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Jones JD, Boyd RC, Sandro AD, Calkins ME, Los Reyes AD, Barzilay R, Young JF, Benton TD, Gur RC, Moore TM, Gur RE. The General Psychopathology 'p' Factor in Adolescence: Multi-Informant Assessment and Computerized Adaptive Testing. Res Child Adolesc Psychopathol 2024:10.1007/s10802-024-01223-8. [PMID: 38869751 DOI: 10.1007/s10802-024-01223-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2024] [Indexed: 06/14/2024]
Abstract
Accumulating evidence supports the presence of a general psychopathology dimension, the p factor ('p'). Despite growing interest in the p factor, questions remain about how p is assessed. Although multi-informant assessment of psychopathology is commonplace in clinical research and practice with children and adolescents, almost no research has taken a multi-informant approach to studying youth p or has examined the degree of concordance between parent and youth reports. Further, estimating p requires assessment of a large number of symptoms, resulting in high reporter burden that may not be feasible in many clinical and research settings. In the present study, we used bifactor multidimensional item response theory models to estimate parent- and adolescent-reported p in a large community sample of youth (11-17 years) and parents (N = 5,060 dyads). We examined agreement between parent and youth p scores and associations with assessor-rated youth global functioning. We also applied computerized adaptive testing (CAT) simulations to parent and youth reports to determine whether adaptive testing substantially alters agreement on p or associations with youth global functioning. Parent-youth agreement on p was moderate (r =.44) and both reports were negatively associated with youth global functioning. Notably, 7 out of 10 of the highest loading items were common across reporters. CAT reduced the average number of items administered by 57%. Agreement between CAT-derived p scores was similar to the full form (r =.40) and CAT scores were negatively correlated with youth functioning. These novel results highlight the promise and potential clinical utility of a multi-informant p factor approach.
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Affiliation(s)
- Jason D Jones
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA 19146, USA.
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA.
| | - Rhonda C Boyd
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA 19146, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
| | - Akira Di Sandro
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
| | - Monica E Calkins
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
| | - Andres De Los Reyes
- Department of Psychology, University of Maryland, College Park, Maryland, USA
| | - Ran Barzilay
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA 19146, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
| | - Jami F Young
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA 19146, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
| | - Tami D Benton
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA 19146, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
| | - Ruben C Gur
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
| | - Tyler M Moore
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
| | - Raquel E Gur
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 2716 South Street, Philadelphia, PA 19146, USA
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
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2
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Thompson EM, Albertella L, Viskovich S, Pakenham KI, Fontenelle LF. Internet-based acceptance and commitment therapy for obsessive-compulsive symptoms: A randomized controlled trial. Behav Res Ther 2024; 180:104595. [PMID: 38885592 DOI: 10.1016/j.brat.2024.104595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 06/08/2024] [Accepted: 06/11/2024] [Indexed: 06/20/2024]
Abstract
Subthreshold obsessive-compulsive symptoms (OCS) are associated with increased distress, help seeking behaviours, and functional problems, and may predict progression into further mental health problems. This study investigated the effectiveness of a four-module internet-based acceptance and commitment therapy (iACT) for adults with OCS compared to internet-based progressive relaxation training (iPRT). Eighty-nine adults with OCS participated in a single-blinded randomised controlled trial of iACT or iPRT. Self-report assessments of OCS, psychological flexibility, and quality of life, among others, were measured at baseline, post-treatment, and at three-month follow-up. Both iACT and iPRT showed large pre-post improvements in OCS (b = 6.32, p < 0.001, d = 0.8) and medium improvements in psychological flexibility (b = -0.38, p = 0.011, d = 0.47) and quality of life (b = -5.26, p = 0.008, d = 0.58), with no significant differences in effects between groups. All improvements were maintained at follow-up. There were no differences in attrition or adherence between groups. iACT was rated more favourably by participants at post-treatment, and there were some differences in qualitative feedback across groups. These findings suggest both iPRT and iACT may be helpful in improving mental health in adults with OCS, but that iACT may be more acceptable.
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Affiliation(s)
- Emma M Thompson
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, 770 Blackburn Road, Clayton, Victoria, 3168, Australia
| | - Lucy Albertella
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, 770 Blackburn Road, Clayton, Victoria, 3168, Australia.
| | - Shelley Viskovich
- School of Psychology, University of Queensland, St Lucia, Brisbane, Queensland, Australia.
| | - Kenneth I Pakenham
- School of Psychology, University of Queensland, St Lucia, Brisbane, Queensland, Australia
| | - Leonardo F Fontenelle
- BrainPark, Turner Institute for Brain and Mental Health, Monash University, 770 Blackburn Road, Clayton, Victoria, 3168, Australia; Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ) & D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil.
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Linkovski O, Moore TM, Argabright ST, Calkins ME, Gur RC, Gur RE, Barzilay R. Hoarding behavior and its association with mental health and functioning in a large youth sample. Eur Child Adolesc Psychiatry 2024; 33:1955-1962. [PMID: 37728661 DOI: 10.1007/s00787-023-02296-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 09/01/2023] [Indexed: 09/21/2023]
Abstract
Hoarding behavior is prevalent in children and adolescents, yet clinicians do not routinely inquire about it and youth may not spontaneously report it due to stigma. It is unknown whether hoarding behavior, over and above obsessive-compulsive symptoms (OCS), is associated with major clinical factors in a general youth population. This observational study included N = 7054 youth who were not seeking help for mental health problems (ages 11-21, 54% female) and completed a structured interview that included evaluation of hoarding behavior and OCS, as a part of the Philadelphia Neurodevelopmental Cohort between November 2009 and December 2011. We employed regression models with hoarding behavior and OCS (any/none) as independent variables, and continuous (linear regression) or binary (logistic regression) mental health measures as dependent variables. All models covaried for age, sex, race, and socioeconomic status. A total of 374 participants endorsed HB (5.3%), most of which reported additional OCS (n = 317). When accounting for OCS presence, hoarding behavior was associated with greater dimensional psychopathology burden (i.e., higher P-factor) (β = 0.19, p < .001), and with poorer functioning (i.e., lower score on the child global assessment scale) (β = - 0.07, p < .001). The results were consistent when modeling psychopathology using binary variables. The results remained significant in sensitivity analyses accounting for count of endorsed OCS and excluding participants who met criteria for obsessive-compulsive disorder (n = 210). These results suggest that hoarding behavior among youth is associated with poorer mental health and functioning, independent of OCS. Brief hoarding-behavior assessments in clinical settings may prove useful given hoarding behavior's stigma and detrimental health associations.
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Affiliation(s)
- Omer Linkovski
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
- Department of Psychiatry, Neurodevelopment and Psychosis Section, Perelman School of Medicine, University of Pennsylvania, 10th floor, Gates Pavilion, Hospital of the University of Pennsylvania, 34Th and Spruce Street, Philadelphia, PA, 19104, USA
- Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, 52900, Ramat-Gan, Israel
| | - Tyler M Moore
- Department of Psychiatry, Neurodevelopment and Psychosis Section, Perelman School of Medicine, University of Pennsylvania, 10th floor, Gates Pavilion, Hospital of the University of Pennsylvania, 34Th and Spruce Street, Philadelphia, PA, 19104, USA
- Lifespan Brain Institute of Children's Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, PA, USA
| | - Stirling T Argabright
- Lifespan Brain Institute of Children's Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, PA, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, CHOP, Philadelphia, PA, USA
| | - Monica E Calkins
- Department of Psychiatry, Neurodevelopment and Psychosis Section, Perelman School of Medicine, University of Pennsylvania, 10th floor, Gates Pavilion, Hospital of the University of Pennsylvania, 34Th and Spruce Street, Philadelphia, PA, 19104, USA
- Lifespan Brain Institute of Children's Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, PA, USA
| | - Ruben C Gur
- Department of Psychiatry, Neurodevelopment and Psychosis Section, Perelman School of Medicine, University of Pennsylvania, 10th floor, Gates Pavilion, Hospital of the University of Pennsylvania, 34Th and Spruce Street, Philadelphia, PA, 19104, USA
- Lifespan Brain Institute of Children's Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, PA, USA
| | - Raquel E Gur
- Department of Psychiatry, Neurodevelopment and Psychosis Section, Perelman School of Medicine, University of Pennsylvania, 10th floor, Gates Pavilion, Hospital of the University of Pennsylvania, 34Th and Spruce Street, Philadelphia, PA, 19104, USA
- Lifespan Brain Institute of Children's Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, PA, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, CHOP, Philadelphia, PA, USA
| | - Ran Barzilay
- Department of Psychiatry, Neurodevelopment and Psychosis Section, Perelman School of Medicine, University of Pennsylvania, 10th floor, Gates Pavilion, Hospital of the University of Pennsylvania, 34Th and Spruce Street, Philadelphia, PA, 19104, USA.
- Lifespan Brain Institute of Children's Hospital of Philadelphia (CHOP) and Penn Medicine, Philadelphia, PA, USA.
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, CHOP, Philadelphia, PA, USA.
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4
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Strom NI, Burton CL, Iyegbe C, Silzer T, Antonyan L, Pool R, Lemire M, Crowley JJ, Hottenga JJ, Ivanov VZ, Larsson H, Lichtenstein P, Magnusson P, Rück C, Schachar R, Wu HM, Cath D, Crosbie J, Mataix-Cols D, Boomsma DI, Mattheisen M, Meier SM, Smit DJA, Arnold PD. Genome-Wide Association Study of Obsessive-Compulsive Symptoms including 33,943 individuals from the general population. Mol Psychiatry 2024:10.1038/s41380-024-02489-6. [PMID: 38548983 DOI: 10.1038/s41380-024-02489-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/18/2024] [Accepted: 02/15/2024] [Indexed: 04/24/2024]
Abstract
While 1-2% of individuals meet the criteria for a clinical diagnosis of obsessive-compulsive disorder (OCD), many more (~13-38%) experience subclinical obsessive-compulsive symptoms (OCS) during their life. To characterize the genetic underpinnings of OCS and its genetic relationship to OCD, we conducted the largest genome-wide association study (GWAS) meta-analysis of parent- or self-reported OCS to date (N = 33,943 with complete phenotypic and genome-wide data), combining the results from seven large-scale population-based cohorts from Sweden, the Netherlands, England, and Canada (including six twin cohorts and one cohort of unrelated individuals). We found no genome-wide significant associations at the single-nucleotide polymorphism (SNP) or gene-level, but a polygenic risk score (PRS) based on the OCD GWAS previously published by the Psychiatric Genetics Consortium (PGC-OCD) was significantly associated with OCS (Pfixed = 3.06 × 10-5). Also, one curated gene set (Mootha Gluconeogenesis) reached Bonferroni-corrected significance (Ngenes = 28, Beta = 0.79, SE = 0.16, Pbon = 0.008). Expression of genes in this set is high at sites of insulin mediated glucose disposal. Dysregulated insulin signaling in the etiology of OCS has been suggested by a previous study describing a genetic overlap of OCS with insulin signaling-related traits in children and adolescents. We report a SNP heritability of 4.1% (P = 0.0044) in the meta-analyzed GWAS, and heritability estimates based on the twin cohorts of 33-43%. Genetic correlation analysis showed that OCS were most strongly associated with OCD (rG = 0.72, p = 0.0007) among all tested psychiatric disorders (N = 11). Of all 97 tested phenotypes, 24 showed a significant genetic correlation with OCS, and 66 traits showed concordant directions of effect with OCS and OCD. OCS have a significant polygenic contribution and share genetic risk with diagnosed OCD, supporting the hypothesis that OCD represents the extreme end of widely distributed OCS in the population.
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Affiliation(s)
- Nora I Strom
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany.
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany.
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden.
- Department of Biomedicine, Aarhus University, Aarhus, Denmark.
| | - Christie L Burton
- Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Conrad Iyegbe
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
- Department of Genetics and Genomic Sciences, Icahn School of Medicine, Mount Sinai, New York, USA
| | - Talisa Silzer
- Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Lilit Antonyan
- The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - René Pool
- Department of Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Mathieu Lemire
- Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - James J Crowley
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden
- Departments of Genetics and Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jouke-Jan Hottenga
- Netherlands Twin Register, Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Volen Z Ivanov
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- School of Medical sciences, Örebro University, Örebro, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Patrik Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Christian Rück
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden
| | - Russell Schachar
- Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - Hei Man Wu
- Department of Genetics and Genomic Sciences, Icahn School of Medicine, Mount Sinai, New York, USA
| | - Danielle Cath
- Rijksuniversiteit Groningen and Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
- Department of Specialized Training, Drenthe Mental Health Care Institute, Assen, The Netherlands
| | - Jennifer Crosbie
- Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON, Canada
| | - David Mataix-Cols
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Sweden
| | - Dorret I Boomsma
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Netherlands Twin Register, Biological Psychology, Vrije Universiteit, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Manuel Mattheisen
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Community Health & Epidemiology, Dalhousie University, NS, Halifax, Canada
| | - Sandra M Meier
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Community Health & Epidemiology, Dalhousie University, NS, Halifax, Canada
| | - Dirk J A Smit
- Amsterdam UMC location University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Compulsivity Impulsivity and Attention, Amsterdam, The Netherlands
| | - Paul D Arnold
- The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Departments of Psychiatry and Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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5
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Rueppel M, Becker HC, Iturra-Mena A, Bilek EL, Monk CS, Phan KL, Fitzgerald KD. Obsessive-Compulsive Symptoms: Baseline Prevalence, Comorbidity, and Implications in a Clinically Anxious Pediatric Sample. Child Psychiatry Hum Dev 2024:10.1007/s10578-023-01658-y. [PMID: 38355854 DOI: 10.1007/s10578-023-01658-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/13/2023] [Indexed: 02/16/2024]
Abstract
Subclinical symptoms of obsessive-compulsive disorder (i.e., obsessive compulsive symptoms, or "OCS") cause functional impairment, including for youth without full-syndrome OCD. Further, despite high rates of OCS in youth with anxiety disorders, knowledge of OCS in the context of specific anxiety disorders is limited. The present study seeks to: (1) compare OCS in pediatric patients with anxiety disorders and healthy youth, (2) determine which categorical anxiety disorder(s) associate most with OCS, and (3) determine relationships between OCS with anxiety severity and impairment. Data on OCS, anxiety, and functional impairment were collected from 153 youth with anxiety disorders and 45 healthy controls, ages 7-17 years (M = 11.84, SD = 3.17). Findings indicated that patients had significantly more OCS than healthy controls. Among patients, GAD was a significant predictor of OCS as well as OCD risk. These results suggest that OCS should be a primary diagnostic and treatment consideration for youth who present in clinical settings with GAD.
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Affiliation(s)
- Meryl Rueppel
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, 10032, USA
- New York State Psychiatric Institute, New York, NY, 10032, USA
- Department of Psychology, Fordham University, Bronx, NY, 10458, USA
| | - Hannah C Becker
- Department of Psychology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Ann Iturra-Mena
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, 10032, USA
- New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Emily L Bilek
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Christopher S Monk
- Department of Psychology, University of Michigan, Ann Arbor, MI, 48109, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA
| | - K Luan Phan
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, 43210, USA
| | - Kate D Fitzgerald
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, 10032, USA.
- New York State Psychiatric Institute, New York, NY, 10032, USA.
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6
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Borrelli DF, Cervin M, Ottoni R, Marchesi C, Tonna M. Psychotic Vulnerability and its Associations with Clinical Characteristics in Adolescents with Obsessive-Compulsive Disorder. Res Child Adolesc Psychopathol 2023; 51:1535-1548. [PMID: 37256460 DOI: 10.1007/s10802-023-01089-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2023] [Indexed: 06/01/2023]
Abstract
Compared to peers, children and adolescents with obsessive-compulsive disorder (OCD) are at increased risk of developing psychotic disorders. Yet very few studies have examined early indicators of psychosis in pediatric OCD. In the present study, 52 youth with a primary diagnosis of OCD (Mage = 15.66 [SD = 2.33], 59.6% girls) were interviewed using the Schizophrenia Proneness Instrument Child and Adolescent version (SPI-CY), which is a comprehensive clinical interview assessing both Cognitive-Perceptual basic symptoms (COPER) and high-risk criterion Cognitive Disturbances (COGDIS). Associations between COPER/COGDIS symptoms and demographic and clinical characteristics were examined. Findings showed that COPER or COGDIS symptoms were present in 44% of participants, with no significant difference between girls and boys. Psychotic vulnerability was associated with an earlier age of OCD onset, greater OCD severity, poorer insight, and more contamination/cleaning symptoms. Psychotic vulnerability was also strongly associated with worse psychosocial functioning. Findings suggest that early indicators of psychosis are frequent in pediatric OCD and associated with more severe OCD and poorer functioning. Research examining how psychotic vulnerability is associated with short- and long-term outcomes for youth with OCD is needed.
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Affiliation(s)
- Davide Fausto Borrelli
- Department of Medicine and Surgery, Unit of Neuroscience, University of Parma Ospedale Maggiore, Padiglione Braga Viale A. Gramsci 14, Parma, 43126, Italy.
| | - Matti Cervin
- Department of Clinical Sciences Lund, Lund University, Sofiavägen 2D, SE-22241, Lund, Sweden
| | - Rebecca Ottoni
- Department of Mental Health, Local Health Service, Parma, Italy
| | - Carlo Marchesi
- Department of Medicine and Surgery, Unit of Neuroscience, University of Parma Ospedale Maggiore, Padiglione Braga Viale A. Gramsci 14, Parma, 43126, Italy
- Department of Mental Health, Local Health Service, Parma, Italy
| | - Matteo Tonna
- Department of Medicine and Surgery, Unit of Neuroscience, University of Parma Ospedale Maggiore, Padiglione Braga Viale A. Gramsci 14, Parma, 43126, Italy
- Department of Mental Health, Local Health Service, Parma, Italy
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7
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Destrée L, Albertella L, Jobson L, McGorry P, Chanen A, Ratheesh A, Davey C, Polari A, Amminger P, Yuen HP, Hartmann J, Spooner R, Fontenelle LF, Nelson B. The association between stressful experiences and OCD symptoms in young adults at transdiagnostic risk. J Affect Disord 2023; 328:128-134. [PMID: 36812805 DOI: 10.1016/j.jad.2023.02.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 12/06/2022] [Accepted: 02/14/2023] [Indexed: 02/22/2023]
Abstract
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.
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Affiliation(s)
- Louise Destrée
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Victoria, Australia; Orygen, Parkville, VIC, Australia.
| | - Lucy Albertella
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Victoria, Australia
| | - Laura Jobson
- BrainPark, Turner Institute for Brain and Mental Health, School of Psychological Sciences & Monash Biomedical Imaging Facility, Monash University, Victoria, Australia
| | - Patrick McGorry
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Andrew Chanen
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Aswin Ratheesh
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Christopher Davey
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Andrea Polari
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Paul Amminger
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Hok Pan Yuen
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Jessica Hartmann
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Rachael Spooner
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Leonardo F Fontenelle
- Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Brazil; D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Barnaby Nelson
- Orygen, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
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8
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Abstract
Obsessive-compulsive disorder (OCD) is characterized by time-consuming, distressing, or impairing obsessions and compulsions. Obsessions are recurrent, persistent, and intrusive thoughts, urges, or images. Compulsions are repetitive and often ritualized behaviors or mental acts performed to manage obsession-related distress or prevent harm. OCD affects 1% to 3% of the population, typically begins during adolescence or early adulthood, and can have a chronic or deteriorating course in the absence of effective treatment.
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Affiliation(s)
- Matti Cervin
- Department of Clinical Sciences, Lund, Child and Adolescent Psychiatry, Faculty of Medicine, Lund University, Sofiavägen 2D, Lund SE-22241, Sweden.
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9
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Early Identification and Intervention in Pediatric Obsessive-Compulsive Disorder. Brain Sci 2023; 13:brainsci13030399. [PMID: 36979207 PMCID: PMC10046131 DOI: 10.3390/brainsci13030399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/19/2023] [Accepted: 02/24/2023] [Indexed: 03/03/2023] Open
Abstract
Obsessive-compulsive disorder (OCD) is a psychiatric disorder characterized by persistent thoughts with subsequent repetitive behaviors. Interventions that are effective for adult OCD cannot simply be generalized to pediatric OCD, since OCD in children and adolescents usually has a different clinical presentation, etiology and course from adult OCD. Delayed and inadequate treatment is associated with a worse prognosis, making the need for early identification and intervention in pediatric OCD very urgent. In this paper, we reflected on the current constraints that make early interventions for pediatric OCD unpromoted and reviewed the approaches with potential application for early identification and early intervention in pediatric OCD, categorized by three-level prevention stages corresponding to a clinical staging model. Since the etiology of pediatric OCD is still unclear, primary prevention is most lacking, and early interventions for pediatric OCD are currently focused on the secondary prevention stage, which aims to prevent the conversion of obsessive-compulsive symptoms into full-blown OCD; tertiary prevention mostly focuses on the alleviation of mild to moderate OCD, while interventions for co-morbidities are still in their infancy. We closed by considering the important research questions on this topic.
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10
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Bakhshaie J, Storch EA, Rogers AH, Zvolensky MJ. Pain Intensity Moderates the Association between Obsessive-Compulsive Symptoms and Problematic Alcohol Use among Emerging Adults. J Dual Diagn 2023; 19:16-25. [PMID: 36576218 DOI: 10.1080/15504263.2022.2157181] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Objective: Emerging adulthood is a vulnerable period for problematic alcohol use, defined by a pattern of use associated with physical and functional impairment. Obsessive-compulsive psychopathology, which demonstrates high rates of onset in emerging adults, seems to be related to problematic alcohol use in this age group, consistent with research among the general population suggesting an association between emotional disorders and alcohol use in the context of coping drinking motives. Pain intensity, another risk factor of problematic alcohol use, may link obsessive-compulsive symptoms to problematic alcohol use among emerging adults. Therefore, the current study examined the moderating role of pain intensity on the association between obsessive-compulsive symptoms and problematic alcohol use among emerging adults. Methods: Participants were 198 college students (81.30% female, Mage = 22.33, SD = 4.38) who reported problematic alcohol use. Results: Results from the current study supported a significant moderation role of pain intensity for the association between obsessive-compulsive symptoms and problematic alcohol use, whereby the association between obsessive-compulsive symptoms and problematic alcohol use was stronger for emerging adults with high compared to low pain intensity. Conclusions: These results highlighted a clinically-relevant interaction between obsessive-compulsive symptoms and pain intensity concerning the risk of problematic alcohol use among emerging adults as a vulnerable population.
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Affiliation(s)
- Jafar Bakhshaie
- Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Eric A Storch
- Menninger Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Andrew H Rogers
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, Texas, USA.,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.,HEALTH Institute, University of Houston, Houston, Texas, USA
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11
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Hearne LJ, Cocchi L. Hunting the Brain Basis of a Mind Under Siege. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:1049-1050. [PMID: 36344036 DOI: 10.1016/j.bpsc.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Luke J Hearne
- Department of Mental Health and Neuroscience, Queensland Institute of Medical Research Berghofer, Brisbane, Australia
| | - Luca Cocchi
- Department of Mental Health and Neuroscience, Queensland Institute of Medical Research Berghofer, Brisbane, Australia.
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12
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Alexander-Bloch AF, Sood R, Shinohara RT, Moore TM, Calkins ME, Chertavian C, Wolf DH, Gur RC, Satterthwaite TD, Gur RE, Barzilay R. Connectome-wide Functional Connectivity Abnormalities in Youth With Obsessive-Compulsive Symptoms. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:1068-1077. [PMID: 34375730 PMCID: PMC8821731 DOI: 10.1016/j.bpsc.2021.07.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/16/2021] [Accepted: 07/29/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Obsessive-compulsive symptomatology (OCS) is common in adolescence but usually does not meet the diagnostic threshold for obsessive-compulsive disorder. Nevertheless, both obsessive-compulsive disorder and subthreshold OCS are associated with increased likelihood of experiencing other serious psychiatric conditions, including depression and suicidal ideation. Unfortunately, there is limited information on the neurobiology of OCS. METHODS Here, we undertook one of the first brain imaging studies of OCS in a large adolescent sample (analyzed n = 832) from the Philadelphia Neurodevelopmental Cohort. We investigated resting-state functional magnetic resonance imaging functional connectivity using complementary analytic approaches that focus on different neuroanatomical scales, from known functional systems to connectome-wide tests. RESULTS We found a robust pattern of connectome-wide, OCS-related differences, as well as evidence of specific abnormalities involving known functional systems, including dorsal and ventral attention, frontoparietal, and default mode systems. Analysis of cerebral perfusion imaging and high-resolution structural imaging did not show OCS-related differences, consistent with domain specificity to functional connectivity. CONCLUSIONS The brain connectomic associations with OCS reported here, together with early studies of its clinical relevance, support the potential for OCS as an early marker of psychiatric risk that may enhance our understanding of mechanisms underlying the onset of adolescent psychopathology.
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Affiliation(s)
- Aaron F Alexander-Bloch
- Department of Child and Adolescent Psychiatry and Behavioral Science, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania; CHOP/Penn Lifespan Brain Institute, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Rahul Sood
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Russell T Shinohara
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania; Penn Statistics in Imaging and Visualization Center, University of Pennsylvania, Philadelphia, Pennsylvania; Penn Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Tyler M Moore
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania; CHOP/Penn Lifespan Brain Institute, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Monica E Calkins
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania; CHOP/Penn Lifespan Brain Institute, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Casey Chertavian
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Daniel H Wolf
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ruben C Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania; CHOP/Penn Lifespan Brain Institute, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Theodore D Satterthwaite
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania; Penn Lifespan Informatics and Neuroimaging Center, University of Pennsylvania, Philadelphia, Pennsylvania; CHOP/Penn Lifespan Brain Institute, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Raquel E Gur
- Department of Child and Adolescent Psychiatry and Behavioral Science, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania; CHOP/Penn Lifespan Brain Institute, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ran Barzilay
- Department of Child and Adolescent Psychiatry and Behavioral Science, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania; CHOP/Penn Lifespan Brain Institute, University of Pennsylvania, Philadelphia, Pennsylvania
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13
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Grazioplene RG, DeYoung CG, Hampson M, Anticevic A, Pittenger C. Obsessive compulsive symptom dimensions are linked to altered white-matter microstructure in a community sample of youth. Transl Psychiatry 2022; 12:328. [PMID: 35948535 PMCID: PMC9365814 DOI: 10.1038/s41398-022-02013-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 05/05/2022] [Accepted: 05/30/2022] [Indexed: 11/17/2022] Open
Abstract
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.
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Affiliation(s)
| | - Colin G DeYoung
- University of Minnesota, Department of Psychology, Minneapolis, MN, USA
| | - Michelle Hampson
- Yale University, Department of Radiology and Biomedical Imaging, New Haven, CT, USA
| | - Alan Anticevic
- Yale University, Department of Psychiatry, New Haven, CT, USA
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14
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Schwarzlose RF, Hennefield L, Hoyniak CP, Luby JL, Gilbert KE. Picky Eating in Childhood: Associations With Obsessive-Compulsive Symptoms. J Pediatr Psychol 2022; 47:816-826. [PMID: 35238927 PMCID: PMC9297090 DOI: 10.1093/jpepsy/jsac006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To test whether childhood picky eating (PE)-a behavior previously linked to many forms of psychopathology-is specifically associated with symptoms of obsessive-compulsive disorder (OCD). METHODS We investigated the relationship between PE and symptoms of several forms of psychopathology in two separate observational samples: a sample of 110 children (5 and 6 years old) and a sample of 210 children (8 and 9 years old) drawn from a longitudinal study. In each sample, regression models based on psychiatric symptoms or diagnoses were used to assess the specificity of PE associations while accounting for cooccurring symptoms or comorbidities. RESULTS Although bivariate associations emerged between PE and multiple forms of psychopathology, multivariate analyses revealed these associations were driven by a strong and specific association between PE and symptoms of OCD in both samples. Moreover, PE among 8- and 9-year-olds in the longitudinal study predicted emergence of additional later psychopathology, specifically attention-deficit/hyperactivity disorder (ADHD). CONCLUSIONS Findings suggest that PE, an easily identifiable clinical presentation, is also a specific marker for obsessive-compulsive symptomatology in school-age children and may impart risk for ADHD later in childhood.
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Affiliation(s)
| | - Laura Hennefield
- Department of Psychiatry, Washington University School of Medicine in St Louis, USA
| | - Caroline P Hoyniak
- Department of Psychiatry, Washington University School of Medicine in St Louis, USA
| | - Joan L Luby
- Department of Psychiatry, Washington University School of Medicine in St Louis, USA
| | - Kirsten E Gilbert
- Department of Psychiatry, Washington University School of Medicine in St Louis, USA
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15
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Childhood maltreatment and disordered eating: The mediating role of emotion regulation. Appetite 2022; 172:105952. [DOI: 10.1016/j.appet.2022.105952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 01/17/2022] [Accepted: 01/25/2022] [Indexed: 11/19/2022]
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16
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Thompson EM, Brierley MEE, Destrée L, Albertella L, Fontenelle LF. Psychological flexibility and inflexibility in obsessive-compulsive symptom dimensions, disability, and quality of life: An online longitudinal study. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022. [DOI: 10.1016/j.jcbs.2021.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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17
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Strom NI, Soda T, Mathews CA, Davis LK. A dimensional perspective on the genetics of obsessive-compulsive disorder. Transl Psychiatry 2021; 11:401. [PMID: 34290223 PMCID: PMC8295308 DOI: 10.1038/s41398-021-01519-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 06/04/2021] [Accepted: 06/16/2021] [Indexed: 12/21/2022] Open
Abstract
This review covers recent findings in the genomics of obsessive-compulsive disorder (OCD), obsessive-compulsive symptoms, and related traits from a dimensional perspective. We focus on discoveries stemming from technical and methodological advances of the past five years and present a synthesis of human genomics research on OCD. On balance, reviewed studies demonstrate that OCD is a dimensional trait with a highly polygenic architecture and genetic correlations to multiple, often comorbid psychiatric phenotypes. We discuss the phenotypic and genetic findings of these studies in the context of the dimensional framework, relying on a continuous phenotype definition, and contrast these observations with discoveries based on a categorical diagnostic framework, relying on a dichotomous case/control definition. Finally, we highlight gaps in knowledge and new directions for OCD genetics research.
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Affiliation(s)
- Nora I Strom
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Department of Psychology, Humboldt Universität zu Berlin, Berlin, Germany
| | - Takahiro Soda
- Department of Psychiatry, Duke University, Durham, NC, USA
| | - Carol A Mathews
- Department of Psychiatry, University of Florida, Gainesville, FL, USA
| | - Lea K Davis
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA.
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18
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Developmental Trajectories of Pediatric Obsessive-Compulsive Symptoms. Res Child Adolesc Psychopathol 2021; 49:1635-1648. [PMID: 34236586 DOI: 10.1007/s10802-020-00742-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2020] [Indexed: 10/20/2022]
Abstract
Children who experience obsessive-compulsive symptoms (OCS) may be at risk for developing Obsessive-Compulsive Disorder (OCD). The current study aimed to investigate developmental trajectories of OCS, as well as possible predictors, within a community-based sample of children. Children (N = 1147) from the longitudinal NICHD Study of Early Child Care and Youth Development (SECCYD) were assessed for OCS, via the Child Behavioral Checklist - Obsessive-Compulsive Scale (OCS-8), eight times between Pre-Kindergarten (54 months; Pre-K) and High School (15 years of age; HS.) Participants were recruited within the United States and included only maternal caregivers. Preliminary analyses indicated that approximately 3% of the sample was above the diagnostic cutoff score on the OCS-8 at the High School time-point. Latent growth models tested symptom trajectories. Findings demonstrated three groups of OCS trajectories. Most children fell within a low symptomatology group (the No Peak group) with low OCS across all time points. Two additional OCS trajectories were also demonstrated: Pre-K Peak (high to low OCS across time) and HS Peak (low to high OCS across time). Both higher attention problems and greater depression/anxiety symptoms at the Pre-K time point predicted children's membership in the Pre-K Peak or HS Peak groups compared to the No Peak group. Membership within the HS Peak group predicted a high likelihood of children's OCS being above previously established cutoff scores for an OCD diagnosis at age 15 years. Membership within either the Pre-K Peak or No Peak groups predicted a low likelihood. This study provides new evidence for the existence of different developmental trajectories for youth with OCS. From a clinical perspective, these results may have important implications when considering the identification and early intervention of childhood OCS and OCD within the community.
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19
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Weinzimmer SA, Schneider SC, Cepeda SL, Guzick AG, Lázaro-Muñoz G, McIngvale E, Goodman WK, Sheth SA, Storch EA. Perceptions of Deep Brain Stimulation for Adolescents with Obsessive-Compulsive Disorder. J Child Adolesc Psychopharmacol 2021; 31:109-117. [PMID: 33534637 PMCID: PMC7984933 DOI: 10.1089/cap.2020.0166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: The present study aims to understand perceptions of deep brain stimulation (DBS) for severe obsessive-compulsive disorder (OCD) in adolescents among two groups: parents of children with a history of OCD and adults with a history of OCD. Methods: Two hundred sixty participants completed a questionnaire exploring their treatment history, relevant symptom severity, DBS knowledge, and DBS attitudes using an acceptability scale and a series of statements indicating levels of willingness or reluctance to consider DBS for adolescents with severe OCD or severe epilepsy. Results: Overall, participants found DBS to be fairly acceptable for adolescents with severe OCD, with 63% reporting at least 7/10 on a 0-10 acceptability Likert scale. Respondents were more willing to consider DBS for epilepsy than for OCD. Several factors were associated with greater willingness to consider DBS for OCD, including familiarity with DBS, the presence of suicidal thoughts, assurances of daily functioning improvements, and assurances of substantial symptom reduction. Concerns about safety, personality changes, and long-term effects on the body were associated with greatest reluctance to consider DBS for OCD. Conclusions: Our findings support the importance of increasing parents' familiarity with DBS, monitoring factors participants identified as most important to their DBS perceptions in future DBS research, and communicating benefits and risks clearly. We also highlight the need for further research on perceptions of DBS for severe and refractory OCD in adolescents.
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Affiliation(s)
- Saira A. Weinzimmer
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA.,Address correspondence to: Saira Weinzimmer, BA, Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Boulevard, Suite 4-400, Houston, TX 77030, USA
| | - Sophie C. Schneider
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Sandra L. Cepeda
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Andrew G. Guzick
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Gabriel Lázaro-Muñoz
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas, USA
| | | | - Wayne K. Goodman
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
| | - Sameer A. Sheth
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - Eric A. Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA.,Address correspondence to: Eric Storch, PhD, Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Boulevard, Suite 4-400, Houston, TX 77030, USA
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20
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Ravagnani Salto AB, Santoro ML, Hoexter MQ, Jackowski AP, Pan PM, Rosário MC, Belangero SI, Alvarenga PG, Doretto VF, Fumo AMT, Batistuzzo MC, Macul Ferreira de Barros P, Timpano KR, Ota VK, Rohde LA, Miguel EC, Leckman JF, Zugman A. Obsessive-Compulsive Symptoms, Polygenic Risk Score, and Thalamic Development in Children From the Brazilian High-Risk Cohort for Mental Conditions (BHRCS). Front Psychiatry 2021; 12:673595. [PMID: 34163385 PMCID: PMC8215160 DOI: 10.3389/fpsyt.2021.673595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 05/11/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Thalamic volume measures have been linked to obsessive-compulsive disorder (OCD) in children and adolescents. However, it is unclear if alterations in thalamic volumes occur before or after symptom onset and if there is a relation to the presence of sub-clinical obsessive-compulsive symptoms (OCS). Here, we explore the relationship between OCS and the rate of thalamic volume change in a cohort of children and youth at high risk to develop a mental disorder. A secondary aim was to determine if there is a relationship between OCS and the individual's OCD polygenic risk score (OCD-PRS) and between the rate of thalamic volume change and the OCD-PRS. Methods: The sample included 378 children enrolled in the longitudinal Brazilian High-Risk Cohort for Mental Conditions. Participants were assessed for OCS and the symmetrized percent change (SPC) of thalamic volume across two time-points separated by 3 years, along with the OCD-PRS. Zero-altered negative binomial models were used to analyze the relationship between OCS and thalamic SPC. Multiple linear regressions were used to examine the relationship between thalamic SPC and OCD-PRS. Results: A significant relationship between OCS and the right thalamus SPC (p = 0.042) was found. There was no significant relationship between changes in thalamic volume SPC and OCD-PRS. Conclusions: The findings suggest that changes in the right thalamic volume over the course of 3 years in children may be associated to OCS. Future studies are needed to confirm these results and further characterize the specific nature of OCS symptoms associated with thalamic volumes.
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Affiliation(s)
| | - Marcos L Santoro
- Departamento de Morfologia e Genética, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Marcelo Q Hoexter
- Department and Institute of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Andrea Parolin Jackowski
- Laboratory of Integrative Neuroscience, Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Pedro M Pan
- Laboratory of Integrative Neuroscience, Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Maria Conceição Rosário
- Laboratory of Integrative Neuroscience, Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Sintia I Belangero
- Departamento de Morfologia e Genética, Universidade Federal de São Paulo, São Paulo, Brazil.,Laboratory of Integrative Neuroscience, Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Pedro Gomes Alvarenga
- Department and Institute of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Victoria Fogaça Doretto
- Department and Institute of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Afonso Mazine Tiago Fumo
- Department and Institute of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Marcelo C Batistuzzo
- Department and Institute of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.,Department of Methods and Techniques in Psychology, Pontifical Catholic University, São Paulo, Brazil
| | | | - Kiara R Timpano
- Department of Psychology, University of Miami, Coral Gables, FL, United States
| | - Vanessa K Ota
- Departamento de Morfologia e Genética, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Luis Augusto Rohde
- Attention-Deficit/Hyperactivity Disorder and Developmental Psychiatry Programs, Hospital de Clínicas de Porto Alegre, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | | | - James F Leckman
- Yale Child Study Centre, Yale School of Medicine, Yale University, New Haven, CT, United States
| | - André Zugman
- Laboratory of Integrative Neuroscience, Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, Brazil
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21
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Macul Ferreira de Barros P, do Rosário MC, Szejko N, Polga N, Requena GDL, Ravagnani B, Fatori D, Batistuzzo MC, Hoexter MQ, Rohde LA, Polanczyk GV, Leckman JF, Miguel EC, de Alvarenga PG. Risk factors for obsessive-compulsive symptoms. Follow-up of a community-based youth cohort. Eur Child Adolesc Psychiatry 2021; 30:89-104. [PMID: 32076869 DOI: 10.1007/s00787-020-01495-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 02/07/2020] [Indexed: 12/19/2022]
Abstract
Environmental factors are at least as important as genetic factors for the development of obsessive-compulsive symptoms (OCS), but the identification of such factors remain a research priority. Our study aimed to investigate the association between a broad scope of potential risk factors and OCS in a large community cohort of children and adolescents. We evaluated 1877 participants and their caregivers at baseline and after 3 years to assess various demographic, prenatal, perinatal, childhood adversity, and psychopathological factors. Mean age at baseline was 10.2 years (SD 1.9) and mean age at follow-up was 13.4 years (SD 1.9). Reports of OCS at baseline and follow-up were analyzed using latent variable models. At preliminary regression analysis, 15 parameters were significantly associated with higher OCS scores at follow-up. At subsequent regression analysis, we found that eight of these parameters remained significantly associated with higher follow-up OCS scores while being controlled by each other and by baseline OCS scores. The significant predictors of follow-up OCS were: lower socioeconomic status (p = 0.033); lower intelligence quotient (p = 0.013); lower age (p < 0.001); higher maternal stress level during pregnancy (p = 0.028); absence of breastfeeding (p = 0.017); parental baseline OCS (p = 0.038); youth baseline anxiety disorder (p = 0.023); and youth baseline OCS scores (p < 0.001). These findings may better inform clinicians and policymakers engaged in the mental health assessment and prevention in children and adolescents.
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Affiliation(s)
| | - Maria Conceição do Rosário
- Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Natalia Szejko
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland.,Department of Bioethics, Medical University of Warsaw, Warsaw, Poland
| | - Natália Polga
- Graduate Program in Psychology, Federal University of São Paulo, Santos, Brazil
| | - Guaraci de Lima Requena
- Department of Statistics, Institute of Mathematics and Statistics, University of São Paulo, São Paulo, Brazil
| | - Beatriz Ravagnani
- Institute of Psychiatry, University of São Paulo, R. Dr. Ovídio Pires de Campos, 785, São Paulo, 05403-903, Brazil
| | - Daniel Fatori
- Institute of Psychiatry, University of São Paulo, R. Dr. Ovídio Pires de Campos, 785, São Paulo, 05403-903, Brazil
| | - Marcelo Camargo Batistuzzo
- Institute of Psychiatry, University of São Paulo, R. Dr. Ovídio Pires de Campos, 785, São Paulo, 05403-903, Brazil
| | - Marcelo Queiroz Hoexter
- Institute of Psychiatry, University of São Paulo, R. Dr. Ovídio Pires de Campos, 785, São Paulo, 05403-903, Brazil
| | - Luis Augusto Rohde
- Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande Do Sul, Porto Alegre, Brazil
| | - Guilherme Vanoni Polanczyk
- Institute of Psychiatry, University of São Paulo, R. Dr. Ovídio Pires de Campos, 785, São Paulo, 05403-903, Brazil
| | | | - Eurípedes Constantino Miguel
- Institute of Psychiatry, University of São Paulo, R. Dr. Ovídio Pires de Campos, 785, São Paulo, 05403-903, Brazil
| | - Pedro Gomes de Alvarenga
- Institute of Psychiatry, University of São Paulo, R. Dr. Ovídio Pires de Campos, 785, São Paulo, 05403-903, Brazil
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22
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Screening for Pediatric Obsessive-Compulsive Disorder Using the Obsessive-Compulsive Inventory-Child Version. Child Psychiatry Hum Dev 2020; 51:888-899. [PMID: 32030629 DOI: 10.1007/s10578-020-00966-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The study assessed the ability of the Obsessive-Compulsive Inventory-Child Version (OCI-CV) to detect pediatric obsessive-compulsive disorder (OCD) using receiver operating characteristic analyses. The sample consisted of 114 cases with current OCD, 340 cases with other psychiatric disorders (OPD), and 301 healthy controls (HC) ages 7 to 18 years. All 755 participants were assessed with two semi-structured interviews and seven rating scales. In a comparison of current OCD cases and all other participants, the optimal OCI-CV cut-score was 11 with an area under the curve (AUC) of .88. In a comparison of current OCD cases and OPD cases, the optimal OCI-CV cut-score was 11 with an AUC of .82. In a comparison of current OCD cases and HC, the optimal OCI-CV cut-score was 10 with an AUC of .94. The results indicate that the OCI-CV provides an effective screen for pediatric OCD using empirically derived cut-scores.
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23
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Destrée L, Albertella L, Torres AR, Ferrão YA, Shavitt RG, Miguel EC, Fontenelle LF. Social losses predict a faster onset and greater severity of obsessive-compulsive disorder. J Psychiatr Res 2020; 130:187-193. [PMID: 32828024 DOI: 10.1016/j.jpsychires.2020.07.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 07/09/2020] [Accepted: 07/20/2020] [Indexed: 11/19/2022]
Abstract
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.
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Affiliation(s)
- Louise Destrée
- Brain & Mental Health Research Hub, Turner Institute for Brain and Mental Health, Monash University, Victoria, Australia
| | - Lucy Albertella
- Brain & Mental Health Research Hub, Turner Institute for Brain and Mental Health, Monash University, Victoria, Australia
| | - Albina R Torres
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, Universidade Estadual Paulista (Unesp), Brazil
| | - Ygor A Ferrão
- Department of Psychiatry, Federal University of Health Sciences of Porto Alegre (UFCSPA), Brazil
| | - Roseli G Shavitt
- Obsessive-Compulsive Spectrum Disorders Program (PROTOC), Department and Institute of Psychiatry, University of São Paulo (USP), Brazil
| | - Euripedes C Miguel
- Obsessive-Compulsive Spectrum Disorders Program (PROTOC), Department and Institute of Psychiatry, University of São Paulo (USP), Brazil
| | - Leonardo F Fontenelle
- Brain & Mental Health Research Hub, Turner Institute for Brain and Mental Health, Monash University, Victoria, Australia; Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, Universidade Estadual Paulista (Unesp), Brazil; Obsessive, Compulsive, and Anxiety Spectrum Research Program. Institute of Psychiatry, Federal University of Rio de Janeiro & D'Or Institute for Research and Education, Rio de Janeiro, Brazil.
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24
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Pellegrini L, Maietti E, Rucci P, Casadei G, Maina G, Fineberg NA, Albert U. Suicide attempts and suicidal ideation in patients with obsessive-compulsive disorder: A systematic review and meta-analysis. J Affect Disord 2020; 276:1001-1021. [PMID: 32750613 DOI: 10.1016/j.jad.2020.07.115] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/21/2020] [Accepted: 07/18/2020] [Indexed: 12/23/2022]
Abstract
INTRODUCTION There is controversy on the magnitude of suicide risk in OCD and on the psychopathological features that raise the risk. This systematic review and meta-analysis aims to estimate the pooled prevalence of suicide attempts and suicidal ideation (current/lifetime) in subjects with OCD and identify sociodemographic and clinical factors associated with greater risk. METHODS We conducted a literature search in PubMed/Medline, PsycINFO, Web of Science and CINAHL databases up to June 20, 2019, according to PRISMA guidelines. Stata statistical software (Version 15) was used to obtain forest plots, execute subgroup analyses and perform univariate and multivariate meta-regressions. RESULTS We found 61 eligible studies including OCD patients: 52 investigated suicide attempts and reported a pooled prevalence of 0.135 (95% CI 0.123-0.147); 26 explored current suicidal ideation and reported a pooled prevalence of 0.273 (95% CI 0.214-0.335); 22 researched lifetime suicidal ideation and reported a pooled prevalence of 0.473 (95% CI 0.397-0.548). Severity of obsessions, comorbid substance use and depressive/anxious symptoms increased the risk, whereas compulsions had a comparatively protective effect. LIMITATIONS Owing to the small number of studies reporting completed suicide rates, this metric was not included in the meta-analysis. The degree of heterogeneity between the studies was high. CONCLUSION Clinicians should keep in mind that one out of ten patients with OCD attempts suicide during his/her lifetime, about one third has current suicidal ideation and about half has had suicidal ideation in the past. Several clinical features are associated with increased risk and should be factored into clinical risk management.
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Affiliation(s)
- Luca Pellegrini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Viale Carlo Pepoli, 5, 40123, Bologna (BO), Italy; Highly Specialized Service for OCD and BDD, Hertfordshire Partnership University NHS Foundation Trust and University of Hertfordshire, Hatfield, United Kingdom.
| | - Elisa Maietti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Viale Carlo Pepoli, 5, 40123, Bologna (BO), Italy
| | - Paola Rucci
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Viale Carlo Pepoli, 5, 40123, Bologna (BO), Italy
| | - Giacomo Casadei
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Viale Carlo Pepoli, 5, 40123, Bologna (BO), Italy
| | - Giuseppe Maina
- Rita Levi Montalcini Department of Neuroscience, University of Torino, Italy
| | - Naomi A Fineberg
- Highly Specialized Service for OCD and BDD, Hertfordshire Partnership University NHS Foundation Trust and University of Hertfordshire, Hatfield, United Kingdom; University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, UCO Clinica Psichiatrica, University of Trieste, Trieste, Italy; Azienda Sanitaria Universitaria Giuliano-Isontina - ASUGI, Italy
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25
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Lamothe H, Acquaviva E, Baleyte JM, Delorme R. Is sustained attention deficit related to subclinical obsessive thoughts in children and adolescents with ADHD? Int J Psychiatry Clin Pract 2020; 24:250-256. [PMID: 32362208 DOI: 10.1080/13651501.2020.1759102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Thought content and its impact on sustained attention in individuals with attention deficit hyperactivity disorder (ADHD) are topics of growing interest in literature.Objective: We hypothesised that subclinical obsessive thoughts may be correlated with attention lapses in individuals with ADHD.Method: Thirty children diagnosed with ADHD participated in the study and their level of subclinical obsessive thoughts, attention, and executive function were measured using Children Yale-Brown Obsessive Scale and Conners' Continuous Performance Test II.Results: No significant correlation between sustained attention impairment and the level of obsessive thoughts in patients with ADHD was found. Nevertheless, patients with ADHD with subclinical obsessive thoughts showed more commission errors than those without (W = 51.5; p = 0.02).Conclusion: The nature of thought content in individuals with ADHD should be linked to executive dysfunction rather than attentional impairment. This could be of importance in the therapeutic strategy choice, addressing the importance of executive function remediation in the specific context of subclinical obsessive thoughts.Key points Patients with ADHD, without OCD or ASD comorbidity, still present subclinical obsessive thoughts (36% of our sample). • Subclinical obsessive thoughts could be a part of thought content in patients with ADHD. • Subclinical obsessive thoughts as measured by the CPT-II are not correlated with attention function in patients with ADHD. • ADHD patients with subclinical obsessive symptoms present more impairment in response inhibition than the ones without. • Results on subclinical obsessive thoughts are similar to those on another type of thought content called 'mind wandering'. • A clinical improvement strategy for patients with ADHD could be using executive function remediation rather than classical attention function remediation, according to both to our and previous results.
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Affiliation(s)
- Hugues Lamothe
- Child and Adolescent Psychiatry Department, Robert Debré University Hospital, Paris University, Paris, France.,Child and Adolescent Psychiatry Department, Intercommunal University Hospital, Paris Est University, Creteil, France
| | - Eric Acquaviva
- Child and Adolescent Psychiatry Department, Robert Debré University Hospital, Paris University, Paris, France
| | - Jean-Marc Baleyte
- Child and Adolescent Psychiatry Department, Intercommunal University Hospital, Paris Est University, Creteil, France
| | - Richard Delorme
- Child and Adolescent Psychiatry Department, Robert Debré University Hospital, Paris University, Paris, France.,Human and Genetic Functions, Pasteur Institute, Paris, France
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26
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Cropley VL, Tian Y, Fernando K, Mansour L S, Pantelis C, Cocchi L, Zalesky A. Brain-Predicted Age Associates With Psychopathology Dimensions in Youths. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 6:410-419. [PMID: 32981878 DOI: 10.1016/j.bpsc.2020.07.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/05/2020] [Accepted: 07/20/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study aimed to investigate whether dimensional constructs of psychopathology relate to variation in patterns of brain development and to determine whether these constructs share common neurodevelopmental profiles. METHODS Psychiatric symptom ratings from 9312 youths (8-21 years old) from the Philadelphia Neurodevelopmental Cohort were parsed into 7 independent dimensions of clinical psychopathology representing conduct, anxiety, obsessive-compulsive, attention, depression, bipolar, and psychosis symptoms. Using a subset of this cohort with structural magnetic resonance imaging (n = 1313), a normative model of brain morphology was established and the model was then applied to predict the age of youths with clinical symptoms. We investigated whether the deviation of brain-predicted age from true chronological age, called the brain age gap, explained individual variation in each psychopathology dimension. RESULTS Individual variation in the brain age gap significantly associated with clinical dimensions representing psychosis (t = 3.16, p = .0016), obsessive-compulsive symptoms (t = 2.5, p = .01), and general psychopathology (t = 4.08, p < .0001). Greater symptom severity along these dimensions was associated with brain morphology that appeared older than expected for typically developing youths of the same age. Psychopathology dimensions clustered into 2 modules based on shared brain loci where putative accelerated neurodevelopment was most prominent. Patterns of morphological development were accelerated in frontal cortices for depression, psychosis, and conduct symptoms (module 1), whereas acceleration was most evident in subcortex and insula for the remaining dimensions (module 2). CONCLUSIONS Our findings suggest that increased brain age, particularly in frontal cortex and subcortical nuclei, underpins clinical psychosis and obsessive-compulsive symptoms in youths. Psychopathology dimensions share common neural substrates, despite representing clinically independent symptom profiles.
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Affiliation(s)
- Vanessa L Cropley
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia; Centre for Mental Health, Faculty of Health, Arts and Design, School of Health Sciences, Swinburne University, Melbourne, Victoria, Australia.
| | - Ye Tian
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia
| | - Kavisha Fernando
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia
| | - Sina Mansour L
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia; Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia; Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia
| | - Luca Cocchi
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Andrew Zalesky
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia; Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia
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27
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Bao H, Miao D. Operational method of reliability and content-validity analysis: Taking "trait-symptoms" screening of individuals at high-risk for OCD as an example. PLoS One 2020; 15:e0232368. [PMID: 32396537 PMCID: PMC7217456 DOI: 10.1371/journal.pone.0232368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 04/13/2020] [Indexed: 12/01/2022] Open
Abstract
A well-designed self-reported scale is highly applicable to current clinical and research practices. However, the problems with the scale method, such as quantitative analysis of content validity and test-retest reliability analysis of state-like variables are yet to be resolved. The main purpose of this paper is to propose an operational method for solving these problems. Additionally, it aims to enhance understanding of the research paradigm for the scale method (excluding criterion-related validity). This paper used a study that involved screening of high-risk groups for OCD (Obsessive-Compulsive Disorder), conducted 5 rounds of tests, and developed scales, reliability, and validity analysis (using sample sizes of 496, 610, 600, 600 and 990). The operational method we propose is practical, feasible, and can be used to develop and validate a scale.
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Affiliation(s)
- Hongxiang Bao
- Department of Medical Psychology, Fourth Military Medical University (Air Force Medical University), Xi'an, Shaanxi, China
| | - Danmin Miao
- Department of Medical Psychology, Fourth Military Medical University (Air Force Medical University), Xi'an, Shaanxi, China
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28
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Bralten J, Widomska J, Witte WD, Yu D, Mathews CA, Scharf JM, Buitelaar J, Crosbie J, Schachar R, Arnold P, Lemire M, Burton CL, Franke B, Poelmans G. Shared genetic etiology between obsessive-compulsive disorder, obsessive-compulsive symptoms in the population, and insulin signaling. Transl Psychiatry 2020; 10:121. [PMID: 32341337 PMCID: PMC7186226 DOI: 10.1038/s41398-020-0793-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 03/11/2020] [Accepted: 03/30/2020] [Indexed: 11/25/2022] Open
Abstract
Obsessive-compulsive symptoms (OCS) in the population have been linked to obsessive-compulsive disorder (OCD) in genetic and epidemiological studies. Insulin signaling has been implicated in OCD. We extend previous work by assessing genetic overlap between OCD, population-based OCS, and central nervous system (CNS) and peripheral insulin signaling. We conducted genome-wide association studies (GWASs) in the population-based Philadelphia Neurodevelopmental Cohort (PNC, 650 children and adolescents) of the total OCS score and six OCS factors from an exploratory factor analysis of 22 questions. Subsequently, we performed polygenic risk score (PRS)-based analysis to assess shared genetic etiologies between clinical OCD (using GWAS data from the Psychiatric Genomics Consortium), the total OCS score and OCS factors. We then performed gene-set analyses with a set of OCD-linked genes centered around CNS insulin-regulated synaptic function and PRS-based analyses for five peripheral insulin signaling-related traits. For validation purposes, we explored data from the independent Spit for Science population cohort (5,047 children and adolescents). In the PNC, we found a significant shared genetic etiology between OCD and 'guilty taboo thoughts'. In the Spit for Science cohort, we additionally observed genetic sharing between 'symmetry/counting/ordering' and 'contamination/cleaning'. The CNS insulin-linked gene-set also associated with 'symmetry/counting/ordering' in the PNC. Further, we identified genetic sharing between peripheral insulin signaling-related traits: type 2 diabetes with 'aggressive taboo thoughts', and levels of fasting insulin and 2 h glucose with OCD. In conclusion, OCD, OCS in the population and insulin-related traits share genetic risk factors, indicating a common etiological mechanism underlying somatic and psychiatric disorders.
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Affiliation(s)
- Janita Bralten
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Joanna Widomska
- Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ward De Witte
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dongmei Yu
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Carol A Mathews
- Department of Psychiatry and Genetics Institute, University of Florida, Gainesville, FL, USA
| | - Jeremiah M Scharf
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Jan Buitelaar
- Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
- Department of Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry, Nijmegen, The Netherlands
| | - Jennifer Crosbie
- Neurosciences & Mental Health Program, Hospital for Sick Children, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Russell Schachar
- Neurosciences & Mental Health Program, Hospital for Sick Children, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Paul Arnold
- Genetics & Genome Biology, Hospital for Sick Children, Toronto, ON, Canada
- Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, AB, Canada
- Departments of Psychiatry & Medical Genetics; Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Mathieu Lemire
- Neurosciences & Mental Health Program, Hospital for Sick Children, Toronto, ON, Canada
| | - Christie L Burton
- Neurosciences & Mental Health Program, Hospital for Sick Children, Toronto, ON, Canada
| | - Barbara Franke
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Geert Poelmans
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands.
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29
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Li J, Li J, Jia R, Wang Y, Qian S, Xu Y. Mental health problems and associated school interpersonal relationships among adolescents in China: a cross-sectional study. Child Adolesc Psychiatry Ment Health 2020; 14:12. [PMID: 32256690 PMCID: PMC7106742 DOI: 10.1186/s13034-020-00318-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 03/13/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND During adolescence, middle school students facing psychophysical changes are vulnerable to psychological problems. The present study aimed to investigate mental health status and associated school interpersonal relationships among adolescents in China, which may help to inform effective prevention strategies to reduce the prevalence of mental health problems. METHODS In the cross-sectional study, a total of 10,131 middle school students were selected from three cities in eastern China by stratified random sampling. The Symptom Checklist-90 (SCL-90), Teacher-Student Relationship Questionnaire (TSRQ) and Peer Relationship Scale (PRS) were used to evaluate psychological symptoms, the quality of relationship with teachers and the quality of relationship with peers, respectively. Multivariable logistic regression analysis was conducted to explore the association between school interpersonal relationships and mental health problems in adolescents. RESULTS 36% of the middle school students reported positive in mental health problems assessed by the SCL-90. The most prevalent dimensional symptom was obsessive-compulsive (43.3%). The risk of all types of psychological symptoms was significantly associated with school interpersonal relationships. Moreover, a higher risk of mental health problems was associated with poorer school interpersonal relationships. CONCLUSIONS Mental health problems were prevalent among adolescents and highly associated with school interpersonal relationships. Our findings underscore the pressing need for school administrators to make efforts to improve school interpersonal relationships among adolescents.
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Affiliation(s)
- Jiayu Li
- grid.263761.70000 0001 0198 0694Department of Child and Adolescent Health, School of Public Health, Medical College of Soochow University, No. 199 Ren Ai Road, Suzhou, 215123 Jiangsu People’s Republic of China
| | - Jing Li
- grid.263761.70000 0001 0198 0694Department of Child and Adolescent Health, School of Public Health, Medical College of Soochow University, No. 199 Ren Ai Road, Suzhou, 215123 Jiangsu People’s Republic of China
| | - Ruixia Jia
- grid.263761.70000 0001 0198 0694Department of Social Medicine, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, 215123 Jiangsu People’s Republic of China
| | - Yingquan Wang
- grid.263761.70000 0001 0198 0694Department of Social Medicine, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, 215123 Jiangsu People’s Republic of China
| | - Sheng Qian
- grid.263761.70000 0001 0198 0694Department of Child and Adolescent Health, School of Public Health, Medical College of Soochow University, No. 199 Ren Ai Road, Suzhou, 215123 Jiangsu People’s Republic of China
| | - Yong Xu
- grid.263761.70000 0001 0198 0694Department of Child and Adolescent Health, School of Public Health, Medical College of Soochow University, No. 199 Ren Ai Road, Suzhou, 215123 Jiangsu People’s Republic of China ,grid.263761.70000 0001 0198 0694Department of Social Medicine, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, 215123 Jiangsu People’s Republic of China
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30
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Jutla A, Turner JB, Green Snyder L, Chung WK, Veenstra-VanderWeele J. Psychotic symptoms in 16p11.2 copy-number variant carriers. Autism Res 2019; 13:187-198. [PMID: 31724820 DOI: 10.1002/aur.2232] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 09/09/2019] [Accepted: 09/26/2019] [Indexed: 01/26/2023]
Abstract
16p11.2 copy-number variation (CNV) is implicated in neurodevelopmental disorders, with the duplication and deletion associated with autism spectrum disorder (ASD) and the duplication associated with schizophrenia (SCZ). The 16p11.2 CNV may therefore provide insight into the relationship between ASD and SCZ, distinct disorders that co-occur at an elevated rate, and are difficult to distinguish from each other and from common co-occurring diagnoses such as obsessive compulsive disorder (OCD), itself a potential risk factor for SCZ. As psychotic symptoms are core to SCZ but distinct from ASD, we sought to examine their predictors in a population (n = 546) of 16p11.2 CNV carriers and their noncarrier siblings recruited by the Simons Variation in Individuals Project. We hypothesized that psychotic symptoms would be most common in duplication carriers followed by deletion carriers and noncarriers, that an ASD diagnosis would predict psychotic symptoms among CNV carriers, and that OCD symptoms would predict psychotic symptoms among all participants. Using data collected across multiple measures, we identified 19 participants with psychotic symptoms. Logistic regression models adjusting for biological sex, age, and IQ found that 16p11.2 duplication and ASD diagnosis predicted psychotic symptom presence. Our findings suggest that the association between 16p11.2 duplication and psychotic symptoms is independent of ASD diagnosis and that ASD diagnosis and psychotic symptoms may be associated in 16p11.2 CNV carriers. Autism Res 2020, 13: 187-198. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Either deletion or duplication at chromosome 16p11.2 raises the risk of autism spectrum disorder, and duplication, but not deletion, has been reported in schizophrenia (SCZ). In a sample of 16p11.2 deletion and duplication carriers, we found that having the duplication or having an autism diagnosis may increase the risk of psychosis, a key feature of SCZ.
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Affiliation(s)
- Amandeep Jutla
- Department of Psychiatry, Columbia University, New York, New York.,New York State Psychiatric Institute, New York, New York
| | - J Blake Turner
- Department of Psychiatry, Columbia University, New York, New York.,New York State Psychiatric Institute, New York, New York
| | | | - Wendy K Chung
- Department of Pediatrics and Department of Medicine, Columbia University, New York, New York
| | - Jeremy Veenstra-VanderWeele
- Department of Psychiatry, Columbia University, New York, New York.,New York State Psychiatric Institute, New York, New York.,Center for Autism and the Developing Brain, New York-Presbyterian Hospital, New York, New York
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31
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Gur RE, Moore TM, Rosen AFG, Barzilay R, Roalf DR, Calkins ME, Ruparel K, Scott JC, Almasy L, Satterthwaite TD, Shinohara RT, Gur RC. Burden of Environmental Adversity Associated With Psychopathology, Maturation, and Brain Behavior Parameters in Youths. JAMA Psychiatry 2019; 76:966-975. [PMID: 31141099 PMCID: PMC6547104 DOI: 10.1001/jamapsychiatry.2019.0943] [Citation(s) in RCA: 136] [Impact Index Per Article: 27.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
IMPORTANCE Low socioeconomic status (L-SES) and the experience of traumatic stressful events (TSEs) are environmental factors implicated in behavioral deficits, abnormalities in brain development, and accelerated maturation. However, the relative contribution of these environmental factors is understudied. OBJECTIVE To compare the association of L-SES and TSEs with psychopathology, puberty, neurocognition, and multimodal neuroimaging parameters in brain maturation. DESIGN, SETTING, AND PARTICIPANTS The Philadelphia Neurodevelopmental Cohort is a community-based study examining psychopathology, neurocognition, and neuroimaging among participants recruited through the Children's Hospital of Philadelphia pediatric network. Participants are youths aged 8 to 21 years at enrollment with stable health and fluency in English. The sample of 9498 participants was racially (5298 European ancestry [55.8%], 3124 African ancestry [32.9%], and 1076 other [11.4%]) and economically diverse. A randomly selected subsample (n = 1601) underwent multimodal neuroimaging. Data were collected from November 5, 2009, through December 30, 2011, and analyzed from February 1 through November 7, 2018. MAIN OUTCOMES AND MEASURES The following domains were examined: (1) clinical, including psychopathology, assessed with a structured interview based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children, and puberty, assessed with the Tanner scale; (2) neurocognition, assessed by the Penn Computerized Neurocognitive Battery; and (3) multimodal magnetic resonance imaging parameters of brain structure and function. RESULTS A total of 9498 participants were included in the analysis (4906 [51.7%] female; mean [SD] age, 14.2 [3.7] years). Clinically, L-SES and TSEs were associated with greater severity of psychiatric symptoms across the psychopathology domains of anxiety/depression, fear, externalizing behavior, and the psychosis spectrum. Low SES showed small effect sizes (highest for externalizing behavior, 0.306 SD; 95% CI, 0.269 to 0.342), whereas TSEs had large effect sizes, with the highest in females for anxiety/depression (1.228 SD; 95% CI, 1.156 to 1.300) and in males for the psychosis spectrum (1.099 SD; 95% CI, 1.032 to 1.166). Both were associated with early puberty. Cognitively, L-SES had moderate effect sizes on poorer performance, the greatest being on complex cognition (-0.500 SD 95% CI, -0.536 to -0.464), whereas TSEs were associated with slightly better memory (0.129 SD; 95% CI, 0.084 to 0.174) and poorer complex reasoning (-0.109 SD; 95% CI, -0.154 to -0.064). Environmental factors had common and distinct associations with brain structure and function. Structurally, both were associated with lower volume, but L-SES had correspondingly lower gray matter density, whereas TSEs were associated with higher gray matter density. Functionally, both were associated with lower regional cerebral blood flow and coherence and with accelerated brain maturation. CONCLUSIONS AND RELEVANCE Low SES and TSEs are associated with common and unique differences in symptoms, neurocognition, and structural and functional brain parameters. Both environmental factors are associated with earlier completion of puberty by physical features and brain parameters. These findings appear to underscore the need for identifying and preventing adverse environmental conditions associated with neurodevelopment.
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Affiliation(s)
- Raquel E. Gur
- Neuropsychiatry Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia,Lifespan Brain Institute, Penn Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania,Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Tyler M. Moore
- Neuropsychiatry Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia,Lifespan Brain Institute, Penn Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Adon F. G. Rosen
- Neuropsychiatry Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia,Lifespan Brain Institute, Penn Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Ran Barzilay
- Lifespan Brain Institute, Penn Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania,Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - David R. Roalf
- Neuropsychiatry Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia,Lifespan Brain Institute, Penn Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Monica E. Calkins
- Neuropsychiatry Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia,Lifespan Brain Institute, Penn Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Kosha Ruparel
- Neuropsychiatry Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia,Lifespan Brain Institute, Penn Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - J. Cobb Scott
- Neuropsychiatry Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Laura Almasy
- Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania,Perelman School of Medicine, Department of Genetics University of Pennsylvania, Philadelphia
| | - Theodore D. Satterthwaite
- Neuropsychiatry Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia,Lifespan Brain Institute, Penn Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Russell T. Shinohara
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Ruben C. Gur
- Neuropsychiatry Section, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia,Lifespan Brain Institute, Penn Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania,Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
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Barzilay R, Patrick A, Calkins ME, Moore TM, Gur RC, Gur RE. Association between early-life trauma and obsessive compulsive symptoms in community youth. Depress Anxiety 2019; 36:586-595. [PMID: 31066996 DOI: 10.1002/da.22907] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 03/27/2019] [Accepted: 04/05/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Obsessive-compulsive symptoms (OCS) in youth are common, have heterogeneous manifestations, and have been shown to be associated with serious psychopathology. While early-life trauma exposure is associated with increased risk for obsessive-compulsive disorder (OCD), its association with different OCS and its clinical relevance for serious psychopathology is unclear. Here we aimed to evaluate associations among traumatic stressful events (TSE), OCS, and serious psychiatric conditions in community youth. METHODS We studied nonmental-help seeking youths from the Philadelphia Neurodevelopmental Cohort (N = 7054, aged 11-21, 54% females, 52% prepubertal), assessed for lifetime TSE exposure and OCS. Regression models investigated cross-sectional associations of TSEs with OCS, and associations with depression, suicide ideation and psychosis. Models examined sex and puberty effects, controlling for age and socioeconomic status. RESULTS Trauma exposure was associated with higher OCS rates, especially in females (Trauma × Sex interaction Wald = 7.93, p = 0.005) and prepuberty (Trauma × Puberty interaction Wald = 7.68, p = 0.006). TSEs were associated with all OCS manifestations, most prominently with bad intrusive thoughts (odds ratio [OR] = 1.63). Assaultive TSEs, especially sexual assault, showed stronger associations with OCS compared with nonassaultive TSEs. While TSEs and OCS were independently associated with depression, suicide ideation, and psychosis, a significant interaction was observed only in association with increased rates of psychosis (Trauma × OCS interaction Wald = 5.08, p = 0.024). CONCLUSION Early-life trauma is associated with OCS in a dose-response manner, more so in females and prepuberty. The trauma-OCS association varied by load, type of trauma, and by OCS subtypes. Trauma-OCS appears a detrimental combination in association with psychosis.
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Affiliation(s)
- Ran Barzilay
- Lifespan Brain Institute of CHOP and UPenn, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States.,Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Ariana Patrick
- Lifespan Brain Institute of CHOP and UPenn, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States.,Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Monica E Calkins
- Lifespan Brain Institute of CHOP and UPenn, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States.,Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Tyler M Moore
- Lifespan Brain Institute of CHOP and UPenn, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States.,Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Ruben C Gur
- Lifespan Brain Institute of CHOP and UPenn, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States.,Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Raquel E Gur
- Lifespan Brain Institute of CHOP and UPenn, Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States.,Department of Psychiatry, Neuropsychiatry Section, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
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Leckman JF, Rubinstein J. Not just in Philadelphia - But across the globe. Depress Anxiety 2019; 36:584-585. [PMID: 31099452 DOI: 10.1002/da.22905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 04/14/2019] [Indexed: 11/08/2022] Open
Affiliation(s)
- James F Leckman
- Child Study Center and the Departments of Psychiatry, Pediatrics, and Psychology, Yale University, Yale University School of Medicine, New Haven,, Connecticut
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