Early versus late onset obsessive–compulsive disorder: Evidence for distinct subtypes
Highlights
►Diagnostic subtyping is important for understanding OCD. ► Evidence is presented to support the distinction between early and late onset OCD. ► Empirically derived age cutoffs are presented for distinguishing the two groups. ► The groups differ in gender distribution, severity, comorbidity, and family history ► Implications for DSM-V are discussed.
Section snippets
Method
Relevant studies were those of OCD or OC symptoms as defined by contemporary criteria: That is, the third or later editions of the Diagnostic and Statistical Manual of Mental Disorders. Empirical investigations of the age-of-onset of OCD or OC symptoms were identified by systematically searching MEDLINE, PubMed, PsychINFO, and EMBASE. Each of these databases was searched because they are not entirely overlapping (Lefebvre, Manheimer, & Glanville, 2008). Search terms used in various combinations
Are EO and LO distinct classes?
Figure A1 of the Appendix (available online at https://docs.google.com/leaf?id=0BwjbsLVRwm37NjYyNmRkMzItYTVhNS00ZGE3LWI4YjUtMTIwMzdkNjg2MDE4&hl=en_GB) shows the nine previously published histograms included in the latent class analyses in the present review. All the histograms were based on clinical samples, except for Bland, Newman, and Orn (1988), which was based on a community sample. A tenth histogram (Rasmussen & Eisen, 1998) was not included because its tails were truncated; that is, it
Summary of major findings
The present review set out to address questions about whether EO and LO can be reliably distinguished and whether they differ in terms of demographic, clinical, and other variables relevant to understanding the etiology of OCD. Latent class analyses indicated that age-of-onset is best represented as forming two groups; EO (mean onset 11 years) and LO (mean onset 23 years). This result was replicated across datasets, yielding similar cutoffs for distinguishing the two groups. This suggests that EO
References (166)
- et al.
Wisconsin Cart Sorting Test performance in obsessive–compulsive disorder: No evidence for involvement of dorsolateral prefrontal cortex
Psychiatry Research
(1995) - et al.
The role of cognitive factors in the pathogenesis of obsessive–compulsive symptoms: A prospective study
Behaviour Research and Therapy
(2006) - et al.
The cognitive mediation of obsessive–compulsive symptoms: A longitudinal study
Journal of Anxiety Disorders
(2007) - et al.
Obsessive–compulsive disorder
The Lancet
(2009) - et al.
Extensive genotyping of the BDNF and NTRK2 genes define protective haplotypes against obsessive–compulsive disorder
Biological Psychiatry
(2008) - et al.
Neuropsychological performance in children and adolescents with obsessive–compulsive disorder and influence of clinical variables
Biological Psychiatry
(2007) - et al.
Psychiatric disorders in the families of patients with obsessive–compulsive disorder
Psychiatry Research
(1992) - et al.
Dimensional, categorical, or dimensional-categories: Testing the latent structure of anxiety sensitivity using factor-mixture modeling among adults
Behavior Therapy
(2010) - et al.
Clinical course of Tourette syndrome
Journal of Psychosomatic Research
(2009) - et al.
Predicting outcome of treatment for severe, treatment resistant OCD in inpatient and community settings
Journal of Behavior Therapy and Experimental Psychiatry
(2010)
Regional cerebral blood flow abnormalities in early-onset obsessive–compulsive disorder: An exploratory SPECT study
Journal of the American Academy of Child and Adolescent Psychiatry
Obsessive–compulsive disorder subtypes: An attempted replication and an extension of a symptom-based taxonomy
Behaviour Research and Therapy
Association study between the dopamine receptor D4 gene and obsessive–compulsive disorder
European Neuropsychopharmacology
Obsessive–compulsive disorder: A 3-year prospective follow-up of patients treated with serotonin reuptake inhibitors
Journal of Psychiatric Research
OCD comorbid with OCPD: A subtype of OCD?
Journal of Psychiatric Research
Association between serotonergic candidate genes and specific phenotypes of obsessive compulsive disorder
Journal of Affective Disorders
Association between the dopamine D2 receptor Taq1 allele and low activity COMT allele with obsessive–compulsive disorder in males
European Neuropsychopharmacology
Childhood-onset obsessive compulsive disorder: A tic-related subtype of OCD?
Clinical Psychology Review
Clinical features associated to refractory obsessive–compulsive disorder
Journal of Affective Disorders
Early- and late-onset obsessive–compulsive disorder in adult patients: An exploratory clinical and therapeutic study
Journal of Psychiatric Research
Comorbidity of obsessive–compulsive disorder with obsessive–compulsive personality disorder: Does it imply a specific subtype of obsessive–compulsive disorder?
Psychiatry Research
Antineuronal antibodies in OCD: Comparisons in children with OCD-only, OCD + chronic tics and OCD + PANDAS
Journal of Neuroimmunology
Obsessive–compulsive and spectrum disorders in children and adolescents
Psychiatric Clinics of North America
Is juvenile obsessive–compulsive disorder a developmental subtype of the disorder? A review of the literature
Journal of the American Academy of Child and Adolescent Psychiatry
Brain structure and symptom dimension relationships in obsessive–compulsive disorder: A voxel-based morphometry study
Journal of Affective Disorders
Latent class analysis of Gilles de la Tourette syndrome using comorbidities: Clinical and genetic implications
Biological Psychiatry
Late-onset obsessive–compulsive disorder: Clinical characteristics and psychiatric comorbidity
Psychiatry Research
Neuropsychology of obsessive–compulsive disorder: A review and treatment implications
Clinical Psychology Review
Sequence variants of the brain-derived neurotrophic factor (BDNF) gene are strongly associated with obsessive–compulsive disorder
American Journal of Human Genetics
Age-at-onset in bipolar-I disorder: Mixture analysis of 1369 cases identifies three distinct clinical sub-groups
Journal of Affective Disorders
Early- versus late-onset obsessive–compulsive disorder: Investigating genetic and clinical correlates
Psychiatry Research
The current status of association studies in obsessive–compulsive disorder
Psychiatric Clinics of North America
Delineation of two genetic pathways to major depression
Biological Psychiatry
Medial frontal and dorsal cortical morphometric abnormalities are related to obsessive–compulsive disorder
Neuroscience Letters
Tic disorders
Psychiatric Clinics of North America
Clinical characteristics of response to fluoxetine treatment in obsessive–compulsive disorder
Journal of Clinical Psychopharmacology
Predictors of treatment response in obsessive–compulsive disorder: Multivariate analyses from a multicenter trial of clomipramine
Journal of Clinical Psychopharmacology
Long-term follow-up and predictors of clinical outcome in obsessive–compulsive patients treated with serotonin reuptake inhibitors and behavioral therapy
The Journal of Clinical Psychiatry
Diagnostic and statistical manual of mental disorders
Reporting standards for research in psychology
American Psychologist
Glutamate transporter gene SLC1A1 associated with obsessive–compulsive disorder
Archives of General Psychiatry
Thirty years of Alzheimer's disease genetics: The implications of systematic meta-analyses
Nature Reviews Neuroscience
A family genetic study of clinical subtypes of obsessive–compulsive disorder
Psychiatric Genetics
A family study of obsessive–compulsive disorder
Archives of General Psychiatry
Age of onset of psychiatric disorders
Acta Psychiatrica Scandinavica
Association of the serotonin transporter polymorphism and obsessive–compulsive disorder: Systematic review
American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics
Psychopathology and early experience: A reappraisal of retrospective reports
Psychological Bulletin
Symptom clusters in obsessive–compulsive disorder (OCD): Influence of age and age of onset
European Child & Adolescent Psychiatry
Cited by (208)
Early-onset obsessive-compulsive disorder: Sociodemographic and clinical characterization of a large outpatient cohort
2024, Journal of Psychiatric ResearchMechanisms of pathogenesis and environmental moderators in preclinical models of compulsive-like behaviours
2023, Neurobiology of DiseaseObsessive-Compulsive Disorder: Diagnosis, Clinical Features, Nosology, and Epidemiology
2023, Psychiatric Clinics of North AmericaChildhood Obsessive–Compulsive Disorder
2023, Psychiatric Clinics of North America