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Related Experiment Video

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Real-time fMRI Biofeedback Targeting the Orbitofrontal Cortex for Contamination Anxiety
10:51

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Published on: January 20, 2012

Adults with early-onset obsessive-compulsive disorder.

M C Rosario-Campos1, J F Leckman, M T Mercadante

  • 1Department of Psychiatry, University of São Paulo Medical School, Brazil. maria.rosario-campos@yale.edu

The American Journal of Psychiatry
|November 3, 2001
PubMed
Summary

Early onset of obsessive-compulsive disorder (OCD) is linked to distinct symptoms and poorer treatment response. This suggests age at onset is crucial for precise OCD phenotyping and understanding symptom presentation.

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Clinical Psychology

Background:

  • Obsessive-compulsive disorder (OCD) exhibits clinical heterogeneity.
  • A bimodal age of onset suggests distinct underlying mechanisms.
  • Treatment outcomes for OCD vary significantly across individuals.

Purpose of the Study:

  • To investigate the significance of age at symptom onset for precise OCD phenotyping.
  • To compare the clinical characteristics of adult OCD patients with early versus late symptom onset.

Main Methods:

  • Semistructured interviews were conducted with 42 adult OCD outpatients.
  • Patients were divided into an early-onset group (n=21, onset before age 10) and a late-onset group (n=21, onset after age 17).

Main Results:

  • Early-onset OCD was associated with higher Yale-Brown Obsessive Compulsive Scale scores.
  • Higher frequencies of tic-like compulsions and sensory phenomena were observed in the early-onset group.
  • Early-onset OCD patients showed a higher rate of comorbid tic disorders and a poorer response to clomipramine and SSRIs.

Conclusions:

  • Age at symptom onset is a significant factor for subtyping OCD.
  • Phenotypic differences associated with early onset persist beyond childhood.
  • These findings support distinct neurobiological pathways for early- versus late-onset OCD.