Clinical and Cognitive Correlates of Depressive Symptoms Among Youth with Obsessive Compulsive Disorder

UCLA Semel Institute for Neuroscience and Human Behavior, CA, USA.
Journal of Clinical Child & Adolescent Psychology (Impact Factor: 1.92). 08/2010; 39(5):616-26. DOI: 10.1080/15374416.2010.501285
Source: PubMed


Depression is the most common comorbidity among adults with obsessive compulsive disorder (OCD), yet little is known about depressive symptoms in childhood OCD. This study examined clinical and cognitive variables associated with depressive symptomatology in 71 youths (62% male, M age = 12.7 years) with primary OCD. Youths presented with a range of depressive symptoms, with 21% scoring at or above the clinical cutoff on the self-report measure of depression. Higher levels of depressive symptoms were associated with higher levels of cognitive distortions assessed on measures of insight, perceived control, competence, and contingencies. Depressive symptoms were also linked to older age and more severe OCD. Low perceived control and self-competence and high OCD severity independently predicted depression scores.

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    • " significantly related to the compulsion and doubting of the MOCI scale , and thus explain the relationships between depression and OCD , anxiety and OCD , and helplessness and OCD . Previous studies reported that depression and anxiety were preva - lent among adolescents with OCD ( Fireman et al . , 2001 ; Geller , 2006 ; Leonard et al . , 2001 ; Peris et al . , 2010 ) , but the extent of the overlaps among the symptoms of OCD , depression , anxiety , help - lessness were not reported . Therefore , this needs to be assessed when an OCD diagnosis is conducted and may have implications for the treatment of youth with comorbid OCD , depression , anxiety , and feelings of helplessness . To prevent deter"
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    ABSTRACT: Objectives: Youth with obsessive compulsive disorder (OCD) are at risk of experiencing comorbid psychiatric conditions, such as depression and anxiety. Studies of Chinese adolescents with OCD are limited. The aim of this study was to investigate the association of depression, anxiety, and helplessness with the occurrence of OCD in Chinese adolescents. Methods: This study consisted of two stages. The first stage used a cross-sectional design involving a stratified clustered non-clinical sample of 3174 secondary school students. A clinical interview procedure was then employed to diagnose OCD in students who had a Leyton ‘yes’ score of 15 or above. The second phase used a case-control study design to examine the relationship of OCD to depression, anxiety and helplessness in a matched sample of 288 adolescents with clinically diagnosed OCD and 246 students without OCD. Results: Helplessness, depression and anxiety scores were directly associated with the probability of OCD caseness. Canonical correlation analysis indicated that the OCD correlated significantly with depression, anxiety, and helplessness. Cluster analysis further indicated the degree of the OCD is also associated with severity of depression and anxiety, and the level of helplessness. Conclusion: These findings suggest that depression, anxiety and helplessness are important correlates of OCD in Chinese adolescents. Future studies using longitudinal and prospective designs are required to confirm these relationships as causal. Key words: depression, anxiety, helplessness, obsessive-compulsive disorders, Chinese adolescents
    Journal of Affective Disorders 11/2014; DOI:10.1016/j.jad.2014.11.004 · 3.38 Impact Factor
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    • "heoretically , depression may impede response to CBT for OCD for a number of reasons . Depression is characterised by pervasive hopelessness which may lead to lack of optimism and decrease motivation to engage in treatment . Similarly , reduced insight and low perceived self - competence in youth with depression may limit engagement with therapy ( Peris et al . 2010 ) . Alternatively , depression may alter the focus of the therapy ; therapists may need to concurrently treat depres - sive symptoms thus diluting treatment response . A number of studies have examined the effect of concur - rent depressive disorders and / or symptoms on OCD outcomes following CBT . The majority have been conducted with"
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    ABSTRACT: Depression frequently co-occurs with paediatric obsessive-compulsive disorder (OCD), yet the clinical correlates and impact of depression on CBT outcomes remain unclear. The prevalence and clinical correlates of depression were examined in a paediatric specialist OCD-clinic sample (N = 295; Mean = 15 [7 - 18] years, 42 % female), using both dimensional (Beck Depression Inventory-youth; n = 261) and diagnostic (Development and Wellbeing Assessment; n = 127) measures of depression. The impact of depressive symptoms and suspected disorders on post-treatment OCD severity was examined in a sub-sample who received CBT, with or without SSRI medication (N = 100). Fifty-one per-cent of patients reported moderately or extremely elevated depressive symptoms and 26 % (95 % CI: 18 - 34) met criteria for a suspected depressive disorder. Depressive symptoms and depressive disorders were associated with worse OCD symptom severity and global functioning prior to CBT. Individuals with depression were more likely to be female, have had a psychiatric inpatient admission and less likely to be attending school (ps < 0.01). OCD and depressive symptom severity significantly decreased after CBT. Depressive symptoms and depressive disorders predicted worse post-treatment OCD severity (βs = 0.19 and 0.26, ps < 0.05) but became non-significant when controlling for pre-treatment OCD severity (βs = 0.05 and 0.13, ns). Depression is common in paediatric OCD and is associated with more severe OCD and poorer functioning. However, depression severity decreases over the course of CBT for OCD and is not independently associated with worse outcomes, supporting the recommendation for treatment as usual in the presence of depressive symptoms.
    Journal of Abnormal Child Psychology 10/2014; 43(5). DOI:10.1007/s10802-014-9943-0 · 3.09 Impact Factor
    • "It is also possible that individuals with comorbid depression experience decreased motivation (as suggested by Abramowitz, Franklin, Street, Kozak, and Foa (2000)) and energy, and therefore exhibit decreased compliance with ERP procedures. Finally, there is evidence that youth with OCD and comorbid depressive symptoms have lower levels of insight, perceived control and perceived competence (Peris et al., 2010), which may limit their engagement in treatment. "
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    ABSTRACT: Studies examining the impact of depressive symptoms on OCD treatment outcome among adults have led to suggestions that perhaps only severe depressive symptoms negatively impact OCD treatment outcome. The present study sought to examine the impact of level of depression severity on OCD severity at admission and discharge among 126 adolescents (M age = 15.47, 52.4% female, 89.7% Caucasian) who received residential treatment for OCD. Participants were grouped by level of depressive symptoms and several analyses of variance were conducted to determine the impact of level of depressive symptoms on OCD severity at admission and discharge. Further, a hierarchical multiple regression was conducted to determine whether change in depression severity predicted discharge OCD severity controlling for admission OCD severity. Results indicated that level of depression severity at admission significantly related to admission OCD severity but did not have a significant effect on OCD severity at discharge, controlling for admission OCD severity. Further, level of depression severity at admission did not impact treatment duration. Controlling for admission OCD severity, greater change in depression severity significantly predicted lower OCD severity at discharge. It is possible that the intensive treatment setting may reduce the negative impact of depressive symptoms on OCD treatment outcome.
    Journal of Obsessive-Compulsive and Related Disorders 04/2014; 3(2). DOI:10.1016/j.jocrd.2014.02.003 · 1.18 Impact Factor
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