INCIDENCE OF OBSESSIVE-COMPULSIVE DISORDER IN A COMMUNITY SAMPLE OF YOUNG ADOLESCENTS

Objective: To investigate the incidence, transition probabilities, and risk factors for obsessive-compulsive disorder (OCD) and subclinical OCD in adolescents. Method: A two-stage epidemiological Study original ly designed to investigate depression was conducted between 1987 and 1 989 in the southeastern United States. For the screening, a self-repor t depressive symptom questionnaire was administered to a community sam ple of 3,283 adolescents. In the diagnostic stage, tile Schedule for A ffective Disorders and Schizophrenia for School-Age Children was admin istered to 488 mother-child pairs. Baseline screening and diagnostic d ata from the first year the subject completed an Interview and follow- up diagnostic data from subsequent years were used. Results: The 1-yea r incidence rates of OCD and subclinical OCD were found to be 0.7% and 8.4%, respectively. Transition probabilities demonstrated a pattern o f moving from more severe to less severe categories. Of those with bas eline OCD, 17% had the diagnosis of OCD at follow-up; 62% moved to the referent group. Of those with baseline subclinical OCD, 1.5% had OCD at follow-up and 75% moved to the referent group. Black race (odds rat io [OR] = 23.38), age (OR = 4.02), desirable life events (OR = 0.78), undesirable life events (OR = 1.21), and socioeconomic status (OR not estimable) were significant predictors of incident OCD. Age (OR = 2.30 ), desirable life events (OR = 0.92), and undesirable life events (OR = 1.13) were significantly associated with incident subclinical OCD. C onclusion: An initial diagnosis of subclinical OCD was not significant ly predictive of a diagnosis of OCD at 1-year follow-up. The overall m orbidity remained higher at follow-up in the baseline OCD group than i n the baseline subclinical OCD group. The baseline subclinical OCD gro up was more dysfunctional at follow-up than was the baseline referent group. Further research concerning differences in symptomatology and i mpairment between OCD and subclinical OCD is warranted.