Characterizing symptom presentations in children and adolescents with obsessive-compulsive disorder

Area of Science:

• Child and Adolescent Psychiatry
• Behavioral Science
• Clinical Psychology

Background:

• Pediatric obsessive-compulsive disorder (OCD) presents with significant heterogeneity, complicating accurate assessment and effective treatment planning.
• The updated Children's Yale-Brown Obsessive Compulsive Scale-II (CY-BOCS-II) offers expanded symptom content, including a greater focus on avoidance behaviors, for improved pediatric OCD evaluation.

Purpose of the Study:

• To present item-level frequency data for specific pediatric OCD symptoms using the CY-BOCS-II.
• To compare symptom frequency between children and adolescents.
• To highlight the utility of detailed symptom assessment for clinical practice.

Main Methods:

• 101 children and adolescents (ages 7-17) with primary OCD diagnosis were assessed using the CY-BOCS-II.
• Item-level data on the presence or absence of 58 individual symptoms were analyzed.
• Frequency comparisons were made between younger children (≤12 years) and older adolescents (≥13 years).

Main Results:

• Youth endorsed an average of 17 OCD symptoms, with reassurance seeking, "just right" behaviors, and need for symmetry/exactness being most prevalent.
• Adolescents reported significantly more symptoms than children.
• Ritualized avoidance behaviors were present in 31.7% of the sample, and 77.2% experienced symptoms across at least three dimensions.

Conclusions:

• Item-level assessment using the CY-BOCS-II is valuable for characterizing the diverse range of pediatric OCD symptoms.
• Detailed symptom data can guide personalized treatment strategies and enhance diagnostic accuracy in pediatric OCD.
• Understanding symptom heterogeneity is crucial for optimizing care for young individuals with OCD.