Clinical correlates of obsessive compulsive disorder in children and adolescents referred to specialized and non-specialized clinical settings

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.