The speed of progression towards obsessive-compulsive disorder

Area of Science:

• Psychiatry
• Clinical Psychology
• Neuroscience

Background:

• Growing interest in early intervention programs for obsessive-compulsive disorder (OCD).
• Importance of understanding the progression rate from subthreshold symptoms to diagnosable OCD.

Purpose of the Study:

• To investigate the speed of progression from subthreshold to diagnosable OCD.
• To identify sociodemographic and clinical factors associated with faster OCD progression.

Main Methods:

• Retrospective study of 954 patients from the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders.
• Assessment of the time interval between subthreshold and full-blown OCD onset.

Main Results:

• Median time from subthreshold to diagnosable OCD was 7 years (IQR: 2-13 years).
• Faster progression linked to younger age, male gender, new romantic relationships, specific symptom severity (sexual/religious vs. hoarding), comorbid generalized anxiety disorder/agoraphobia, and negative family history of OCD.

Conclusions:

• A specific phenotype associated with rapid escalation to clinical OCD levels was identified.
• Findings are relevant for targeting early intervention initiatives, especially with limited resources.