Association between early-life trauma and obsessive compulsive symptoms in community youth

Does mental contamination mediate the association between childhood trauma and obsessive-compulsive symptoms in adults?

BACKGROUND

Previous research has shown that individuals with obsessive-compulsive disorder (OCD) and OCD symptoms have higher rates of childhood trauma. Although it has been suggested that this relationship is due to mental contamination that developed in response to trauma, no studies have investigated the associations between childhood trauma, mental contamination, and OCD, and none have examined whether the relationship between childhood trauma and OCD is mediated by mental contamination.

OBJECTIVE

We hypothesized that OCD, childhood trauma, and mental contamination are positively correlated, and that mental contamination would mediate the association between childhood trauma and OCD symptoms PARTICIPANTS AND SETTING: We tested these hypotheses in a sample of 245 individuals, which comprised 158 MTurk workers recruited via CloudResearch.com and 87 individuals recruited through social media with OCD diagnoses or OCD symptoms above the clinical cutoff on the Obsessive-Compulsive Inventory-Revised.

METHODS

Participants completed online self-report questionnaires on childhood trauma, mental contamination, and OCD symptoms.

RESULTS

The results revealed statistically significant positive correlations between childhood trauma, mental contamination, and OCD, and statistically significant total and indirect effects for the simple mediational model. Exploratory re-analyses with participants who had high OCD symptoms (n = 87) showed similar results.

CONCLUSIONS

Our research shows that the association between childhood trauma and OCD may be explained by mental contamination. We recommend that mental contamination should be assessed and addressed in OCD patients with a history of childhood trauma.

Impact of the Age at Distal Hypospadias Surgery on Behavioral Problems, Somatic Symptoms and Irritability Levels in Children

BACKGROUND

To assess the effect of age at hypospadias surgery on emotional and behavioural problems, somatic symptoms, irritability, and penile perception.

METHODS

We retrospectively identified the patients who underwent single distal hypospadias surgery and age-matched healthy controls were included. There were two further subgroups according to the age at the time of hypospadias repair (<2 vs. >2 years). The Strengths and Difficulties Questionnaire (SDQ), Revised Children's Anxiety and Depression Scale (RCADS), Affective Reactivity Index (ARI), Level 2 Somatic Symptom Scale, and Penile Perception Score (PPS) scale were used. The groups were compared using multivariate variance analysis (MANOVA).

RESULTS

Both groups consisted of 70 patients (mean age 14.0 ± 0.2 years, for both), while there were 34 patients in the hypospadias groups who underwent surgery at <2 years of age. Depressive, panic, separation anxiety, social phobia, and somatic complaint symptom scores of the hypospadias group were lower than those of the control group. Obsessive-compulsive symptom levels were significantly higher in patients who underwent hypospadias surgery at >2 vs. <2 years of age. Additionally, PPSs rated by the surgeon were significantly higher in the former. A multivariate linear regression model indicated that panic disorder symptom scores predicted child PPS in the hypospadias group. Limitations include retrospective design.

CONCLUSIONS

Single hypospadias surgery seems not to have a negative impact on emotional and behavioural status. Children who underwent distal hypospadias surgery after 2 years of age had higher levels of obsessive-compulsive symptoms. Following emotional status may help the early diagnosis of future psychopathologies.

TYPE OF STUDY

Retrospective comparative study.

LEVEL OF EVIDENCE

III.

Towards the correlates of stressful life events as precipitants of obsessive-compulsive disorder: a systematic review and metanalysis

Obsessive-compulsive disorder (OCD) is a prevalent condition with multifactorial etiology involving genetic and environmental factors. The present study aims to summarize the correlates of stressful life events (SLEs) in OCD by reviewing studies comparing OCD associated or not with SLEs before its onset. To do so, a systematic review was performed by searching PubMed, Web of Science, Scopus, and PsycINFO databases for studies published between the database's inception and November 27, 2023. Studies including individuals whose OCD was precipitated or not by SLEs (SLEs OCD and NSLEs OCD, respectively) were assessed. Effect sizes or odds ratios were then calculated to identify the strength of association between SLEs and clinical characteristics, such as gender, age of onset, family history of OCD, severity of OCD symptoms, depressive symptoms, and mood comorbidities among patients with OCD. Out of the 4083 records initially identified, 5 studies met the inclusion criteria and 3 were comparable through a meta-analysis. Notably, the analyses were limited by the small number of studies available in the literature. The meta-analysis demonstrated SLEs OCD to be associated with female gender, later OCD onset, and increased comorbidity rates with mood disorders. Despite the cross-sectional nature of the reviewed studies, women may be more vulnerable to develop a later onset of OCD following SLEs, which may also lead to mood disorders. Caution is needed to avoid prematurely classifying this presentation as a distinct subtype of OCD.

The Relationship between Childhood Trauma Experiences and Psychotic Vulnerability in Obsessive Compulsive Disorder: An Italian Cross-Sectional Study

People with obsessive compulsive disorder (OCD) are at increased risk of developing psychotic disorders; yet little is known about specific clinical features which might hint at this vulnerability. The present study was aimed at elucidating the pathophysiological mechanism linking OCD to psychosis through the investigation of childhood trauma experiences in adolescents and adults with OCD. One hundred outpatients, aged between 12 and 65 years old, were administered the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and its Child version (CY-BOCS), as well as the Childhood Trauma Questionnaire (CTQ); Cognitive-Perceptual basic symptoms (COPER) and high-risk criterion Cognitive Disturbances (COGDIS) were assessed in the study sample. Greater childhood trauma experiences were found to predict psychotic vulnerability (p = 0.018), as well as more severe OCD symptoms (p = 0.010) and an earlier age of OCD onset (p = 0.050). Participants with psychotic vulnerability reported higher scores on childhood trauma experiences (p = 0.02), specifically in the emotional neglect domain (p = 0.01). In turn, emotional neglect and psychotic vulnerability were found higher in the pediatric group than in the adult group (p = 0.01). Our findings suggest that childhood trauma in people with OCD may represent an indicator of psychotic vulnerability, especially in those with an earlier OCD onset. Research on the pathogenic pathways linking trauma, OCD, and psychosis is needed.

The Relationship Between Trauma Exposure and Obsessive-Compulsive Disorder in Youth: A Systematic Review

Extant literature suggests a possible relationship between childhood trauma exposure and the development and trajectory of obsessive-compulsive symptoms (OCS) and obsessive-compulsive disorder (OCD); however, this relationship is poorly understood. We conducted a systematic review that examined trauma exposure and OCS/OCD in youth. Primary inclusion criteria were English-language articles that addressed a sample with participants under 18 years of age. 46 articles met criteria for review, and were categorized into three groups of overlap: Post-traumatic Stress Disorder (PTSD) and OCS or OCD (n = 3), clearly defined Criterion A event trauma exposure and OCS or OCD (n = 30), and less well-defined potential trauma exposure and OCS or OCD (n = 13). There was mixed evidence linking trauma exposure and the development of OCS or OCD in youth. Major methodological limitations preclude formal conclusions. More research on co-occurring trauma exposure and OCD/OCS in youth is needed to advance research and improve treatment.

The impact of childhood trauma on perceived stress and personality in patients with obsessive-compulsive disorder: A cross-sectional network analysis

OBJECTIVE

Little is known about the role of childhood experiences in the development of obsessive-compulsive disorder (OCD). However, the influence of childhood experiences on personality, behavior, and perceived stress may vary between OCD patients and healthy individuals. The objective of this study was to use network analysis to explore the relationship between childhood trauma, personality, perceived stress, and symptom dimensions, thus finding the difference between patients' and healthy people's network.

METHODS

488 patients with OCD and 210 healthy volunteers were recruited. All of them were assessed with the Obsessive-Compulsive Inventory - Revised (OCI-R), the Perceived Stress Scale-10, the NEO Five-Factor Inventory and the Early Trauma Inventory Self-Report Short Form. Network analysis was conducted and the centrality indices were calculated. Network comparison test was performed.

RESULTS

In patients' network, the Obsession and the Ordering behavior were the most important nodes among the OCI-R. The perceived stress showed the strongest strength centrality of all nodes and positive correlation with the Obsession and Neuroticism. Network comparison test results indicated a statistically significant difference between network structure, and post-hoc analysis found five edges significantly differed between patients and healthy controls, mainly on Obsession and Washing behaviors.

CONCLUSIONS

Emotional abuse was considered significant in both networks due to its higher strength centrality. Meanwhile, perceived stress was found to be more significant in the patient network and exhibited stronger associations with obsession. The obsessive thoughts and washing behavior were different among patients and healthy controls, which brought new understanding to the pathopsychological mechanisms of OCD.

The association between stressful experiences and OCD symptoms in young adults at transdiagnostic risk

BACKGROUND

It is unclear whether there is a specific association between stressful experiences and obsessive-compulsive symptoms or whether this relationship is due to stressful experiences increasing risk for psychopathology generally.

AIMS

The current study examined the association between stressful experiences and obsessive-compulsive symptom dimensions, while adjusting for coexisting psychiatric symptoms and psychological distress in a young adult transdiagnostic at-risk sample.

METHODS

Forty-three participants completed self-report measures assessing obsessive-compulsive symptoms, stressful experiences, and a range of other psychiatric symptoms. Regression models examined the relationship between stressful experiences and different obsessive-compulsive symptoms dimensions (i.e., symmetry, fear of harm, contamination, and unacceptable thoughts), adjusting for the influence of coexisting psychiatric symptoms and psychological distress.

RESULTS

The results showed that there was an association between stressful experiences and obsessive-compulsive symptoms dimension of symmetry. Symptoms of borderline personality disorder were positively associated with the obsessive-compulsive symptom dimensions of symmetry and fear of harm symptoms. Symptoms of psychosis were found to be negatively associated with the obsessive-compulsive symptoms dimension of fear of harm.

CONCLUSIONS

These findings have implications for understanding the psychological mechanisms that underlie symmetry symptoms and highlight the need to study OCS dimensions separately to inform more precise, mechanism-targeted interventions.

Childhood and adolescent trauma and dissociation: The mediating role of rumination, intrusive thoughts and negative affect

Dissociation is a complex phenomenon which is present in a wide variety of psychiatric disorders and also in the general population. The objective of this study was to examine the relationship between childhood and adolescent traumas and development of dissociative phenomena in a nonclinical population, emphasizing the potentially mediating role of rumination, intrusive thoughts and negative affect in a population with no psychiatric pathology in adulthood. The sample was comprised of 337 participants from the general population (58.8% women) with a mean age of 33.10 years (SD: 14.08). They completed the Juvenile Victimization Questionnaire (JVQ), the Ruminative Response Scale (RRS), the White Bear Suppression Scale (WBSI), the Dissociative Experience Scale, 2d ver. Rev. (DES-II) and the Depression, Anxiety and Stress Scale (DASS-21). The results supported the starting hypotheses showing a positive correlation between childhood and adolescent trauma and dissociation, and between childhood and adolescent trauma and rumination, intrusive thoughts and negative affect, and mediation of these variables between childhood and adolescent trauma and dissociative states. The relationship between trauma in early ages and dissociation in adulthood is complex. Although the design used in this study was cross-sectional, the results are compatible with the starting hypothesis that rumination, intrusive thoughts and negative affect mediate this relationship.

Psychotherapies and digital interventions for OCD in adults: What do we know, what do we need still to explore?

BACKGROUND

Despite significant advances in the understanding and treatment of obsessive compulsive disorder (OCD), current treatment options are limited in terms of efficacy for symptom remission. Thus, assessing the potential role of iterative or alternate psychotherapies is important. Also, the potential role of digital technologies to enhance the accessibility of these therapies, should not be underestimated. We also need to embrace the idea of a more personalized treatment choice, being cognisant of clinical, genetic and neuroimaging predictors of treatment response.

PROCEDURES

Non-systematic review of current literature on emerging psychological and digital therapies for OCD, as well as of potential biomarkers of treatment response.

FINDINGS

A number of 'third wave' therapies (e.g., Acceptance and Commitment Therapy, Mindfulness-Based Cognitive Therapy) have an emerging and encouraging evidence base in OCD. Other approaches entail employment of elements of other psychotherapies such as Dialectical Behaviour Therapy; or trauma-focussed therapies such as Eye Movement Desensitisation and Reprocessing, and Imagery Rescripting and Narrative Therapy. Further strategies include Danger Ideation Reduction Therapy and Habit Reversal. For these latter approaches, large-scale randomised controlled trials are largely lacking, and the precise role of these therapies in treating people with OCD, remains to be clarified. A concentrated 4-day program (the Bergen program) has shown promising short- and long-term results. Exercise, music, and art therapy have not been adequately tested in people with OCD, but may have an adjunctive role. Digital technologies are being actively investigated for enhancing reach and efficacy of psychological therapies for OCD. Biomarkers, including genetic and neuroimaging, are starting to point to a future with more 'personalised medicine informed' treatment strategizing for OCD.

CONCLUSIONS

There are a number of potential psychological options for the treatment of people with OCD who do not respond adequately to exposure/response prevention or cognitive behaviour therapy. Adjunctive exercise, music, and art therapy might be useful, albeit the evidence base for these is very small. Consideration should be given to different ways of delivering such interventions, including group-based, concentrated, inpatient, or with outreach, where appropriate. Digital technologies are an emerging field with a number of potential applications for aiding the treatment of OCD. Biomarkers for treatment response determination have much potential capacity and deserve further empirical testing.

Obsessive-Compulsive Symptoms and Daily Experiences of Posttraumatic Stress and Mental Contamination Following Sexual Trauma

Although cross-sectional research highlights similarities between symptoms of obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) among individuals exposed to sexual trauma, little is known about how these disorders relate over time. The goal of the present study was to examine whether 1) OCD symptoms prospectively predicted daily symptoms of PTSD, and 2) OCD and PTSD symptoms prospectively predicted daily experiences of sexual trauma-related mental contamination (i.e., dirtiness in the absence of a physical pollutant). Forty-one women with a sexual trauma history completed baseline measures of OCD and PTSD, as well as twice-daily assessments of PTSD symptoms and mental contamination over a two-week period. Total OCD symptoms and the unacceptable thoughts dimension significantly predicted daily PTSD symptoms after accounting for other OCD dimensions. Only total OCD symptoms significantly predicted daily mental contamination when examined together with total PTSD symptoms. No individual PTSD or OCD clusters/dimensions significantly predicted daily mental contamination when examined simultaneously. Findings from this study highlight the nuanced associations among OCD symptoms, PTSD symptoms, and experiences of mental contamination. Future research is needed to further understand the development of PTSD, OCD, and mental contamination over time to inform targets for intervention.

Obsessive compulsive symptom dimensions are linked to altered white-matter microstructure in a community sample of youth

Obsessive-compulsive symptoms (OCS) are common in school-aged children and predict the development of obsessive compulsive disorder (OCD). White-matter abnormalities have been described in OCD, but the white matter correlates of OCS in the developing brain are unclear. Some correlates of OCS (or a diagnosis of OCD) may reflect correlates of a transdiagnostic or even general psychopathology factor. We examined these questions in a large sample of typically developing youth (N = 1208), using a hierarchical analysis of fixel-based white matter measures in relation to OCS and general psychopathology. General psychopathology was associated with abnormalities in the posterior corpus callosum and forceps major in an age-dependent manner, suggesting altered maturation (specifically, hypermaturation in younger subjects). A unidimensional measure of OCS did not associate with any white-matter abnormalities, but analysis of separate OCS dimensions (derived from factor analysis within this sample) revealed the 'Bad Thoughts' dimension to associate with white-matter abnormalities in dorsal parietal white-matter and descending corticospinal tracts, and the 'Symmetry' dimension to associate with abnormalities in the anterior corpus callosum. Repetition/checking and Symmetry OCS were additionally associated with posterior abnormalities overlapping with the correlates of general psychopathology. Contamination symptoms had no white-matter correlates. Secondary analysis of fractional anisotropy (FA) revealed distinct white-matter abnormalities, suggesting that fixel-based and FA analyses identify distinct features of white matter relevant to psychopathology. These findings suggest that OCS dimensions correlate with dissociable abnormalities in white matter, implicating separable networks. Future studies should examine these white-matter signatures in a longitudinal framework.

The effect of childhood trauma on the severity of obsessive-compulsive symptoms: A systematic review

BACKGROUND

Childhood trauma is associated with a range of psychiatric disorders, including obsessive-compulsive disorder (OCD). However, our understanding of the different types of childhood trauma and its impact on the different types and severity of obsessive-compulsive symptoms (OCS) is still in its infancy.

AIMS

We conducted a systematic review to synthesise the current knowledge on the possible relationships between childhood trauma and obsessive-compulsive symptoms in clinical and non-clinical populations.

METHODS

We systematically searched four electronic databases for studies reporting on childhood trauma and OCS severity. Subsequently, we qualitatively synthesised results of eligible studies and effect sizes were also calculated.

RESULTS

Twenty-four studies were included in this systematic review. Most studies used OCD samples (k = 16), with a few studies using a sample comprising of a range of psychiatric disorders (k = 6) and some studies using a general community sample (k = 2). Overall, there was support for a significant relationship between childhood trauma and OCS severity (8 out of 16 of the studies using OCD clinical samples, both studies using general population samples, and 5 out of 6 studies used mixed psychiatric samples).

CONCLUSIONS

We found evidence of a significant relationship between exposure to childhood trauma and OCS severity across clinical and non-clinical populations. Our results also suggest that a range rather than a single type of childhood trauma was associated with OCD.

Hypermethylation of the oxytocin receptor gene (OXTR) in obsessive-compulsive disorder: further evidence for a biomarker of disease and treatment response

Obsessive-compulsive disorder (OCD) has recently been linked to increased methylation levels in the oxytocin receptor (OXTR) gene, and OXTR hypermethylation has predicted a worse treatment response to cognitive-behavioural therapy (CBT). Furthermore, OCD is associated with childhood trauma and stressful life events, which have both been shown to affect OXTR methylation. Here, we aimed to replicate findings of increased OXTR methylation as a predictor of disease and worse treatment response in an independent sample that received treatment within the public health care system. In addition, we aimed to extend previous findings by examining associations between OXTR hypermethylation, environmental stressors, OCD diagnosis, and treatment response. Methylation levels at two CpGs within OXTR exon III were compared between n = 181 OCD patients and n = 199 healthy controls using linear regression analysis. In a subsample of OCD patients (n = 98) with documented treatment data, we examined associations between methylation and treatment response to CBT. Childhood adversity and stressful life events were assessed using Childhood Trauma Questionnaire and Life Experience Survey, respectively. OCD patients exhibited significant hypermethylation at CpG site cg04523291 compared to controls, and increased methylation was associated with impaired treatment response. Moreover, hypermethylation at cg04523291 was associated with stressful life events in OCD patients, and with childhood adversity in controls. Yet, there were no significant mediation effects. In conclusion, we replicated the association between OXTR hypermethylation and OCD in the largest sample, so far. Furthermore, our findings support the role of OXTR methylation as a promising biomarker for treatment response in OCD.

Association between traumatic stressful events and schizotypal symptoms among a community-based sample of adolescents: A 2-year longitudinal study

BACKGROUND

Traumatic stressful events (TSEs) are among the most studied risk factors for subsequent schizotypal symptoms. However, specificity and aggregate effects of trauma exposure on schizotypal symptoms remain unclear. This study investigates these relationships among a community-based sample of US adolescents.

MATERIAL AND METHODS

A sub-sample of 426 adolescents (51.6% female) from the Philadelphia Neurodevelopmental Cohort study were selected for longitudinal follow-up based on presence (n = 209) or absence (n = 217) of psychosis spectrum symptoms (PSS). At baseline, they completed assessments of demographic, TSEs, other psychopathology (e.g., PSS, anxiety, depression, and behavioral disorder) and family history of psychopathology. Schizotypal symptom dimensions (cognitive-perceptual, interpersonal and disorganized) were evaluated approximately two years later.

RESULTS

More than half of adolescents experienced at least one type of TSE. Adolescents with assaultive trauma reported about 1.5 times as many symptoms on all three schizotypal symptom dimensions, compared to adolescents with non-assaultive TSE, adjusting for demographic and family history variables. No statistical significance was found after further adjusting for other baseline psychopathology (p > 0.05). There was a significant aggregate effect of TSEs on cognitive-perceptual symptoms with small effect size (p < 0.001, Cohen's f2 = 0.034).

CONCLUSIONS

We found evidence of an association between aggregate TSEs and cognitive-perceptual symptoms, but trauma type was not associated with schizotypal symptom dimensions when controlling for potential confounders. Our findings highlight the importance of considering aggregate TSE effects and potential confounds when examining associations between TSEs and schizotypy. Trauma and psychosis spectrum screening may be important in the effort to provide trauma-informed care.

Examination of Initial Evidence for EMDR as a Treatment for Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is a debilitating psychological condition that impacts millions of people globally. The front-line psychological intervention for OCD is exposure/response prevention (ERP), however, many individuals do not respond to this treatment approach. Eye movement desensitization and reprocessing (EMDR) is a new therapeutic option which could be effective in treating OCD. This review examined the initial evidence for the effectiveness of EMDR in reducing OCD symptoms. Nine studies were included in the review, including six case studies and three group studies. Results indicate that EMDR is a promising candidate for treating OCD, with all studies showing EMDR therapy resulted in reduced symptoms from baseline. Results also indicated that EMDR may be as effective as ERP, and more effective than selective serotonin reuptake inhibitors (SSRIs) in treating OCD.

Heart rate variability in late pregnancy: exploration of distinctive patterns in relation to maternal mental health

Exploration of photoplethysmography (PPG), a technique that can be translated to the clinic, has the potential to assess the autonomic nervous system (ANS) through heart rate variable (HRV) in pregnant individuals. This novel study explores the complexity of mental health of individuals in a clinical sample responding to a task in late pregnancy; finding those with several types of past or current anxiety disorders, greater trait anxiety, or greater exposure to childhood traumatic events had significantly different HRV findings from the others in the cohort. Lower high frequency (HF), a measure of parasympathetic activity, was found for women who met the criteria for the history of obsessive-compulsive disorder (OCD) (p = 0.004) compared with women who did not meet the criteria for OCD, and for women exposed to greater than five childhood traumatic events (p = 0.006) compared with those exposed to four or less childhood traumatic events. Conversely higher low frequency (LF), a measure thought to be impacted by sympathetic system effects, and the LF/HF ratio was found for those meeting criteria for a panic disorder (p = 0.006), meeting criteria for social phobia (p = 0.002), had elevated trait anxiety (p = 0.006), or exposure to greater than five childhood traumatic events (p = 0.004). This study indicates further research is needed to understand the role of PPG and in assessing ANS functioning in late pregnancy. Study of the impact of lower parasympathetic functioning and higher sympathetic functioning separately and in conjunction at baseline and in relation to tasks during late pregnancy has the potential to identify individuals that require more support and direct intervention.

Social losses predict a faster onset and greater severity of obsessive-compulsive disorder

BACKGROUND

While stressful life events increase the risk of developing a range of psychiatric disorders, including obsessive-compulsive disorder (OCD), their ability to precipitate specific obsessive-compulsive symptoms' dimensions is unknown. Here we aimed to evaluate the potential role of three different types of stressful life events, herein termed losses (death of a loved one, termination of a romantic relationship and severe illness) in predicting the speed of progression from subclinical to clinical OCD and the severity of specific OCD dimensions in a large multicentre OCD sample.

METHODS

Nine hundred and fifty-four OCD outpatients from the Brazilian OCD Research Consortium were included in this study. Several semi-structured and structured instruments were used, including the Structured Clinical Interview for DSM-IV Axis I Disorders, the Yale-Brown Obsessive-Compulsive Scale, the Dimensional Yale-Brown Obsessive-Compulsive Scale, the Brown Assessment of Beliefs Scale, the Beck Depression Inventory, the Beck Anxiety Inventory and the Yale OCD Natural History Questionnaire. Regression models investigated the interaction between types of loss and gender to predict speed of progression from subclinical obsessive-compulsive symptoms to OCD, and the severity of five symptom dimensions.

RESULTS

While termination of a relationship was associated with a faster speed of progression from subthreshold to clinical OCD, the death of a loved one was associated with increased severity of hoarding symptoms. There was also an interaction between gender and experiences of death, which predicted a faster speed of progression to OCD in males.

CONCLUSIONS

Stressful life events have the ability to accelerate the progression from subclinical to clinical OCD, as well as impact the severity of specific OCD dimensions. Gender also plays a role in both the progression and severity of symptoms. These findings suggest that stressful life events may represent a marker to identify individuals at risk of progressing to clinical OCD.

Obsessive compulsive-disorder and reproductive life events

We explored the association between reproductive life events and the onset or exacerbation of obsessive-compulsive disorder (OCD) among women in comparison with men with OCD. We chose men because there is some evidence of increased occurrence of OCD in expectant fathers as well. We recruited 150 eligible outpatients (58 men and 92 women) with OCD, who attended a specialty OCD Clinic over a period of one year. Occurrence of any life event including reproductive life events in the year before the onset of OCD was assessed using the Interview of Recent Life Events (IRLE). Reproductive life events in the year prior to onset of OCD were overrepresented in women compared to men. Postpartum onset and worsening of OCD was reported in 14 % and 11 % of women respectively. Menarche and menopause as life events were infrequently reported (3% and 1%). Symmetry obsessions and ordering compulsions were more common in women with post-partum onset of OCD than those without. Post-partum period seems to be associated with onset and exacerbation of OCD; therefore, routine screening for OCD during this period is necessary.

Childhood trauma and coping in patients with psychotic disorders and obsessive-compulsive symptoms and in un-affected siblings

BACKGROUND

Research on environmental and individual risk-factors in patients with a psychotic disorder and co-occurring obsessive-compulsive symptoms (OCS) is limited.

OBJECTIVE

This study aimed to examine the role of childhood trauma and coping on the occurrence of OCS in patients with a psychotic disorder and on a subclinical level in siblings.

PARTICIPANTS AND SETTING

626 patients and 638 siblings from the Genetic Risk and Outcome of Psychosis (GROUP) study were included in the current study.

METHODS

Differences between patients and siblings with and without OCS were analyzed with between-group comparisons. Mediation analyses investigated the effect of coping on the association between trauma and OCS severity.

RESULTS

Patients and siblings with OCS reported more childhood traumatic events, particularly sexual (OR = 1.62 / 3.26) and emotional (OR = 1.47 / 2.04) abuse compared to those without OCS. Both patients (d = 0.69) and siblings (d = 0.49) with co-occurring OCS showed a higher tendency for dysfunctional passive coping strategies compared to the group without OCS. The tendency for passive coping mediated the association between sexual and emotional abuse and OCS severity in patients.

CONCLUSIONS

Results imply that childhood trauma is associated with the presence of co-occurring OCS. Enhancing active coping strategies might have a beneficial effect in the prevention and treatment of co-occurring OCS in patients with psychotic disorders.