Quality of life in children with OCD with and without comorbidity

Abstract

BackgroundQuality of life (QoL) is a well-established outcome measure. However, in contrast to adult obsessive-compulsive disorder (OCD), little is known about QoL in children with OCD. This study aimed to assess QoL, social competence and school functioning of paediatric patients with OCD by comparing them with the general population and assessing the relations between comorbidity, duration and severity of symptoms, family accommodation and QoL.MethodsChildren and adolescents (n = 135), aged 7–17 (mean 13 [SD 2.7] years; 48.1% female) were assessed at baseline for treatment. QoL was assessed by self-report and caregiver’s proxy report on the Questionnaire for Measuring Health-related Quality of Life in Children and Adolescents (KINDL-R) and compared with an age- and sex-matched sample from the general population. Social competence and school functioning were assessed with the Child Behavior Checklist, comorbidity with the Kiddie Schedule for Affective Disorders and Schizophrenia (Present and Lifetime Version), severity of OCD with the Children’s Yale-Brown Obsessive Compulsive Scale and the families’ involvement with the child’s OCD symptoms with the Family Accommodation Scale.ResultsQoL and social competence were reduced (p < .001) in patients with OCD compared with controls (KINDL-R mean score 62.40 [SD 13.00] versus 69.72 [12.38] in self-reports and 61.63 [SD 13.27] versus 74.68 [9.97] in parent reports). Patients with comorbidity had lower QoL (p = .001) in proxy ratings than those with OCD only (mean score 56.26 [SD 12.47] versus 64.30 [SD 12.75]). In parent proxy reports, severity of OCD (r = −.28) and family accommodation (r = −.40) correlated moderately negatively with QoL.ConclusionsTo our knowledge, this is the largest QoL study of paediatric OCD. QoL was markedly reduced in children with OCD, especially in those with comorbid psychiatric disorders. Based on our findings, we suggest employing QoL assessment in order to have a more comprehensive understanding of childhood OCD.Clinical trials registration informationThis study was registered in Current Controlled Trials; Nordic Long-term Obsessive Compulsive disorder (OCD) Treatment Study (ISRCTN66385119).

Quality of Life in Children with Obsessive-Compulsive Disorder

“…[12][13][14] Vivian found this significant correlation not only for total score but also for all the subscales (physical health, psychological health, social relationship and environment).…”

“…15 Weidle used the self-report questionnaire and a proxy version for one of the parents in both trials. 13,14 The same procedure was used by Lack. 16 Vivian only assessed adolescents' reports.…”

“…Indeed, almost every studies showed the negative influence of comorbidities in QoL in patients with OCD diagnosis. 12,14,16 Vivian found a strong association between depressive symptoms and QoL in their patients. Relation with anxiety symptoms was also present but with no significance.…”

“…The ones that did 13,14,16 concluded that parents tend to rate their children's QoL at lower levels than the youth. However this difference does not reach statistical significance and there is an overall agreement between children's and parents report.…”

“…Two studies 14,16 showed that internalizing behavior problems are responsible for a significant impairment in QoL in children with OCD. In this sense, therapeutic strategies must be applied in order to minimize the influence of these symptoms and improve QoL in patients that present this kind of behaviors.…”