Empirical severity benchmarks for obsessive‐compulsive disorder across the lifespan

Cervin, Matti; Arumugham, Shyam Sundar; Löchner, Christine; Cervin, O.; Crowley, James J.; Rosário, Maria Conceição do; Jaisoorya, T S; Batistuzzo, Marcelo C.; Wallert, John; Mathis, Maria Alice de; Balachander, Srinivas; Goodman, Wayne K.; Costa, Diogo; Schipper, Elles de; Wilhelm, Sabine; Palo, Amanda; Narayanaswamy, Janardhanan C.; Shavitt, Roseli Gedanke; Ferrão, Ygor Arzeno; Omar, Y.; Boberg, Julia; Murphy, Tanya K.; Tendler, Aron; Ivanova, Ekaterina; Schneider, Sophie C.; Geller, Daniel P.; Rück, Christian; Stein, Dan J.; Miguel, Eurí­pedes Constantino; Storch, Eric A.; Reddy, Y. C. Janardhan; Mataix‐Cols, David

doi:10.1002/wps.20984

Cited by 27 publications

(23 citation statements)

References 8 publications

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“…It yields a score of 0–40 with higher scores indicating more severe OCD symptoms. A cut-off score equal to or above 14 on the CY-BOCS has been shown to best indicate clinical severity of pediatric OCD and scores equal to or above 22 indicate moderately severe OCD (Cervin, OCD Severity Benchmark Consortium, et al, 2022 ). The internal consistency of the items of the CY-BOCS was adequate using the present sample ( a = 0.75).…”

Section: Methodsmentioning

confidence: 99%

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Sensory Processing Difficulties in Children and Adolescents with Obsessive-Compulsive and Anxiety Disorders

Cervin

2022

Res Child Adolesc Psychopathol

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Altered sensory processing has been linked to symptoms of obsessive-compulsive disorder (OCD) and anxiety disorders (ADs) in youth, but few studies have examined sensory processing in clinical samples and no study has analyzed self-report data from youth meeting diagnostic criteria for OCD or ADs. This study included 86 youth with OCD, 82 youth with ADs, and 46 youth without psychiatric disorders. Participants completed the adolescent version of the Sensory Profile and scales measuring three symptom dimensions of OCD, four symptom dimensions of anxiety, and symptoms of major depression. Results showed that different forms of sensory processing difficulties (sensitivity, avoidance, low registration) were adequately captured by one broad sensory processing factor. Youth with OCD and ADs reported statistically significantly more sensory difficulties than youth without psychiatric disorders, but the two clinical groups did not differ from each other. Altered sensory processing in the clinical groups was not explained by the presence of neurodevelopmental disorders. Sensory difficulties were moderately to strongly related to all self-reported symptom dimensions, and uniquely related to the OCD dimension of symmetry/ordering and the anxiety dimensions of panic and social anxiety. Most youth in the clinical groups were classified as having difficulties with sensory processing. The present study shows that sensory processing difficulties are common in youth with OCD and ADs, not explained by co-occurring neurodevelopmental disorders, and linked to a host of internalizing symptoms. More research is needed to identify whether sensory processing difficulties precede, follow, or mutually reinforce the development of OCD and ADs in youth.

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Section: Methodsmentioning

confidence: 99%

“…The internal consistency of the items of the CY-BOCS was adequate using the present sample ( a = 0.75). According to the international severity guidelines (Cervin, OCD Severity Benchmark Consortium, et al, 2022 ), the scores on CY-BOCS indicated that 37% of the OCD sample had mild OCD, 58% moderately severe OCD, and 5% severe OCD.…”

Section: Methodsmentioning

confidence: 99%

Sensory Processing Difficulties in Children and Adolescents with Obsessive-Compulsive and Anxiety Disorders

Cervin

2022

Res Child Adolesc Psychopathol

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“…There are currently no established cut-off scores for clinically significant symptoms for the scales used in this study. However, recent psychometric work with the Y-BOCS have provided cut-off scores that are invariant across age groups and countries for OCD (Cervin et al, 2022). Of note, these cut-offs were established using interview-rated Y-BOCS and not self-report as we use in this study.…”

Section: Determining Cut-off Scoresmentioning

confidence: 99%

“…The proportion of participants that affirmed lifetime presence of the core symptoms of each disorder is also reported. Last, based on recent work showing that a score equal to or above 14 points on the Y-BOCS separates subclinical from clinical OCD (Cervin et al, 2022), we report the proportion that scores above the corresponding 7 points on each scale (with no specific criterium for interference), which was considered a less conservative cut-off.…”

Section: Determining Cut-off Scoresmentioning

confidence: 99%

Body-dysmorphic, hoarding, hair-pulling, and skin-picking symptoms in a large sample of adolescents

et al. 2022

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Few studies have investigated body-dysmorphic, hoarding, hair-pulling, and skin-picking symptoms in adolescents and how they relate to mental health, quality of life, suicide attempts, and non-suicidal self-harm. We used a quota sampling procedure and contacted 100 secondary centres in the Southeast of Spain, of which 34 participated in the study. A sample of 5,345 adolescents (12–18 years) completed dimensional measures of body-dysmorphic, hoarding, hair-pulling, and skin-picking symptoms. The proportion of adolescents with clinically significant symptoms within each symptom type was estimated and associations with other indicators of mental health examined. Clinically significant body-dysmorphic symptoms were reported by 3.7%, hoarding by 0.9%, hair-pulling by 0.7%, and skin-picking by 1.8%. Body-dysmorphic symptoms were more common in girls and in those over 14 years of age. Body-dysmorphic, hoarding, hair-pulling, and skin-picking symptoms were moderately to strongly associated with obsessive-compulsive symptoms, internalizing symptoms, externalizing symptoms, and poor quality of life. Those with significant body-dysmorphic, hoarding, hair-pulling, and skin-picking symptoms were much more likely to have attempted suicide and engaged in non-suicidal self-harm during the last twelve months than those without such symptoms. Body-dysmorphic symptoms showed the strongest associations with internalizing symptoms and poor quality of life. Limitations are the sole use of self-report and a sample from only two regions in Spain, but findings suggest that body-dysmorphic, hoarding, hair-pulling, and skin-picking symptoms are common and impairing during adolescence.

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“…Approximately 10% of patients with OCD develop severe symptoms and do not respond to adequate treatment [6]. Treatment-resistant OCD (trOCD) patients typically have severe symptoms (e.g., a score >30 on the Yale-Brown Obsessive Compulsive Scale, Y-BOCS), are typically disabled for much of their life and do not gain symptom relief from conventional pharmacological or psychotherapeutic treatments [7]. Deep brain stimulation (DBS) has been an option for patients with chronically severe, disabling, and treatment-resistant OCD since 1999 [8], and to date, approximately 350 patients have undergone this procedure [9].…”

Section: Introductionmentioning

confidence: 99%

Genomics of severe and treatment-resistant obsessive-compulsive disorder treated with deep brain stimulation: a preliminary investigation

Chen

Naesström

Halvorsen

et al. 2023

Preprint

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Individuals with severe and treatment-resistant obsessive-compulsive disorder (trOCD) represent a small but severely disabled group of patients. Since trOCD cases eligible for deep brain stimulation (DBS) probably comprise the most severe end of the OCD spectrum, we hypothesize that they may be more likely to have a strong genetic contribution to their disorder. Therefore, while the worldwide population of DBS-treated cases may be small (~300), screening these individuals with modern genomic methods may accelerate gene discovery in OCD. As such, we have begun to collect DNA from trOCD cases who qualify for DBS, and here we report results from whole exome sequencing and microarray genotyping of our first five cases. All participants had previously received DBS in the bed nucleus of stria terminalis (BNST), with two patients responding to the surgery and one showing a partial response. Our analyses focused on gene-disruptive rare variants (GDRVs; rare, predicted-deleterious single-nucleotide variants or copy number variants overlapping protein-coding genes). Three of the five cases carried a GDRV, including a missense variant in the ion transporter domain of KCNB1, a deletion at 15q11.2, and a duplication at 15q26.1. The KCNB1 variant (hg19 chr20-47991077-C-T, NM_004975.3:c.1020G>A, p.Met340Ile) causes substitution of methionine for isoleucine in the trans-membrane region of neuronal potassium voltage-gated ion channel KV2.1. This KCNB1 substitution (Met340Ile) is located in a highly constrained region of the protein where other rare missense variants have previously been associated with neurodevelopmental disorders. The patient carrying the Met340Ile variant responded to DBS, which suggests that genetic factors could potentially be predictors of treatment response in DBS for OCD. In sum, we have established a protocol for recruiting and genomically characterizing trOCD cases. Preliminary results suggest that this will be an informative strategy for finding risk genes in OCD.

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Empirical severity benchmarks for obsessive‐compulsive disorder across the lifespan

Cited by 27 publications

References 8 publications

Sensory Processing Difficulties in Children and Adolescents with Obsessive-Compulsive and Anxiety Disorders

Sensory Processing Difficulties in Children and Adolescents with Obsessive-Compulsive and Anxiety Disorders

Body-dysmorphic, hoarding, hair-pulling, and skin-picking symptoms in a large sample of adolescents

Genomics of severe and treatment-resistant obsessive-compulsive disorder treated with deep brain stimulation: a preliminary investigation

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