkoy State and Research Hospital for Mental Health and Neurologic Disorders , Istanbul, Turkey .
authors.forename: Mustafa Kayhan
authors.initials: MK
authors.lastname: Bahali
authors.affiliation: Department of Child and Adolescent Psychiatry, Bakırkoy State and Research Hospital for Mental Health and Neurologic Disorders , Istanbul, Turkey .
authors.forename: Tugce
authors.initials: T
authors.lastname: Aytemiz
authors.affiliation: Department of Child and Adolescent Psychiatry, Bakırkoy State and Research Hospital for Mental Health and Neurologic Disorders , Istanbul, Turkey .
authors.forename: Ozden Sukran
authors.initials: OS
authors.lastname: Uneri
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000453:epidemiology*; D002648:Child; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000453:epidemiology / Q000503:physiopathology*; D012737:Sex Factors; D013981:Tic Disorders / Q000453:epidemiology / Q000503:physiopathology*