Long-term outcomes of obsessive-compulsive disorder: follow-up of 142 children and adolescents
D. Mataix Cols
Obsessive–compulsive disorder (OCD) often starts in childhood and
adolescence and can be a chronic disorder with high persistence rates. There
are few prospective long-term follow-up studies.
To follow up young people with OCD to clarify persistence rates and
relevant predictors, presence of other psychiatric disorders, functional
impairment, service utilisation and perceived treatment needs.
All young people with OCD assessed over 9 years at the National and
Specialist Paediatric OCD clinic, Maudsley Hospital, London, were included.
Sixty-one per cent (142 of 222) of all contactable young people and parents
completed computerised diagnostic interviews and questionnaires.
We found a persistence rate of OCD of 41%; 40% of participants had a
psychiatric diagnosis other than OCD at follow-up. The main predictor for
persistent OCD was duration of illness at assessment. High levels of baseline
psychopathology predicted other psychiatric disorders at follow-up. Functional
impairment and quality of life were mildly to moderately affected.
Approximately 50% of participants were still receiving treatment and about 50%
felt a need for further treatment.
This study confirms that paediatric OCD can be a chronic condition that
persists into adulthood. Early recognition and treatment might prevent
chronicity. Important challenges for services are ensuring adequate treatment
and a smooth transition from child to adult services.