Obsessive-Compulsive Spectrum Symptoms Are Associated With Functional Impairment in Children and Adolescents With Psychosis Risk Syndrome

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Objective: To compare clinical and functional variables among 3 groups of children and adolescents: subjects at clinical high risk for psychosis (CHR-P) who also have obsessive-compulsive symptoms (OCS), CHR-P patients without OCS, and healthy controls (HC).Methods: A total of 128 CHR-P patients and 98 HC between the ages of 10 and 17 years were recruited as part of a multicenter prospective longitudinal study conducted in Spain between January 1, 2011, and December 31, 2018, with diagnoses made for CHR-P using the Scale of Prodromal Symptoms (SOPS).Two groups were obtained based on Leyton Obsessional Inventory-Child Version (LOI-CV) scores: 64 CHR-P patients with OCS (OCS+) and 64 CHR-P patients without OCS (OCS-).Clinical variables were analyzed with a generalized linear model.Results: Overall, 128 CHR-P patients, 64 (50%) with OCS (mean ± SD age = 15.5 ± 1.4 years, 34.4% male), 64 CHR-P patients without OCS (mean ± SD age = 15.1 ± 1.9 years, 34.4% male), and 98 HC (mean ± SD age = 15.5 ± 1.5 years, 42.9% male), of whom 19 (19.5%) had OCS, were included.Generalized linear model analysis revealed significant differences between the groups.The OCS+ group showed more severe prodromal symptoms (P = .007),worse functioning at baseline (P = .044)and during the previous year (P = .004),and more dysmorphophobic symptoms (P < .001)compared to the OCSgroup.OCS+ patients were also more frequently treated with antidepressants (P = .004)than were OCS-patients. Conclusions:In our sample, among children and adolescents with CHR-P, the prevalence of OCS was high (50%).OCS+ subjects had a more severe clinical and functional profile than OCS-subjects.Early detection and treatment of these symptoms can lead to better outcomes for these patients.

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