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BMC Psychiatry
Published in: BMC Psychiatry 1/2017

Open Access 01-12-2017 | Research article

Register-based study of the incidence, comorbidities and demographics of obsessive-compulsive disorder in specialist healthcare

Authors: Hanna Rintala, Roshan Chudal, Sami Leppämäki, Susanna Leivonen, Susanna Hinkka-Yli-Salomäki, Andre Sourander

Published in: BMC Psychiatry | Issue 1/2017

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Abstract

Background

Incidence of obsessive-compulsive disorder (OCD) has been suspected to increase but nationwide epidemiological studies are limited. This study aims to examine sex-specific incidence time trends and characterize psychiatric and neurodevelopmental comorbidities and sociodemographic risk factors of OCD in specialist healthcare in Finland.

Methods

A nationwide register-based study using data from four Finnish registers identified 3372 OCD cases and 13,372 matched controls (1:4). Cumulative incidence in subjects born between 1987 and 2001 was estimated at ages of 10, 15, 20 and 23 years. Conditional logistic regression was used to examine the sociodemographic factors.

Results

The cumulative incidence of OCD was 0.4% by age 23. Incidence by age 15 among three cohorts increased from 12.4 to 23.7 /10000 live born males and 8.5 to 28.0 /10000 live born females. 73% of the sample had a comorbid condition. Males were significantly more comorbid with psychotic and developmental disorders; females were more comorbid with depressive and anxiety disorders (p <0.001). Higher maternal SES was associated with an increased risk of OCD (OR 1.4; 95% CI 1.1–1.6).

Conclusions

These findings suggest that incidence of treated OCD in specialist healthcare has increased. The reason may be increased awareness and rate of referrals but a true increase cannot be ruled out. Further research on risk factors of OCD is warranted.
Literature
1.
World Health Organization. International Classification of Disesase and Related Health Problems, ICD-10. 2005. p. 1.
2.
Krebs G, Heyman I. Obsessive-compulsive disorder in children and adolescents. Arch Dis Child. 2014;14.
3.
Jacoby RJ, Leonard RC, Riemann BC, Abramowitz JS. Predictors of quality of life and functional impairment in obsessive-compulsive disorder. Compr Psychiatry. 2014;55(5):1195–202.CrossRefPubMed
4.
Pauls DL, Abramovitch A, Rauch SL, Geller DA. Obsessive-compulsive disorder: an integrative genetic and neurobiological perspective. Nat Rev Neurosci. 2014;15(6):410–24.CrossRefPubMed
5.
Taylor S. Early versus late onset obsessive-compulsive disorder: evidence for distinct subtypes. Clin Psychol Rev. 2011;31(7):1083–100.CrossRefPubMed
6.
Stengler K, Olbrich S, Heider D, Dietrich S, Riedel-Heller S, Jahn I. Mental health treatment seeking among patients with OCD: impact of age of onset. Soc Psychiatry Psychiatr Epidemiol. 2013;48(5):813–9.CrossRefPubMed
7.
Poyraz CA, Turan S, Saglam NG, Batun GC, Yassa A, Duran A. Factors associated with the duration of untreated illness among patients with obsessive compulsive disorder. Compr Psychiatry. 2015;58:88–93.CrossRefPubMed
8.
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;179:324–9.CrossRefPubMed
9.
Huang LC, Tsai KJ, Wang HK, Sung PS, Wu MH, Hung KW, et al. Prevalence, incidence, and comorbidity of clinically diagnosed obsessive-compulsive disorder in Taiwan: a national population-based study. Psychiatry Res. 2014;220(1–2):335–41.CrossRefPubMed
10.
Ruscio AM, Stein DJ, Chiu WT, Kessler RC. The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Mol Psychiatry. 2010;15(1):53–63.CrossRefPubMed
11.
Skapinakis P, Bellos S, Koupidis S, Grammatikopoulos I, Theodorakis PN, Mavreas V. Prevalence and sociodemographic associations of common mental disorders in a nationally representative sample of the general population of Greece. BMC Psychiatry. 2013;13:163-244X-13-163.CrossRef
12.
Sun J, Boschen MJ, Farrell LJ, Buys N, Li ZJ. Obsessive-compulsive symptoms in a normative Chinese sample of youth: prevalence, symptom dimensions, and factor structure of the Leyton Obsessional Inventory--Child Version. J Affect Disord. 2014;164:19–27.CrossRefPubMed
13.
Veldhuis J, Dieleman JP, Wohlfarth T, Storosum JG, van Den Brink W, Sturkenboom MC, et al. Incidence and prevalence of "diagnosed OCD" in a primary care, treatment seeking, population. Int J Psychiatry Clin Pract. 2012;16(2):85–92.CrossRefPubMed
14.
Voltas N, Hernandez-Martinez C, Arija V, Aparicio E, Canals J. A prospective study of paediatric obsessive-compulsive symptomatology in a Spanish community sample. Child Psychiatry Hum Dev. 2014;45(4):377–87.CrossRefPubMed
15.
Browne HA, Hansen SN, Buxbaum JD, Gair SL, Nissen JB, Nikolajsen KH, et al. Familial clustering of tic disorders and obsessive-compulsive disorder. JAMA Psychiat. 2015;72(4):359–66.CrossRef
16.
Mataix-Cols D, Boman M, Monzani B, Ruck C, Serlachius E, Langstrom N, et al. Population-based, multigenerational family clustering study of obsessive-compulsive disorder. JAMA Psychiat. 2013;70(7):709–17.CrossRef
17.
Steinhausen HC, Bisgaard C, Munk-Jorgensen P, Helenius D. Family aggregation and risk factors of obsessive-compulsive disorders in a nationwide three-generation study. Depress Anxiety. 2013;30(12):1177–84.CrossRefPubMed
18.
Atladottir HO, Parner ET, Schendel D, Dalsgaard S, Thomsen PH, Thorsen P. Time trends in reported diagnoses of childhood neuropsychiatric disorders: a Danish cohort study. Arch Pediatr Adolesc Med. 2007;161(2):193–8.CrossRefPubMed
19.
Atladottir HO, Gyllenberg D, Langridge A, Sandin S, Hansen SN, Leonard H, et al. The increasing prevalence of reported diagnoses of childhood psychiatric disorders: a descriptive multinational comparison. Eur Child Adolesc Psychiatry. 2015;24(2):173–83.CrossRefPubMed
20.
Pallanti S, Grassi G, Sarrecchia ED, Cantisani A, Pellegrini M. Obsessive-compulsive disorder comorbidity: clinical assessment and therapeutic implications. Front Psychiatry. 2011;2:70.CrossRefPubMedPubMedCentral
21.
Huppert JD, Simpson HB, Nissenson KJ, Liebowitz MR, Foa EB. Quality of life and functional impairment in obsessive-compulsive disorder: a comparison of patients with and without comorbidity, patients in remission, and healthy controls. Depress Anxiety. 2009;26(1):39–45.CrossRefPubMedPubMedCentral
22.
Goodman WK, Storch EA, Geffken GR, Murphy TK. Obsessive-compulsive disorder in Tourette syndrome. J Child Neurol. 2006;21(8):704–14.CrossRefPubMed
23.
Leckman JF, Bloch MH, King RA. Symptom dimensions and subtypes of obsessive-compulsive disorder: a developmental perspective. Dialogues Clin Neurosci. 2009;11(1):21–33.PubMedPubMedCentral
24.
Ortiz AE, Morer A, Moreno E, Plana MT, Cordovilla C, Lazaro L. Clinical significance of psychiatric comorbidity in children and adolescents with obsessive-compulsive disorder: subtyping a complex disorder. Eur Arch Psychiatry Clin Neurosci. 2016;266(3):199–208.CrossRefPubMed
25.
Brander G, Perez-Vigil A, Larsson H, Mataix-Cols D. Systematic review of environmental risk factors for Obsessive-Compulsive Disorder: a proposed roadmap from association to causation. Neurosci Biobehav Rev. 2016;65:36–62.CrossRefPubMed
26.
Thomsen PH. Children and adolescents with obsessive-compulsive disorder: an analysis of sociodemographic background. A case-control study. Psychopathology. 1994;27(6):303–11.CrossRefPubMed
27.
Ernst H, Klosinski G. Development and family environment in compulsive neurotic children and adolescents: a retrospective and comparative study. Prax Kinderpsychol Kinderpsychiatr. 1989;38(7):256–63.PubMed
28.
Alvarenga PG, do Rosario MC, Cesar RC, Manfro GG, Moriyama TS, Bloch MH, et al. Obsessive-compulsive symptoms are associated with psychiatric comorbidities, behavioral and clinical problems: a population-based study of Brazilian school children. Eur Child Adolesc Psychiatry 2015 May 27.
29.
Guerrero AP, Hishinuma ES, Andrade NN, Bell CK, Kurahara DK, Lee TG, et al. Demographic and clinical characteristics of adolescents in Hawaii with obsessive-compulsive disorder. Arch Pediatr Adolesc Med. 2003;157(7):665–70.CrossRefPubMed
30.
Rajmil L, Herdman M, Ravens-Sieberer U, Erhart M, Alonso J, European KIDSCREEN group. Socioeconomic inequalities in mental health and health-related quality of life (HRQOL) in children and adolescents from 11 European countries. Int J Public Health. 2014;59(1):95–105.CrossRefPubMed
31.
Reiss F. Socioeconomic inequalities and mental health problems in children and adolescents: a systematic review. Soc Sci Med. 2013;90:24–31.CrossRefPubMed
32.
Lampi KM, Banerjee PN, Gissler M, Hinkka-Yli-Salomaki S, Huttunen J, Kulmala U, et al. Finnish Prenatal Study of Autism and Autism Spectrum Disorders (FIPS-A): overview and design. J Autism Dev Disord. 2011;41(8):1090–6.CrossRefPubMed
33.
Chudal R, Sucksdorff D, Suominen A, Lehti V, Hinkka-Yli-Salomaki S, Huttunen J, et al. Finnish Prenatal Study of Bipolar Disorders (FIPS-B): overview, design and description of the sample. Nord J Psychiatry. 2014;68(3):169–79.CrossRefPubMed
34.
Sund R. Quality of the Finnish Hospital Discharge Register: a systematic review. Scand J Public Health. 2012;40(6):505–15.CrossRefPubMed
35.
Leivonen S, Voutilainen A, Hinkka-Yli-Salomaki S, Timonen-Soivio L, Chudal R, Gissler M, et al. A nationwide register study of the characteristics, incidence and validity of diagnosed Tourette syndrome and other tic disorders. Acta Paediatr. 2014;103(9):984–90.CrossRefPubMed
36.
Joelsson P, Chudal R, Gyllenberg D, Kesti AK, Hinkka-Yli-Salomaki S, Virtanen JP, et al. Demographic characteristics and psychiatric comorbidity of children and adolescents diagnosed with ADHD in specialized healthcare. Child Psychiatry Hum Dev. 2015
37.
Lehti V, Hinkka-Yli-Salomaki S, Cheslack-Postava K, Gissler M, Brown AS, Sourander A. Maternal socio-economic status based on occupation and autism spectrum disorders: a national case-control study. Nord J Psychiatry. 2015;3:1–8.
38.
Jokiranta-Olkoniemi E, Cheslack-Postava K, Sucksdorff D, Suominen A, Gyllenberg D, Chudal R, Leivonen S, Gissler M, Brown AS, Sourander A. Risk of psychiatric and neurodevelopmental disorders among siblings of probands with autism spectrum disorders. JAMA Psychiat. 2016;73(6):622–9.CrossRef
39.
Gyllenberg D, Sourander A, Surcel HM, Hinkka-Yli-Salomaki S, McKeague IW, Brown AS. Hypothyroxinemia during gestation and offspring schizophrenia in a national birth cohort. Biol Psychiatry 2015.
40.
41.
Sourander A, Niemela S, Santalahti P, Helenius H, Piha J. Changes in psychiatric problems and service use among 8-year-old children: a 16-year population-based time-trend study. J Am Acad Child Adolesc Psychiatry. 2008;47(3):317–27.CrossRefPubMed
42.
Tick NT, van der Ende J, Verhulst FC. Ten-year increase in service use in the Dutch population. Eur Child Adolesc Psychiatry. 2008;17(6):373–80.CrossRefPubMed
43.
44.
Malm H, Brown AS, Gissler M, Gyllenberg D, Hinkka-Yli-Salomaki S, McKeague IW, et al. Gestational exposure to selective serotonin reuptake inhibitors and offspring psychiatric disorders: a national register-based study. J Am Acad Child Adolesc Psychiatry. 2016;55(5):359–66.CrossRefPubMed
45.
Vasconcelos MS, Sampaio AS, Hounie AG, Akkerman F, Curi M, Lopes AC, et al. Prenatal, perinatal, and postnatal risk factors in obsessive-compulsive disorder. Biol Psychiatry. 2007;61(3):301–7.CrossRefPubMed
46.
Polo-Kantola P, Lampi KM, Hinkka-Yli-Salomaki S, Gissler M, Brown AS, Sourander A. Obstetric risk factors and autism spectrum disorders in Finland. J Pediatr. 2014;164(2):358–65.CrossRefPubMed
47.
Lampi KM, Hinkka-Yli-Salomaki S, Lehti V, Helenius H, Gissler M, Brown AS, et al. Parental age and risk of autism spectrum disorders in a Finnish national birth cohort. J Autism Dev Disord. 2013;43(11):2526–35.CrossRefPubMed
48.
Vidal-Ribas P, Stringaris A, Ruck C, Serlachius E, Lichtenstein P, Mataix-Cols D. Are stressful life events causally related to the severity of obsessive-compulsive symptoms? A monozygotic twin difference study. Eur Psychiatry. 2015;30(2):309–16.CrossRefPubMedPubMedCentral
49.
Esposito S, Bianchini S, Baggi E, Fattizzo M, Rigante D. Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: an overview. Eur J Clin Microbiol Infect Dis. 2014;33(12):2105–9.CrossRefPubMed
50.
Cederlof M, Lichtenstein P, Larsson H, Boman M, Ruck C, Landen M, et al. Obsessive-compulsive disorder, psychosis, and bipolarity: a longitudinal cohort and multigenerational family study. Schizophr Bull. 2014 Dec;15.
51.
de Mathis MA, Diniz JB, Hounie AG, Shavitt RG, Fossaluza V, Ferrao Y, et al. Trajectory in obsessive-compulsive disorder comorbidities. Eur Neuropsychopharmacol. 2013;23(7):594–601.CrossRefPubMed
52.
de Laat SA, Essink-Bot ML, van Wassenaer-Leemhuis AG, Vrijkotte TG. Effect of socioeconomic status on psychosocial problems in 5- to 6-year-old preterm- and term-born children: the ABCD study. Eur Child Adolesc Psychiatry. 2015 Nov;12.
53.
Siponen SM, Ahonen RS, Savolainen PH, Hameen-Anttila KP. Children's health and parental socioeconomic factors: a population-based survey in Finland. BMC Public Health. 2011;11:457-2458-11-457.CrossRef
54.
Fernandez de la Cruz L, Llorens M, Jassi A, Krebs G, Vidal-Ribas P, Radua J, et al. Ethnic inequalities in the use of secondary and tertiary mental health services among patients with obsessive-compulsive disorder. Br J Psychiatry. 2015.
55.
Fernandez de la Cruz L, Kolvenbach S, Vidal-Ribas P, Jassi A, Llorens M, Patel N, et al. Illness perception, help-seeking attitudes, and knowledge related to obsessive-compulsive disorder across different ethnic groups: a community survey. Soc Psychiatry Psychiatr Epidemiol. 2015.
56.
Wang PS, Lane M, Olfson M, Pincus HA, Wells KB, Kessler RC. Twelve-month use of mental health services in the United States: results from the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):629–40.CrossRefPubMed
57.
Torres AR, Prince MJ, Bebbington PE, Bhugra DK, Brugha TS, Farrell M, et al. Treatment seeking by individuals with obsessive-compulsive disorder from the british psychiatric morbidity survey of 2000. Psychiatr Serv. 2007;58(7):977–82.CrossRefPubMed
58.
Williams MT, Domanico J, Marques L, Leblanc NJ, Turkheimer E. Barriers to treatment among African Americans with obsessive-compulsive disorder. J Anxiety Disord. 2012;26(4):555–63.CrossRefPubMedPubMedCentral
Metadata
Title
Register-based study of the incidence, comorbidities and demographics of obsessive-compulsive disorder in specialist healthcare
Authors
Hanna Rintala
Roshan Chudal
Sami Leppämäki
Susanna Leivonen
Susanna Hinkka-Yli-Salomäki
Andre Sourander
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2017
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-017-1224-3

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