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Psychotic Vulnerability and its Associations with Clinical Characteristics in Adolescents with Obsessive-Compulsive Disorder

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Abstract

Compared to peers, children and adolescents with obsessive-compulsive disorder (OCD) are at increased risk of developing psychotic disorders. Yet very few studies have examined early indicators of psychosis in pediatric OCD. In the present study, 52 youth with a primary diagnosis of OCD (Mage = 15.66 [SD = 2.33], 59.6% girls) were interviewed using the Schizophrenia Proneness Instrument Child and Adolescent version (SPI-CY), which is a comprehensive clinical interview assessing both Cognitive–Perceptual basic symptoms (COPER) and high-risk criterion Cognitive Disturbances (COGDIS). Associations between COPER/COGDIS symptoms and demographic and clinical characteristics were examined. Findings showed that COPER or COGDIS symptoms were present in 44% of participants, with no significant difference between girls and boys. Psychotic vulnerability was associated with an earlier age of OCD onset, greater OCD severity, poorer insight, and more contamination/cleaning symptoms. Psychotic vulnerability was also strongly associated with worse psychosocial functioning. Findings suggest that early indicators of psychosis are frequent in pediatric OCD and associated with more severe OCD and poorer functioning. Research examining how psychotic vulnerability is associated with short- and long-term outcomes for youth with OCD is needed.

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Data Availability

The data that support the findings of this study are available from the corresponding author, DFB, upon reasonable request.

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Funding

This research received no specific grant from any funding agency, commercial or not-for-profit sectors. The authors have no competing interests to declare that are relevant to the content of this article.

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Authors and Affiliations

  1. Department of Medicine and Surgery, Unit of Neuroscience, University of Parma Ospedale Maggiore, Padiglione Braga Viale A. Gramsci 14, Parma, 43126, Italy

    Davide Fausto Borrelli, Carlo Marchesi & Matteo Tonna

  2. Department of Clinical Sciences Lund, Lund University, Sofiavägen 2D, SE-22241, Lund, Sweden

    Matti Cervin

  3. Department of Mental Health, Local Health Service, Parma, Italy

    Rebecca Ottoni, Carlo Marchesi & Matteo Tonna

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  1. Davide Fausto Borrelli
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  2. Matti Cervin
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  3. Rebecca Ottoni
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  4. Carlo Marchesi
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  5. Matteo Tonna
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Contributions

DFB and RO conceived the idea, selected the patients, and collected the data. DFB and MC conducted the statistical analyses and the literature searches and wrote the first manuscript. DFB designed the study and administered the CY-BOCS and SPI-CY scales to patients. CM and MT supervised the study and edited the manuscript. All authors contributed to the article and approved the submitted version.

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Correspondence to Davide Fausto Borrelli.

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Borrelli, D.F., Cervin, M., Ottoni, R. et al. Psychotic Vulnerability and its Associations with Clinical Characteristics in Adolescents with Obsessive-Compulsive Disorder. Res Child Adolesc Psychopathol 51, 1535–1548 (2023). https://doi.org/10.1007/s10802-023-01089-2

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