title: Childhood, adolescent and adult age at onset and related clinical correlates in obsessive-compulsive disorder: a report from the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS).
abstract: OBJECTIVE
  Many studies suggest that age at onset (AAO) is an important factor for clinically differentiating patients with juvenile and adult onset of obsessive-compulsive disorder (OCD). The present international study aimed to assess the prevalence of different AAO groups and compare related socio-demographic and clinical features in a large sample of OCD patients.
  
  
  METHODS
  A total of 431 OCD outpatients, participating in the ICOCS network, were first categorised in groups with childhood (≤12 years), adolescent (13-17 years) and adult-onset (≥18 years), then in pre-adult and adult onset (≥18 years) and their socio-demographic and clinical features compared.
  
  
  RESULTS
  Twenty-one percent (n = 92) of the sample reported childhood onset, 36% (n = 155) adolescent onset, and 43% (n = 184) adult onset. Patients with adult onset showed a significantly higher proportion of females compared with the other subgroups (χ(2 )=( )10.9, p< 0.05). Childhood- and adolescent-onset patients had been more frequently treated with cognitive behavioural therapy (CBT), compared to adult-onset patients (χ(2 )=( )11.5; p < 0.05). The pre-adult- versus adult-onset analysis did not show any additional significant difference.
  
  
  CONCLUSIONS
  The present international multicentre study confirms that OCD onset occurs more frequently before adult age, with approximately one out of five patients showing childhood onset. Pre-adult onset was associated with higher rate of CBT, while adult onset was more prevalent in females.
authors.affiliation: a Department of Neuroscience and Mental Health , University of Milan, Fondazione IRCCS Ca'Granda , Ospedale Maggiore Policlinico , Milano , Italy ;|b Bipolar Disorders Clinic; Stanford University , Stanford, CA , USA ;
authors.forename: Bernardo
authors.initials: B
authors.lastname: Dell'Osso
authors.affiliation: a Department of Neuroscience and Mental Health , University of Milan, Fondazione IRCCS Ca'Granda , Ospedale Maggiore Policlinico , Milano , Italy ;
authors.forename: Beatrice
authors.initials: B
authors.lastname: Benatti
authors.affiliation: c Department of Psychiatry and Behavioral Sciences , Albert Einstein College of Medicine and Montefiore Medical Center , New York , USA ;
authors.forename: Eric
authors.initials: E
authors.lastname: Hollander
authors.affiliation: d Mental Health Unit , Hertfordshire Partnership Foundation Trust, Queen Elizabeth II Hospital , Welwyn Garden City , UK ;
authors.forename: Naomi
authors.initials: N
authors.lastname: Fineberg
authors.affiliation: e Department of Psychiatry and Mental Health, MRC Unit on Anxiety and Stress Disorders , University of Cape Town , Cape Town , South Africa ;
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
authors.affiliation: f Department of Psychiatry, MRC Unit on Anxiety and Stress Disorders , University of Stellenbosch , Stellenbosch , South Africa ;
authors.forename: Christine
authors.initials: C
authors.lastname: Lochner
authors.affiliation: g Carracci Medical Group , Mexico City , Mexico ;
authors.forename: Humberto
authors.initials: H
authors.lastname: Nicolini
authors.affiliation: g Carracci Medical Group , Mexico City , Mexico ;
authors.forename: Nuria
authors.initials: N
authors.lastname: Lanzagorta
authors.affiliation: a Department of Neuroscience and Mental Health , University of Milan, Fondazione IRCCS Ca'Granda , Ospedale Maggiore Policlinico , Milano , Italy ;
authors.forename: Carlotta
authors.initials: C
authors.lastname: Palazzo
authors.affiliation: a Department of Neuroscience and Mental Health , University of Milan, Fondazione IRCCS Ca'Granda , Ospedale Maggiore Policlinico , Milano , Italy ;
authors.forename: A Carlo
authors.initials: AC
authors.lastname: Altamura
authors.affiliation: h Dipartimento Di Psichiatria, Neurobiologia, Farmacologia E Biotechnologie , Università Di Pisa , Italy ;
authors.forename: Donatella
authors.initials: D
authors.lastname: Marazziti
authors.affiliation: i Department of Psychiatry , University of Florence, and Institute of Neurosciences , Florence , Italy ;
authors.forename: Stefano
authors.initials: S
authors.lastname: Pallanti
authors.affiliation: j Department of Psychiatry and Behavioural Neurosciences , McMaster University, MacAnxiety Research Center Hamilton , Canada ;
authors.forename: Michael
authors.initials: M
authors.lastname: Van Ameringen
authors.affiliation: k Department of Psychiatry , Sisli Eftal Teaching and Research Hospital , Istanbul , Turkey ;
authors.forename: Oguz
authors.initials: O
authors.lastname: Karamustafalioglu
authors.affiliation: l National and Trustwide Services for OCD/BDD, SW London and St George's NHS Trust , London ;
authors.forename: Lynne M
authors.initials: LM
authors.lastname: Drummond
authors.affiliation: m University Multiprofile Hospital for Active Treatment in Neurology and Psychiatry Sveti Naum , Sofia , Bulgaria ;
authors.forename: Luchezar
authors.initials: L
authors.lastname: Hranov
authors.affiliation: n Department of Psychiatry , Academic Medical Center , Amsterdam , the Netherlands ;
authors.forename: Martijn
authors.initials: M
authors.lastname: Figee
authors.affiliation: o Department of Psychiatry and Behavioral Neuroscience , University of Chicago, Pritzker School of Medicine , Chicago , IL , USA ;
authors.forename: Jon E
authors.initials: JE
authors.lastname: Grant
authors.affiliation: p National Post-Trauma Center , Research Foudation by the Sheba Medical Center , Israel ;
authors.forename: Joseph
authors.initials: J
authors.lastname: Zohar
authors.affiliation: q Department of Psychiatry , Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands ;
authors.forename: Damiaan
authors.initials: D
authors.lastname: Denys
authors.affiliation: r Department of Psychiatry , Hospital Universitari De Bellvitge-IDIBELL, University of Barcelona, Cibersam , Barcelona , Spain.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Menchon
mesh_terms: D000328:Adult; D017668:Age of Onset; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008002:Libya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009656:North America / Q000453:epidemiology; D009771:Obsessive-Compulsive Disorder / Q000453:epidemiology*; D012955:Societies, Medical; D013019:South Africa / Q000453:epidemiology
keywords: Age at onset; cognitive behavioural therapy; gender; obsessive–compulsive disorder