Psychotic vulnerability in pediatric OCD: associations with neurocognitive functioning.

Area of Science:

• Child and Adolescent Psychiatry
• Neuroscience
• Clinical Psychology

Background:

• Obsessive-compulsive disorder (OCD) in children and adolescents can present with psychotic vulnerability.
• The neurocognitive underpinnings of this presentation are not well understood.

Purpose of the Study:

• To investigate the association between psychotic vulnerability and neurocognitive functioning in pediatric OCD.
• To compare neurocognitive profiles of pediatric OCD patients with and without psychotic vulnerability.

Main Methods:

• Compared 112 pediatric OCD patients (52 with psychotic vulnerability [Psy+], 60 without [Psy-]) and 30 healthy controls.
• Utilized Structured Interview for Psychosis-Risk Syndromes, psychopathology, neurocognition, global functioning, and premorbid adjustment assessments.
• Employed ANOVA and multiple linear regression for group and dimensional analyses.

Main Results:

• Psy+ OCD cases exhibited poorer global functioning, worse premorbid adjustment, and higher psychosis-spectrum symptoms than Psy- cases.
• Both OCD subgroups underperformed compared to controls on verbal learning and memory, with Psy+ showing the lowest scores.
• Verbal learning and memory differences were most pronounced between Psy+ and Psy- groups.

Conclusions:

• Psychotic vulnerability is a clinically significant feature in pediatric OCD.
• This vulnerability is associated with impaired global functioning and specific neurocognitive deficits, especially in verbal learning and memory.
• Negative symptoms, not overall OCD severity, correlated with poorer neurocognitive performance.