Top

Health and Quality of Life Outcomes

Published in:

Open Access 01-12-2014 | Research

Quality of life in children with OCD with and without comorbidity

Authors: Bernhard Weidle, Thomas Jozefiak, Tord Ivarsson, Per Hove Thomsen

Published in: Health and Quality of Life Outcomes | Issue 1/2014

Abstract

Background

Quality 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.

Methods

Children 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.

Results

QoL 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.

Conclusions

To 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 information

This study was registered in Current Controlled Trials; Nordic Long-term Obsessive Compulsive disorder (OCD) Treatment Study (ISRCTN66385119).

Available only for authorised users

Heyman I, Fombonne E, Simmons H, Ford T, Meltzer H, Goodman R: Prevalence of obsessive-compulsive disorder in the British nationwide survey of child mental health. Br J Psychiatry 2001, 179: 324–329. 10.1192/bjp.179.4.324CrossRefPubMed

Valleni-Basile LA, Garrison CZ, Jackson KL, Waller JL, McKeown RE, Addy CL, Cuffe SP: Frequency of obsessive-compulsive disorder in a community sample of young adolescents. J Am Acad Child Adolesc Psychiatry 1994, 33: 782–791. 10.1097/00004583-199407000-00002CrossRefPubMed

Verhulst FC, van der Ende J, Ferdinand RF, Kasius MC: The prevalence of DSM-III-R diagnoses in a national sample of Dutch adolescents. Arch Gen Psychiatry 1997, 54: 329–336. 10.1001/archpsyc.1997.01830160049008CrossRefPubMed

Micali N, Heyman I, Perez M, Hilton K, Nakatani E, Turner C, Mataix-Cols D: Long-term outcomes of obsessive-compulsive disorder: follow-up of 142 children and adolescents. Br J Psychiatry 2010, 197: 128–134. 10.1192/bjp.bp.109.075317CrossRefPubMed

Skoog G, Skoog I: A 40-year follow-up of patients with obsessive-compulsive disorder. Arch Gen Psychiatry 1999, 56: 121–127. 10.1001/archpsyc.56.2.121CrossRefPubMed

Stewart SE, Geller DA, Jenike M, Pauls D, Shaw D, Mullin B, Faraone SV: Long-term outcome of pediatric obsessive-compulsive disorder: a meta-analysis and qualitative review of the literature. Acta Psychiatr Scand 2004, 110: 4–13. 10.1111/j.1600-0447.2004.00302.xCrossRefPubMed

DeVeaugh-Geiss JMG, Biederman J, Dennis Cantwell D, Fontaine R, Greist JH, Reichler R, Katz R, Landau P: Clomipramine hydrochloride in childhood and adolescence obsessive-compulsive disorder - a multicenter trial. J Am Acad Child Adolesc Psychiatry 1992, 31: 45–49. 10.1097/00004583-199201000-00008CrossRefPubMed

Hanna GL: Demographic and clinical feature of obsessive-compulsive disorder in children and adolescents. J Am Acad Child Adolesc Psychiatry 1995, 34: 19–27. 10.1097/00004583-199501000-00009CrossRefPubMed

Ivarsson T, Melin K, Wallin L: Categorical and dimensional aspects of co-morbidity in obsessive-compulsive disorder (OCD). Eur Child Adolesc Psychiatry 2008, 17: 20–31. 10.1007/s00787-007-0626-zCrossRefPubMed

10.

Bejerot S, Nylander L, Lindstrom E: Autistic traits in obsessive-compulsive disorder. Nord J Psychiatry 2001, 55: 169–176. 10.1080/08039480152036047CrossRefPubMed

11.

Cath DC, Ran N, Smit JH, van Balkom AJ, Comijs HC: Symptom overlap between autism spectrum disorder, generalized social anxiety disorder and obsessive-compulsive disorder in adults: a preliminary case-controlled study. Psychopathology 2008, 41: 101–110. 10.1159/000111555CrossRefPubMed

12.

LaSalle VH, Cromer KR, Nelson KN, Kazuba D, Justement L, Murphy DL: Diagnostic interview assessed neuropsychiatric disorder comorbidity in 334 individuals with obsessive-compulsive disorder. Depress Anxiety 2004, 19: 163–173. 10.1002/da.20009CrossRefPubMed

13.

Ivarsson T, Melin K: Autism spectrum traits in children and adolescents with obsessive-compulsive disorder (OCD). J Anxiety Disord 2008, 22: 969–978. 10.1016/j.janxdis.2007.10.003CrossRefPubMed

14.

FDA: Guidance for Industry - Patients-Reported Outcome Measures: Use in Medical Product Development to Support Labeling Claims. (Administration USDoHaHSFaD ed. 2006, [http://www.fda.gov/ohrms/dockets/98fr/06d-0044-gdl0001.pdf]

15.

Bastiaansen D, Koot HM, Ferdinand RF: Psychopathology in children: improvement of quality of life without psychiatric symptom reduction? Eur Child Adolesc Psychiatry 2005, 14: 364–370. 10.1007/s00787-005-0481-8CrossRefPubMed

16.

Eisen JL, Mancebo MA, Pinto A, Coles ME, Pagano ME, Stout R, Rasmussen SA: Impact of obsessive-compulsive disorder on quality of life. Compr Psychiatry 2006, 47: 270–275. 10.1016/j.comppsych.2005.11.006PubMedCentralCrossRefPubMed

17.

Hollander E, Stein DJ, Fineberg NA, Marteau F, Legault M: Quality of life outcomes in patients with obsessive-compulsive disorder: relationship to treatment response and symptom relapse. J Clin Psychiatry 2010, 71: 784–792. 10.4088/JCP.09m05911bluCrossRefPubMed

18.

Macy AS, Theo JN, Kaufmann SC, Ghazzaoui RB, Pawlowski PA, Fakhry HI, Cassmassi BJ, IsHak WW: Quality of life in obsessive compulsive disorder. CNS Spectr 2013, 18: 21–33. 10.1017/S1092852912000697CrossRefPubMed

19.

Palermo SD, Bloch MH, Craiglow B, Landeros-Weisenberger A, Dombrowski PA, Panza K, Smith ME, Peterson BS, Leckman JF: Predictors of early adulthood quality of life in children with obsessive-compulsive disorder. Soc Psychiatry Psychiatr Epidemiol 2011, 46: 291–297. 10.1007/s00127-010-0194-2PubMedCentralCrossRefPubMed

20.

Sorensen CB, Kirkeby L, Thomsen PH: Quality of life with OCD. A self-reported survey among members of the Danish OCD Association. Nord J Psychiatry 2004, 58: 231–236. 10.1080/08039480410006287CrossRefPubMed

21.

Lack CW, Storch EA, Keeley ML, Geffken GR, Ricketts ED, Murphy TK, Goodman WK: Quality of life in children and adolescents with obsessive-compulsive disorder: base rates, parent-child agreement, and clinical correlates. Soc Psychiatry Psychiatr Epidemiol 2009, 44: 935–942. 10.1007/s00127-009-0013-9CrossRefPubMed

22.

Thomsen PH, Torp NC, Dahl K, Christensen K, Englyst I, Melin KH, Nissen JB, Hybel KA, Valderhaug R, Weidle B, Skarphedinsson G, von Bahr PL, Ivarsson T: The Nordic long-term OCD treatment study (NordLOTS): rationale, design, and methods. Child Adolesc Psychiatry Ment Health 2013, 7: 41. 10.1186/1753-2000-7-41PubMedCentralCrossRefPubMed

23.

Torp NC, Dahl K, Skarphedinsson G, Thomsen PH, Valderhaug R, Weidle B, Melin K, Hybel K, Nissen JB, Lenhard F, Wentzel-Larsen T, Franklin ME, Ivarsson T: Effectiveness of cognitive behavior treatment for pediatric Obsessive- Compulsive Disorder: Acute outcomes from the Nordic long-term OCD treatment study (NordLOTS). Behav Res Ther 2014, Accepted for publication.

24.

Jozefiak T, Larsson B, Wichstrom L: Changes in quality of life among Norwegian school children: a six-month follow-up study. Health Qual Life Outcomes 2009, 7: 7. 10.1186/1477-7525-7-7PubMedCentralCrossRefPubMed

25.

Ravens-Sieberer U, Bullinger M: KINDL-R. Questionnaire for measuring health-related quality of life in children and adolescents - Revised version 2000. 2000. , [http://www.kindl.org/deutsch/sprachversionen/englisch/]

26.

Bullinger M, Brutt AL, Erhart M, Ravens-Sieberer U, Group BS: Psychometric properties of the KINDL-R questionnaire: results of the BELLA study. Eur Child Adolesc Psychiatry 2008, 17(Suppl 1):125–132. 10.1007/s00787-008-1014-zCrossRefPubMed

27.

Jozefiak T, Larsson B, Wichstrom L, Mattejat F, Ravens-Sieberer U: Quality of Life as reported by school children and their parents: a cross-sectional survey. Health Qual Life Outcomes 2008, 6: 34. 10.1186/1477-7525-6-34PubMedCentralCrossRefPubMed

28.

Achenbach TMRL: An Integrated System of Multi-Informant Assessment - School age Forms and Profiles. Library of Congress, Washington, DC; 2001.

29.

Jozefiak T, Larsson B, Wichstrom L, Rimehaug T: Competence and emotional/behavioural problems in 7–16-year-old Norwegian school children as reported by parents. Nord J Psychiatry 2012, 66: 311–319. 10.3109/08039488.2011.638934CrossRefPubMed

30.

Novik TS: Validity of the child behaviour checklist in a Norwegian sample. Eur Child Adolesc Psychiatry 1999, 8: 247–254. 10.1007/s007870050098CrossRefPubMed

31.

Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, Williamson D, Ryan N: Schedule for affective disorders and schizophrenia for school-Age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 1997, 36: 980–988. 10.1097/00004583-199707000-00021CrossRefPubMed

32.

Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM IV). American Psychiatric Association, Washington, DC; 1994.

33.

Axelson D, Birmaher B, Zelazny J, Kaufman J, Gill MK: Kiddie-Sads-Present and Lifetime Version (K-SADSPL) 2009 Working Draft. Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA; 2009.

34.

Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL, Heninger GR, Charney DS: The Yale-brown obsessive compulsive scale. I. Development, use, and reliability. Arch Gen Psychiatry 1989, 46: 1006–1011. 10.1001/archpsyc.1989.01810110048007CrossRefPubMed

35.

Calvocoressi L, Mazure CM, Kasl SV, Skolnick J, Fisk D, Vegso SJ, Van Noppen BL, Price LH: Family accommodation of obsessive-compulsive symptoms: instrument development and assessment of family behavior. J Nerv Ment Dis 1999, 187: 636–642. 10.1097/00005053-199910000-00008CrossRefPubMed

36.

Geffken GR, Storch EA, Duke DC, Monaco L, Lewin AB, Goodman WK: Hope and coping in family members of patients with obsessive-compulsive disorder. J Anxiety Disord 2006, 20: 614–629. 10.1016/j.janxdis.2005.07.001CrossRefPubMed

37.

Storch EA, Geffken GR, Merlo LJ, Jacob ML, Murphy TK, Goodman WK, Larson MJ, Fernandez M, Grabill K: Family accommodation in pediatric obsessive-compulsive disorder. J Clin Child Adolesc Psychol 2007, 36: 207–216. 10.1080/15374410701277929CrossRefPubMed

38.

Hollingshead AB: Four factor index of social status. Yale J Sociology 1975, 2011: 21–52.

39.

Upton P, Lawford J, Eiser C: Parent-child agreement across child health-related quality of life instruments: a review of the literature. Qual Life Res 2008, 17: 895–913. 10.1007/s11136-008-9350-5CrossRefPubMed

40.

Cutler D, Murphy T, Gilmour J, Heyman I: The quality of life of young people with Tourette syndrome. Child Care Health Dev 2009, 35: 496–504. 10.1111/j.1365-2214.2009.00983.xCrossRefPubMed

41.

Klassen AF, Miller A, Fine S: Health-related quality of life in children and adolescents who have a diagnosis of attention-deficit/hyperactivity disorder. Pediatrics 2004, 114: e541-e547. 10.1542/peds.2004-0844CrossRefPubMed

42.

Storch EA, Merlo LJ, Lack C, Milsom VA, Geffken GR, Goodman WK, Murphy TK: Quality of life in youth with Tourette's syndrome and chronic tic disorder. J Clin Child Adolesc Psychol 2007, 36: 217–227. 10.1080/15374410701279545CrossRefPubMed

43.

Bernard BA, Stebbins GT, Siegel S, Schultz TM, Hays C, Morrissey MJ, Leurgans S, Goetz CG: Determinants of quality of life in children with Gilles de la Tourette syndrome. Mov Disord 2009, 24: 1070–1073. 10.1002/mds.22487CrossRefPubMed

44.

Eddy CM, Cavanna AE, Gulisano M, Cali P, Robertson MM, Rizzo R: The effects of comorbid obsessive-compulsive disorder and attention-deficit hyperactivity disorder on quality of life in tourette syndrome. J Neuropsychiatry Clin Neurosci 2012, 24: 458–462. 10.1176/appi.neuropsych.11080181CrossRefPubMed

45.

Mitchell P, O'Keefe K: Brief report: do individuals with autism spectrum disorder think they know their own minds? J Autism Dev Disord 2008, 38: 1591–1597. 10.1007/s10803-007-0530-xCrossRefPubMed

46.

Shipman DL, Sheldrick RC, Perrin EC: Quality of life in adolescents with autism spectrum disorders: reliability and validity of self-reports. J Dev Behav Pediatr 2011, 32: 85–89. 10.1097/DBP.0b013e318203e558CrossRefPubMed

47.

Baron-Cohen S: Do autistic children have obsessions and compulsions? Br J Clin Psychol 1989, 28(Pt 3):193–200. 10.1111/j.2044-8260.1989.tb01369.xCrossRefPubMed

48.

Ruta L, Mugno D, D'Arrigo VG, Vitiello B, Mazzone L: Obsessive-compulsive traits in children and adolescents with Asperger syndrome. Eur Child Adolesc Psychiatry 2010, 19: 17–24. 10.1007/s00787-009-0035-6CrossRefPubMed

Title: Quality of life in children with OCD with and without comorbidity
Authors: Bernhard Weidle
Thomas Jozefiak
Tord Ivarsson
Per Hove Thomsen
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: Health and Quality of Life Outcomes / Issue 1/2014
Electronic ISSN: 1477-7525
DOI: https://doi.org/10.1186/s12955-014-0152-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Quality of life in children with OCD with and without comorbidity

Abstract

Background

Methods

Results

Conclusions

Clinical trials registration information

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Clinical trials registration information

Please log in to get access to this content

Other articles of this Issue 1/2014

Deriving a mapping algorithm for converting SF-36 scores to EQ-5D utility score in a Korean population

Interviewing to develop Patient-Reported Outcome (PRO) measures for clinical research: eliciting patients’ experience

Perceptions of individuals living with spinal cord injury toward preference-based quality of life instruments: a qualitative exploration

Impact of tooth loss related to number and position on oral health quality of life among adults

Translation and psychometric properties of the Chinese (Mandarin) version of the Child Oral Health Impact Profile-Short Form 19 (COHIP-SF 19) for school-age children

Health-related quality of life for pre-diabetic states and type 2 diabetes mellitus: a cross-sectional study in Västerbotten Sweden