Main author: Orri Smárason
Institution or Company: Faculty of Psychology, University of Iceland
Co-Authors, Institution or Company:
Davið R.M.A Hojgaard, Department of Child and Adolescent Psychiatry. Aarhus University Hospital, Psychiatry. Aarhus, Denmark. Nor Christian Torp, Division of Mental Health and Addiction, Vestre Viken Hospital, Drammen, Norway. Katja Anna Hybel, Department of Child and Adolescent Psychiatry. Aarhus University Hospital, Psychiatry. Aarhus, Denmark. Guðmundur Skarphéðinsson, Faculty of Psychology, University of Iceland.
Background: Children with Obsessive-Compulsive Disorder (OCD) show significant impairment in daily functioning which is only moderately correlated with severity of OCD symptoms. Increased impairment has been associated with higher depressive symptoms, but previous studies have had fairly small sample sizes (n<100). We examine if depressive symptoms predict high levels of functional impairment in children with OCD while controlling for variables associated with high functional impairment in previous studies; age, gender, OCD symptom severity, family accommodation (FA) and level of insight in a larger sample than has previously been reported.
Methods: A cross-sectional study of 239 Scandinavian children and adolescents (50.3% female), aged 7-17 years (m=13.07 years), with OCD. A logistic regression model was used to examine how well the predictor and confounders predict high functional impairment (defined as a COIS-R score above 26).
Results: 41.1% of participants were classified as having high functional impairment. The numerical predictor variables were tested a priori to verify that there was no violation of the assumption of linearity. R2 of the regression model was 0.33 and AUC 0.79. Depressive symptoms predicted high functional impairment independently (p=0.013, OR=1.33) and in interaction with family accommodation (p=0.010), while controlling for all confounders. Higher family accommodation also predicted high functional impairment independently (p<0.001, OR=1.17), while OCD symptom severity was not a significant predictor in this model (p=0.052)
Conclusions: The data suggests that depressive symptoms and high family accommodation (and not OCD symptom severity) are associated with increased impairment in pediatric OCD.
