D. Geller et al., Clinical correlates of obsessive compulsive disorder in children and adolescents referred to specialized and non-specialized clinical settings, DEPRESS ANX, 11(4), 2000, pp. 163-168
The objective of this study was to assess the extent of referral bias by co
mparing children and adolescents with Obsessive Compulsive Disorder (OCD) a
scertained through a specialized pediatric OCD and a general child psychiat
ry clinic. Subjects were juveniles meeting DSM-III-R and DSM IV criteria fo
r OCD referred to a general pediatric psychopharmacology clinic and to a sp
ecialized OCD clinic within the same academic medical center. Subjects were
evaluated clinically and with structured diagnostic interviews using the K
iddie SADS-E. OCD was identified in 8.6% of the general psychiatry clinic s
ubjects. The only differences between ascertainment sources in clinical or
sociodemographic characteristics of OCD subjects were higher rates of socia
l phobia and ADHD in the non-specialized clinic, while specialty clinic sub
jects had a greater lifetime severity of OCD and were more likely to have r
eceived treatment of their OCD. Because we found limited evidence for refer
ral biases, oar results suggest that findings from studies using either of
these sources may generalize to the other. It also suggests that pooling su
bjects from the two sources is justified. Nevertheless, because some group
differences did emerge, researchers should acknowledge referral bias as a p
otential limitation of their work. (C) 2000 Wiley-Liss, Inc.