The influence of age at onset and duration of illness on long-term outcome in patients with obsessive-compulsive disorder: a report from the International College of Obsessive Compulsive Spectrum Disorders (ICOCS)

Eur Neuropsychopharmacol. 2013 Aug;23(8):865-71. doi: 10.1016/j.euroneuro.2013.05.004. Epub 2013 Jun 21.

Abstract

Several studies reported a negative effect of early onset and long duration of illness on long-term outcome in psychiatric disorders, including Obsessive-Compulsive Disorder (OCD). OCD is a prevalent, comorbid and disabling condition, associated with reduced quality of life and overall well-being for affected patients and related caregivers. The present multicenter naturalistic study sought to assess the influence of early onset and duration of illness on long-term outcome in a sample of 376 OCD out-patients worldwide, as part of the "International College of Obsessive-Compulsive Spectrum Disorders" (ICOCS) network. Binary logistic regressions were performed with age at the onset and duration of illness, as continuous independent variables, on a series of different outcome dependent variables, including lifetime number of hospitalizations and suicide attempts, poly-therapy and psychiatric comorbidity. Correlations in terms of disability (SDS) were analyzed as well. Results showed that a longer duration of illness (but not earlier age of onset) was associated with hospitalization (odds ratio=1.03, p=0.01), earlier age at onset with CBT (odds ratio=0.94, p<0.001) and both a later age at onset (odds ratio=1.05, p=0.02) and a shorter duration of illness (odds ratio=0.93, p=0.02) with panic disorder comorbidity. In addition, earlier age at onset inversely correlated with higher social disability (r=-0.12, p=0.048) and longer duration of illness directly correlated with higher disability in work, social and family life (r=0.14, p=0.017; r=0.13, p=0.035; r=0.14, p=0.02). The findings from the present large, multicenter study indicate early onset and long duration of illness as overall negative predictors of long-term outcome in OCD.

Keywords: Duration of illness; Early onset; Long-term outcome; Obsessive compulsive disorder (OCD).

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Age of Onset
  • Aging*
  • Chronic Disease
  • Cognitive Behavioral Therapy
  • Comorbidity
  • Electronic Health Records
  • Female
  • Humans
  • Male
  • Mental Disorders / epidemiology
  • Middle Aged
  • Obsessive-Compulsive Disorder / diagnosis*
  • Obsessive-Compulsive Disorder / epidemiology
  • Obsessive-Compulsive Disorder / therapy
  • Prognosis
  • Psychiatric Status Rating Scales
  • Psychotherapy
  • Remission Induction
  • Retrospective Studies
  • Societies, Medical