Neurocognitive function in paediatric obsessive-compulsive disorder
Daniel A Geller1, Amitai Abramovitch1,2, Andrew Mittelman1
1a Department of Psychiatry Massachusetts General Hospital & Harvard Medical School , Boston, MA , USA.
Insights
Youths with obsessive-compulsive disorder (OCD) show slower processing speed and perform worse on timed visuospatial and working memory tasks. However, their overall cognitive performance remains within the normative range.
Area of Science:
- Neuropsychology
- Child and Adolescent Psychiatry
Background:
- Research on cognitive impairments in pediatric obsessive-compulsive disorder (OCD) is inconsistent.
- Previous meta-analyses suggest minimal cognitive deficits, highlighting the need for further investigation.
Purpose of the Study:
- To examine neuropsychological performance in a large sample of children and adolescents with OCD.
- To identify potential moderators of cognitive performance in pediatric OCD.
Main Methods:
- A comprehensive neuropsychological assessment was administered to 102 youths with OCD and 161 matched controls.
- Evaluated domains included processing speed, visuospatial abilities (VSA), working memory (WM), non-verbal memory (NVM), and executive functions (EF).
- Comorbidities were screened and participants were blindly evaluated.
Main Results:
- Youths with OCD demonstrated slower processing speed compared to controls.
- Underperformance in VSA and WM was observed exclusively on timed tasks.
- No significant differences were found in NVM and EF tasks between groups.
- Standardized scores for the OCD group fell within the normative range.
Conclusions:
- Pediatric OCD is associated with slower processing speed and deficits in timed VSA and WM tasks.
- Despite normative overall scores, relative cognitive weaknesses in these areas may be clinically significant.
- These findings underscore the importance of considering specific cognitive profiles in clinical and educational settings for youths with OCD.
Objectives:
The small body of neuropsychological research in paediatric obsessive-compulsive disorder (OCD) yields inconsistent results. A recent meta-analysis found small effect sizes, concluding that paediatric OCD may not be associated with cognitive impairments, stressing the need for more research. We investigated neuropsychological performance in a large sample of youths with OCD, while assessing potential moderators.
Methods:
Participants with OCD (n = 102) and matched controls (n = 161) were thoroughly screened and blindly evaluated for comorbidities, and completed a neuropsychological battery assessing processing speed, visuospatial abilities (VSA), working memory (WM), non-verbal memory (NVM), and executive functions (EF).
Results:
Compared to controls, youths with OCD exhibited underperformance on tasks assessing processing speed. On tests of VSA and WM, underperformance was found only on timed tasks. There were no differences on NVM and EF tasks. Notably, the OCD group's standardised scores were in the normative range. Test performance was not associated with demographic or clinical variables.
Conclusions:
Youths with OCD exhibited intact performance on memory and EF tests, but slower processing speed, and underperformance only on timed VSA and WM tasks. While the OCD group performed in the normative range, these findings reveal relative weaknesses that may be overlooked. Such an oversight may be of particular importance in clinical and school settings.
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