Skip to main content
SpringerLink
Log in

Exploring latent clusters in pediatric OCD based on symptoms, severity, age, gender, and comorbidity

  • Original Contribution
  • Published:
European Child & Adolescent Psychiatry Aims and scope Submit manuscript

Abstract

Given diverse symptom expression and high rates of comorbid conditions, the present study explored underlying commonalities among OCD-affected children and adolescents to better conceptualize disorder presentation and associated features. Data from 830 OCD-affected participants presenting to OCD specialty centers was aggregated. Dependent mixture modeling was used to examine latent clusters based on their age- and gender adjusted symptom severity (as measured by the Children’s Yale-Brown Obsessive-Compulsive Scale; CY-BOCS), symptom type (as measured by factor scores calculated from the CY-BOCS symptom checklist), and comorbid diagnoses (as assessed via diagnostic interviews). Fit statistics favored a four-cluster model with groups distinguished primarily by symptom expression and comorbidity type. Fit indices for 3–7 cluster models were only marginally different and characteristics of the clusters remained largely stable between solutions with small clusters of distinct presentations added in more complex models. Rather than identifying a single classification system, the findings support the utility of integrating dimensional, developmental, and transdiagnostic information in the conceptualization of OCD-affected children and adolescents. Identified clusters point to the centrality of contamination concerns to OCD, relationships between broader symptom expression and higher levels of comorbidity, and the potential for complex/neurodevelopmental presentations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Fawcett EJ, Power H, Fawcett JM (2020) Women are at greater risk of OCD than men: a meta-analytic review of OCD prevalence worldwide. J Clin Psychiatr. https://doi.org/10.4088/JCP.19r13085

    Article  Google Scholar 

  2. Anholt GE et al (2014) Age of onset in obsessive-compulsive disorder: admixture analysis with a large sample. Psychol Med 44(1):185–194

    Article  CAS  PubMed  Google Scholar 

  3. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5(TM)). American Psychiatric Publishing, Arlington

    Book  Google Scholar 

  4. Nakatani E et al (2011) Children with very early onset obsessive-compulsive disorder: clinical features and treatment outcome. J Child Psychol Psychiatr 52(12):1261–1268

    Article  Google Scholar 

  5. Selles RR, Storch EA, Lewin AB (2014) Variations in symptom prevalence and clinical correlates in younger versus older youth with obsessive-compulsive disorder. Child Psychiatr Hum Dev 45(6):666–674

    Article  Google Scholar 

  6. Smarason O et al (2022) Age differences in children with obsessive-compulsive disorder: symptoms, comorbidity, severity and impairment. Nord J Psychiatr. https://doi.org/10.1080/08039488.2021.2019917

    Article  Google Scholar 

  7. Højgaard DRMA et al (2018) Symptom Dimensions and Clinical Correlates of OCD in a Large Sample of Children and Adolescents. In: Højgaard DRMA (ed) 65th annual meeting. The American Academy of Child and Adolescent Psychiatry, Seattle

    Google Scholar 

  8. Nestadt G et al (2009) Obsessive-compulsive disorder: subclassification based on co-morbidity. Psychol Med 39(9):1491–1501

    Article  CAS  PubMed  Google Scholar 

  9. Højgaard DRMA et al (2018) Obsessive-compulsive symptom dimensions: Association with comorbidity profiles and cognitive-behavioral therapy outcome in pediatric obsessive-compulsive disorder. Psychiatr Res 270:317–323

    Article  Google Scholar 

  10. Selles RR et al (2018) Symptom insight in pediatric obsessive-compulsive disorder: outcomes of an international aggregated cross-sectional sample. J Am Acad Child Adolesc Psychiatr 57(8):615–619

    Article  Google Scholar 

  11. Krueger RF, Markon KE (2006) Understanding psychopathology: melding behavior genetics, personality, and quantitative psychology to develop an empirically based model. Curr Dir Psychol Sci 15(3):113–117

    Article  PubMed  PubMed Central  Google Scholar 

  12. Gillan CM, Fineberg NA, Robbins TW (2017) A trans-diagnostic perspective on obsessive-compulsive disorder. Psychol Med 47(9):1528–1548

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Scahill L et al (1997) Children’s yale-brown obsessive compulsive scale: reliability and validity. J Am Acad Child Adolesc Psychiatr 36(6):844–852

    Article  CAS  Google Scholar 

  14. Bernstein GA et al (2013) Pediatric obsessive–compulsive disorder: Symptom patterns and confirmatory factor analysis. J Obsess Compuls Relat Disord 2(3):299–305

    Article  Google Scholar 

  15. Bloch MH et al (2008) Meta-analysis of the symptom structure of obsessive-compulsive disorder. Am J Psychiatr 165(12):1532–1542

    Article  PubMed  Google Scholar 

  16. Højgaard DRMA et al (2017) Structure and clinical correlates of obsessive-compulsive symptoms in a large sample of children and adolescents: a factor analytic study across five nations. Eur Child Adolesc Psychiatr 26(3):281–291

    Article  Google Scholar 

  17. Stewart SE et al (2008) Four-factor structure of obsessive-compulsive disorder symptoms in children, adolescents, and adults. J Am Acad Child Adolesc Psychiatr 47(7):763–772

    Article  Google Scholar 

  18. Petersen KJ, Qualter P, Humphrey N (2019) The application of latent class analysis for investigating population child mental health: a systematic review. Front Psychol 10:1214

    Article  PubMed  PubMed Central  Google Scholar 

  19. Molenaar PCM, von Eye A (1994) On the arbitrary nature of latent variables. In: von Eye A, Clogg CC (eds) Latent variables analysis: Applications for developmental research. Sage Publications, Inc., Thousand Oaks, CA, pp 226–242

    Google Scholar 

  20. Van Lissa CJ, Garnier-Villarreal M, Anadria D (2023) Recommended practices in latent class analysis using the open-source R-package tidySEM. Struct Equat Model Multidiscip J. https://doi.org/10.1080/10705511.2023.2250920

    Article  Google Scholar 

  21. Delucchi KL et al (2011) Latent class analysis of the yale-brown obsessive-compulsive scale symptoms in obsessive-compulsive disorder. Compr Psychiatr 52(3):334–341

    Article  Google Scholar 

  22. Atli A et al (2014) Latent class analysis of obsessive-compulsive symptoms in a clinical sample. Compr Psychiatr 55(3):604–612

    Article  Google Scholar 

  23. Nestadt G et al (2003) The identification of OCD-related subgroups based on comorbidity. Biol Psychiatr 53(10):914–920

    Article  Google Scholar 

  24. Hybel KA et al (2017) Symptom profiles and executive function in childhood obsessive-compulsive disorder. J Obsess-Compu Relat Disord 14:36–46

    Article  Google Scholar 

  25. Ivarsson T, Valderhaug R (2006) Symptom patterns in children and adolescents with obsessive-compulsive disorder (OCD). Behav Res Ther 44(8):1105–1116

    Article  PubMed  Google Scholar 

  26. Torp NC et al (2015) Effectiveness of cognitive behavior treatment for pediatric obsessive-compulsive disorder: acute outcomes from the nordic long-term OCD treatment study (NordLOTS). Behav Res Ther 64:15–23

    Article  PubMed  Google Scholar 

  27. Melin K et al (2015) Treatment and 12 month outcome of children and adolescents with obsessive-compulsive disorder: a naturalistic study. J Obsess-Compu Relat Disord 6:1–6

    Article  Google Scholar 

  28. Storch EA et al (2016) Efficacy of augmentation of cognitive behavior therapy with weight-adjusted d-cycloserine vs placebo in pediatric obsessive-compulsive disorder: a randomized clinical trial. JAMA Psychiat 73(8):779–788

    Article  Google Scholar 

  29. Stewart SE et al (2017) A multisite study of family functioning impairment in pediatric obsessive-compulsive disorder. J Am Acad Child Adolesc Psychiatr 56(3):241–249

    Article  Google Scholar 

  30. Farrell L et al (2022) Efficacy of D-cycloserine augmented brief intensive cognitive-behavioural therapy for paediatric obsessive-compulsive disorder: a randomised clinical trial. Depress Anxiety 39(6):461–473

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Kaufman J et al (1997) Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatr 36(7):980–988

    Article  CAS  Google Scholar 

  32. Silverman WK, Albano AM (1996) The anxiety disorders interview schedule for children and parents— DSM-IV version. Graywind, New York

    Google Scholar 

  33. Storch EA et al (2004) Psychometric evaluation of the children’s yale-brown obsessive-compulsive scale. Psychiatr Res 129(1):91–98

    Article  Google Scholar 

  34. Piacentini J et al (2003) Functional impairment in children and adolescents with obsessive-compulsive disorder. J Child Adolesc Psychopharmacol 13(Suppl 1):S61–S69

    Article  PubMed  Google Scholar 

  35. Piacentini J et al (2007) Functional impairment in childhood OCD: development and psychometrics properties of the child obsessive-compulsive impact scale-revised (COIS-R). J Clin Child Adolesc Psychol 36(4):645–653

    Article  PubMed  Google Scholar 

  36. Calvocoressi L et al (1999) Family accommodation of obsessive-compulsive symptoms: instrument development and assessment of family behavior. J Nerv Ment Dis 187(10):636–642

    Article  CAS  PubMed  Google Scholar 

  37. Flessner CA et al (2011) Predictors of parental accommodation in pediatric obsessive-compulsive disorder: findings from the pediatric obsessive-compulsive disorder treatment study (POTS) trial. J Am Acad Child Adolesc Psychiatr 50(7):716–725

    Article  Google Scholar 

  38. Pinto A, Van Noppen B, Calvocoressi L (2013) Development and preliminary psychometric evaluation of a self-rated version of the family accommodation scale for obsessive-compulsive disorder. J Obsess Compuls Relat Disord 2(4):457–465

    Article  Google Scholar 

  39. Muthén LK, Muthén BO (1998) Mplus user´s guide, 8th edn. Muthén & Muthén, Los Angeles

    Google Scholar 

  40. Satorra A, Bentler PM (2001) A scaled difference chi-square test statistic for moment structure analysis. Psychometrika 66(4):507–514

    Article  Google Scholar 

  41. Rosseel Y (2012) lavaan: an R package for structural equation modeling. J Stat Softw 48(2):1–36

    Article  Google Scholar 

  42. Visser I, Speekenbrink M (2010) depmixS4: an R package for hidden markov models. J Stat Softw 36(7):1–21

    Article  Google Scholar 

  43. Masyn KE (2013) Latent class analysis and finite mixture modeling. In: Little TD (ed) The oxford handbook of quantitative methods. Oxford University Press, pp 551–611

    Google Scholar 

  44. Nylund KL, Asparoutiov T, Muthen BO (2007) Deciding on the number of classes in latent class analysis and growth mixture modeling: A Monte Carlo simulation study. Struct Equ Model Multidiscip J 14(4):535–569

    Article  Google Scholar 

  45. Nylund-Gibson K (2018) Ten frequently asked questions about latent class analysis. Transl Issu Psychol Sci. https://doi.org/10.1037/tps0000176

    Article  Google Scholar 

  46. Howard MC (2016) A review of exploratory factor analysis decisions and overview of current practices: what we are doing and how can we improve? Int J Hum-Comput Interact 32(1):51–62

    Article  Google Scholar 

  47. Cervin M et al (2020) Incompleteness, harm avoidance, and disgust: a comparison of youth with OCD, anxiety disorders, and no psychiatric disorder. J Anxiety Disord 69:102175

    Article  PubMed  Google Scholar 

  48. Cervin M et al (2021) Involvement of fear, incompleteness, and disgust during symptoms of pediatric obsessive-compulsive disorder. Eur Child Adolesc Psychiatr 30(2):271–281

    Article  Google Scholar 

  49. Torres AR et al (2013) Clinical features of pure obsessive-compulsive disorder. Compr Psychiatr 54(7):1042–1052

    Article  Google Scholar 

  50. Højgaard DRMA et al (2017) Pediatric obsessive-compulsive disorder with tic symptoms: clinical presentation and treatment outcome. Eur Child Adolesc Psychiatr 26(6):681–689

    Article  Google Scholar 

  51. Leckman JF et al (1997) Symptoms of obsessive-compulsive disorder. Am J Psychiatr 154(7):911–917

    Article  CAS  PubMed  Google Scholar 

  52. Storch EA et al (2008) Obsessive-compulsive disorder in youth with and without a chronic tic disorder. Depress Anxiety 25(9):761–767

    Article  PubMed  Google Scholar 

  53. Caporino NE, Storch EA (2016) Personalizing the treatment of pediatric obsessive-compulsive disorder: evidence for predictors and moderators of treatment outcomes. Curr Behav Neurosci Rep 3(1):73–85

    Article  Google Scholar 

  54. Ginsburg GS et al (2008) Predictors of treatment response in pediatric obsessive-compulsive disorder. J Am Acad Child Adolesc Psychiatr 47(8):868–878

    Article  Google Scholar 

  55. Cervin M et al (2022) Cognitive beliefs across the symptom dimensions of pediatric obsessive-compulsive disorder: type of symptom matters. Behav Ther 53(2):240–254

    Article  PubMed  Google Scholar 

  56. Abramowitz JS et al (2003) Symptom presentation and outcome of cognitive-behavioral therapy for obsessive-compulsive disorder. J Consult Clin Psychol 71(6):1049–1057

    Article  PubMed  Google Scholar 

  57. Mataix-Cols D et al (2002) Obsessive-compulsive symptom dimensions as predictors of compliance with and response to behaviour therapy: results from a controlled trial. Psychother Psychosom 71(5):255–262

    Article  PubMed  Google Scholar 

  58. Storch EA et al (2008) Impact of comorbidity on cognitive-behavioral therapy response in pediatric obsessive-compulsive disorder. J Am Acad Child Adolesc Psychiatr 47(5):583–592

    Article  Google Scholar 

  59. Leckman JF, Bloch MH, King RA (2009) Symptom dimensions and subtypes of obsessive-compulsive disorder: a developmental perspective. Dialog Clin Neurosci 11(1):21–33

    Article  Google Scholar 

  60. Nylund-Gibson K, Masyn KE (2016) Covariates and mixture modeling: results of a simulation study exploring the impact of misspecified effects on class enumeration. Struct Equ Model Multidiscip J 23(6):782–797

    Article  Google Scholar 

  61. Abramovitch A, De Nadai AS, Geller DA (2021) Neurocognitive endophenotypes in pediatric OCD probands, their unaffected parents and siblings. Prog Neuropsychopharmacol Biol Psychiatr 110:110283

    Article  Google Scholar 

  62. Geller DA et al (2018) Neurocognitive function in paediatric obsessive-compulsive disorder. W J Biol Psychiatr 19(2):142–151

    Article  Google Scholar 

  63. McGuire JF et al (2016) Fear conditioning and extinction in youth with obsessive-compulsive disorder. Depress Anxiety 33(3):229–237

    Article  PubMed  PubMed Central  Google Scholar 

  64. Negreiros J et al (2020) Neurocognitive risk markers in pediatric obsessive-compulsive disorder. J Child Psychol Psychiatr 61(5):605–613

    Article  Google Scholar 

Download references

Funding

This work was supported by fellowships to Dr. Selles from the BC Children’s Hospital Research Institute and the Michael Smith Foundation for Health Research (MSFHR: #17821). In addition, the original studies from which data were aggregated in the present study report the following funding: The DCS-CBT study was supported by grants from the National Institute of Mental Health (NIMH) to Drs. Storch (1R01MH093381) and Geller (5R01MH093402). The Griffith program received funding from the National Health and Medical Research Council (NHMRC), Foundation for Children, and Rotary Foundation. Nord-LOTS was supported by the TrygFonden, Danish Council for Strategic Research, Pulje til styrkelse af psykiatrisk Forskning i Region Midtjylland, Center for Child and Adolescent Mental Health, Eastern and Southern Norway, Stiftelsen Clas Groschinskys Minnesfond, and Norwegian Research Council, Helse and Rehabilitering, Norge. UBC-POP was supported by MSFHR and the British Columbia Provincial Health Services Administration. Sahlgrenska University Hospital OCD Outpatient Clinic – GBG study was supported by the Agreement concerning research and education of doctors – Region Vestra Götaland, the Claes Groschinky Memorial Fund and the Iris Jonzén-Sandblom and Greta Jonzén´s Foundation. The funding organizations were not involved in the design or conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, and approval of the manuscript. The opinions expressed within the present study are those of the authors and do not necessarily reflect those of the funding organizations.

Author information

Authors and Affiliations

  1. Faculty of Psychology, University of Iceland, Reykjavik, Iceland

    Orri Smárason & Gudmundur Skarphedinsson

  2. Department of Child and Adolescent Psychiatry, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland

    Orri Smárason

  3. University of British Columbia, Vancouver, BC, Canada

    Robert R. Selles, John R. Best & S. Evelyn Stewart

  4. BC Children’s Hospital, Vancouver, BC, Canada

    Robert R. Selles, John R. Best & S. Evelyn Stewart

  5. Department of Child and Adolescent Psychiatry, Aarhus University Hospital, Psychiatry, Denmark

    Davíð R. M. A. Højgaard & Per Hove Thomsen

  6. Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Karin Melin

  7. University of Gothenburg, Gothenburg, Sweden

    Tord Ivarsson

  8. Regional Center for Child Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway

    Bernhard Weidle

  9. St. Olavs University Hospital, Trondheim, Norway

    Bernhard Weidle

  10. Embedded Preventive Behavioral Health Capability, III MEF, United States Marine Corps, Okinawa, Japan

    Nicole Michelle McBride

  11. Baylor College of Medicine, Houston, TX, USA

    Eric A. Storch

  12. Harvard Medical School, Boston, MA, USA

    Daniel Geller & Sabine Wilhelm

  13. Massachusetts General Hospital, Boston, MA, USA

    Daniel Geller & Sabine Wilhelm

  14. Griffith University, Queensland, Australia

    Lara J. Farrell, Allison M. Waters & Sharna Mathieu

  15. St. Joseph’s Hospital, Hamilton, ON, Canada

    Noam Soreni

  16. McMaster University, Hamilton, ON, Canada

    Noam Soreni

  17. BC Mental Health and Substance Use Services, Burnaby, BC, Canada

    S. Evelyn Stewart

  18. Region Västra Götaland, Department of Child and Adolescent Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden

    Karin Melin

Authors
  1. Orri Smárason
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Robert R. Selles
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Davíð R. M. A. Højgaard
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. John R. Best
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Karin Melin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tord Ivarsson
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Per Hove Thomsen
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Bernhard Weidle
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Nicole Michelle McBride
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Eric A. Storch
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Daniel Geller
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Sabine Wilhelm
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Lara J. Farrell
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Allison M. Waters
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Sharna Mathieu
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Noam Soreni
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. S. Evelyn Stewart
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. Gudmundur Skarphedinsson
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Drs. Smárason, Skarphedinsson and Højgaard had full access to the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: Selles, Best, Stewart, Højgaard, Smárason & Skarphedinsson. Acquisition, analysis, or interpretation of data: all authors. Drafting of the manuscript: Smárason, Selles, Best, Skarphedinsson and Højgaard. Critical revision of the manuscript for important intellectual content: all authors. Administrative, technical, or material support: Selles, Stewart. Study supervision: Selles, Stewart, Smárason, Højgaard and Skarphedinsson.

Corresponding author

Correspondence to Orri Smárason.

Ethics declarations

Conflict of interest

Dr. Selles has served as a consultant and Scientific Advisory Committee Member for AnxietyCanada. Dr. Thomsen has served on the Advisory Board for the Tryg Foundation and has received speaking honoraria from Medice and Shire within the last three years. Dr. Storch has received research support from the National Institutes of Health (NIH), the Agency for Healthcare Research and Quality, the International OCD Foundation, the Ream Foundation, Greater Houston Community Foundation, and the Texas Higher Education Coordinating Board. He has received royalties from Elsevier Publications, Springer Publications, American Psychological Association, Wiley, Inc, and Lawrence Erlbaum. He has served on the Speaker’s Bureau and Scientific Advisory Board for the International OCD Foundation. He is a consultant for Biohaven and Brainsway. He has received research support from the McIngvale Presidential Endowed Chair. Dr. Geller has received grant support from NIH, book honorarium from the American Academy of Child and Adolescent Psychiatry, and speaking honoraria for Advanced Institute lectures from the American Academy of Child and Adolescent Psychiatry and Massachusetts General Hospital Psychiatry Academy in educational programs supported through independent medical education grants from pharmaceutical companies. He has received funding from Neurocrine Bioscience and Biohaven Pharmaceuticals. Dr. Wilhelm has received grant support from NIH, International OCD Foundation and the Tourette Association of America. She is a presenter for the Massachusetts General Hospital Psychiatry Academy in educational programs supported through independent medical education grants from pharmaceutical companies; she has received royalties from Elsevier Publications, Guilford Publications, New Harbinger Publications, Springer, and Oxford University Press. Dr. Wilhelm has also received speaking honoraria from various academic institutions and foundations, including the International OCD Foundation, Tourette Association of America, and Brattleboro Retreat. In addition, she received payments from the Association for Behavioral and Cognitive Therapies for her role as Associate Editor for the Behavior Therapy journal, as well as from John Wiley & Sons, Inc. for her role as Associate Editor on the journal Depression & Anxiety. Dr. Wilhelm has also received honoraria from One-Mind for her role in PsyberGuide Scientific Advisory Board. Dr. Wilhelm is also on the Scientific Advisory Board for Koa Health and Noom. Dr. Wilhelm has received salary support from Novartis and research support from Koa Health. Dr. Soreni has received grants and research funding from the Canadian Institutes of Health Research, HAHSO Hamilton and the Ontario Brain Institute. Dr. Soreni has been the recipient of an investigator-initiated operating grant from Lundbeck, LLC. He has served on the scientific committee of the Anxiety and Depression Association of America. Dr. Stewart has received grants and research funding from the Anxiety Disorders Association of America, the Canadian Institutes of Health Research, the American Academy of Child and Adolescent Psychiatry, and the Michael Smith Foundation for Health Research. She has received honoraria from Aarhus University for service as an external examiner as well as speaking honoraria from Yale University and from the National Institutes of Mental Health and Neurosciences. She has served as a member of the Scientific and Clinical Advisory Board of the International OCD Foundation and the Scientific Advisory Board of AnxietyCanada. Drs. Skarphedinsson, Højgaard, Ivarsson, Farrell, Waters, Mathieu, Soreni, McBride and Smárason report no biomedical financial interests or potential conflicts of interest.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 83 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Smárason, O., Selles, R.R., Højgaard, D.R.M.A. et al. Exploring latent clusters in pediatric OCD based on symptoms, severity, age, gender, and comorbidity. Eur Child Adolesc Psychiatry (2024). https://doi.org/10.1007/s00787-024-02431-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00787-024-02431-9

Keywords

Search

Navigation