Impulse-control disorders in children and adolescents with obsessive-compulsive disorder

Butler Hospital, Providence, Rhode Island, United States
Psychiatry Research (Impact Factor: 2.47). 12/2009; 175(1-2):109-13. DOI: 10.1016/j.psychres.2009.04.006
Source: PubMed


The aim of this study was to examine current prevalences, clinical correlates and patterns of co-occurrence of impulse-control disorders (ICDs) in children and adolescents with obsessive-compulsive disorder (OCD). We examined rates and clinical correlates of comorbid ICDs in 70 consecutive child and adolescent subjects with lifetime DSM-IV OCD (32.9% females; mean age = 13.8 +/- 2.9 years). Comorbidity data were obtained with structured clinical interviews using DSM-IV criteria. OCD severity was assessed with the Child Yale-Brown Obsessive-Compulsive Scale. All variables were compared in OCD subjects with and without current ICDs. 12 (17.1%) subjects met criteria for a current ICD. Pathological skin picking and compulsive nail biting were the most common ICDs with current rates of 12.8% and 10.0%, respectively. OCD subjects with current ICDs were significantly more likely to have a co-occurring tic disorder (66.7% vs. 20.7%). Although having an ICD was associated with greater numerical scores of OCD symptomatology, these differences were not statistically significant. There were no sex-specific patterns of ICD occurrence in children and adolescents with OCD. Certain ICDs are common among children and adolescents with OCD. Better identification of ICDs in children and adolescents with OCD is needed, as are empirically validated treatments for youth with co-occurring ICDs.

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Available from: Maria C Mancebo, Dec 31, 2013
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    • "This is consistent with the findings of both Grant et al. [16] and Lochner et al. [17], who related SPD to addictive behaviors. An association between SPD and body dysmorphic disorder [18] [19] and that between SPD and trichotillomania [20], as well as SPD and OCD [21] [22], have been reported by several authors. To our surprise, none of our Israeli students screening positively for SPD endorsed either of these two OCD-related disorders, or OCD. "
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    ABSTRACT: Objective The purpose of the study was to examine the prevalence of excoriation (skin picking) disorder (SPD) and associated physical and mental health correlates in a sample of Israeli university students. Methods Five thousand Israeli students were given questionnaires screening for SPD, depression, obsessive-compulsive disorder, body dysmorphic disorder and disruptive, impulse control and conduct disorders. A total of 2176 participants (43.6%) responded and were included in the analysis. Mean age was 25.1±4.8 (range 17-60) years and 64.3% were female. Results 3.03% of students screened positive for SPD with a nearly equal gender distribution (3.0% in females and 3.1% in males). There was a trend towards significantly higher rates of psychiatric problems such as generalized anxiety, compulsive sexual behavior and eating disorders in these students. Within the group of students screening positive for SPD, alcohol intake was higher in male students, while female students perceived themselves as less attractive. No association was found between depression and SPD. A high prevalence rate of skin picking was found within first-degree family members of the participants screening positive for SPD. Conclusions Clinicians and public health officials within university settings should screen for SPD as it is common and associated with psychosocial dysfunction.
    Full-text · Article · Nov 2014 · General Hospital Psychiatry
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    • "Disorder-specific rates in our study ranged from 6.2%-13.3%, which is in agreement with the rates of 12.8% and 10.0% of skin picking and nail biting respectively according to a study conducted in the U.S. [6]. Our study also found greater occurrence among females than males, a finding consistent with previous studies [1,7,8]. "
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    ABSTRACT: Body-focused repetitive behaviors (BFRBs) that include skin picking (dermatillomania), hair pulling (trichotillomania) and nail biting (onychophagia), lead to harmful physical and psychological sequelae. The objective was to determine the prevalence of BFRBs among students attending three large medical colleges of Karachi. It is imperative to come up with frequency to design strategies to decrease the burden and adverse effects associated with BFRBs among medical students. A cross-sectional study was conducted among 210 students attending Aga Khan University, Dow Medical College and Sind Medical College, Karachi, in equal proportion. Data were collected using a pre tested tool, “Habit Questionnaire”. Diagnoses were made on the criteria that a student must be involved in an activity 5 times or more per day for 4 weeks or more. Convenience sampling was done to recruit the participants aged 18 years and above after getting written informed consent. The overall prevalence of BFRBs was found to be 46 (22%). For those positive for BFRBs, gender distribution was as follows: females 29 (13.9%) and males 17 (8.1%). Among these students, 19 (9.0%) were engaged in dermatillomania, 28 (13.3%) in trichotillomania and 13 (6.2%) in onychophagia. High proportions of BFRBs are reported among medical students of Karachi. Key health messages and interventions to reduce stress and anxiety among students may help in curtailing the burden of this disease which has serious adverse consequences.
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    • "For example, several studies have documented significant gender differences in the sociodemographic correlates, trauma types, onset, and comorbidity of PTSD across countries (Breslau et al., 1997; Darves-Bornoz et al., 2008; Hapke et al., 2006; Jeon et al., 2007; Rosenman, 2002; Yasan et al., 2009; Zlotnick et al., 2006). Similar gender differences in epidemiological parameters have also been found within OCD (Grabe et al., 2000; Grant et al., 2010; Kolada et al., 1994; Mohammadi et al., 2004), PD (Eaton et al., 1994; Krystal et al., 1992), GAD (Hunt et al., 2002; Vesga-López et al., 2008) and SAD (Beesdo et al., 2007). In addition, several studies have documented gender differences among clinical samples of individuals with anxiety disorders (e.g., all anxiety disorders: Scheibe and Albus, 1992; Yonkers et al., 2003, PD: Clayton et al., 2006; OCD: Bogetto et al., 1999; Torresan et al., 2009, SAD: Turk et al., 1998; Yonkers et al., 2003). "
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    ABSTRACT: Women have consistently higher prevalence rates of anxiety disorders, but less is known about how gender affects age of onset, chronicity, comorbidity, and burden of illness. Gender differences in DSM-IV anxiety disorders were examined in a large sample of adults (N=20,013) in the United States using data from the Collaborative Psychiatric Epidemiology Studies (CPES). The lifetime and 12-month male:female prevalence ratios of any anxiety disorder were 1:1.7 and 1:1.79, respectively. Women had higher rates of lifetime diagnosis for each of the anxiety disorders examined, except for social anxiety disorder which showed no gender difference in prevalence. No gender differences were observed in the age of onset and chronicity of the illness. However, women with a lifetime diagnosis of an anxiety disorder were more likely than men to also be diagnosed with another anxiety disorder, bulimia nervosa, and major depressive disorder. Furthermore, anxiety disorders were associated with a greater illness burden in women than in men, particularly among European American women and to some extend also among Hispanic women. These results suggest that anxiety disorders are not only more prevalent but also more disabling in women than in men.
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