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Obsessive-compulsive characteristics: From symptoms to syndrome

Geha Psychiatric Hospital, Sackler School of Medicine, University of Tel Aviv.
Journal of the American Academy of Child & Adolescent Psychiatry (Impact Factor: 6.35). 08/1996; 35(7):907-12. DOI: 10.1097/00004583-199607000-00016
Source: PubMed

ABSTRACT To assess the distribution and severity of obsessions and compulsions in a nonclinical adolescent population.
During preinduction military screening, 861 sixteen-year-old Israelis completed a questionnaire regarding the lifetime presence of eight obsessive-compulsive (OC) symptoms and three severity measures. The presence or absence of obsessive-compulsive disorder (OCD) or subclinical OCD was ascertained by an independent interview.
Although only 8.0% and 6.3% of respondents reported disturbing and intrusive thoughts, respectively, 27% to 72% of subjects endorsed the six remaining OCD symptoms. Twenty percent of subjects regarded the symptoms they endorsed as senseless and 3.5% found them disturbing; 8% reported spending more than an hour daily on symptoms. OCD and subclinical OCD cases differed significantly from non-OCD cases, but not from each other, in distress and mean number of symptoms. Although the distribution of nine of the items differed for noncases, compared with OCD and subclinical OCD cases, the distributions for all items overlapped markedly across the three groups.
OC phenomena appear to be on a continuum with few symptoms and minimal severity at one end and many symptoms and severe impairment on the other. Defining optimal cutoff points for distinguishing between psychiatric disorder and OC phenomena that are common in the general population remains an open question.

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    • "Obsessive–compulsive disorder (OCD) is characterized by interfering obsessions and/or compulsions (American Psychiatric Association 2000) that occurs in approximately 1–2 % of children and adolescents (Apter et al. 1996; Rapoport et al. 2000). Additionally OCD caseness confers significant functional impairment (Piacentini et al. 2007) and risk for other psychological disorders that increase the discomfort and complicate OCD's assessment and treatment (Storch et al. 2010). "
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    • "About 2–3% of individuals in Israel contract OCD (Zohar et al., 1992; Zohar, 1999). However, most normal individuals exhibit some degree of obsessive and compulsive behavior (Apter et al., 1996). In very young children (Zohar & Felz, 2001), in school age children (Zohar & Bruno, 1997), and in young adults (Zohar, LaBuda, & Moschel-Ravid, 1995) there are individual differences in the level of OC behavior, and in OC personality traits. "
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    • "Consistent with the constitution of DSM-lV, the categorical approach to OCD is accepted by many clinicians. Although obsessive tendencies may be demonstrated in a large minority of people [54], florid OCD appears to occur precipitously in a relatively small number of people while leaving the remainder of the population almost completely unaffected. "
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