Obsessive-compulsive symptoms and obsessive-compulsive disorder in adolescents: a population-based study

Area of Science:

• Psychiatry
• Adolescent Health
• Mental Health Epidemiology

Background:

• Obsessive-compulsive symptoms (OCS) and disorder (OCD) represent a significant mental health concern in adolescents.
• Understanding the prevalence and characteristics of adolescent OCD is crucial for effective intervention.

Purpose of the Study:

• To determine the prevalence of OCS and OCD in a sample of Brazilian adolescents.
• To describe the clinical characteristics of OCD, including symptom dimensions and comorbidities, stratified by gender.

Main Methods:

• A two-stage cluster sampling methodology was employed in seven high schools in southern Brazil.
• 2,323 students were initially screened for OCS using the OCI-R scale, with those scoring ≥ 21 undergoing further assessment.
• Diagnosis of OCD was confirmed via the Schedule for Affective Disorders and Schizophrenia for School Aged Children: Present and Lifetime Version (K-SADS-PL) semi-structured interview.

Main Results:

• The estimated past-month prevalence of OCS was 18.3%, and the point prevalence of OCD was 3.3%.
• Girls exhibited significantly higher prevalence and scores for both OCS and OCD compared to boys (p < 0.001).
• Only 9.3% of adolescents with OCD had a prior diagnosis, and 6.7% had received treatment. Common dimensions included miscellaneous and symmetry symptoms. Comorbidities differed by gender, with depression more frequent in females and tic disorders in males.

Conclusions:

• Adolescent OCD is notably underdiagnosed and undertreated, indicating a substantial unmet need for mental health services.
• Further research is warranted to explore the relationship between obsessive-compulsive symptoms and the developmental trajectory of OCD in adolescents.