Long-term outcome and prognosis of obsessive-compulsive disorder with onset in childhood or adolescence

The aim of the catch-up follow-up study is to describe the long-term outcom e of obsessive-compulsive disorder (OCD) with onset in childhood and adoles cence. The psychiatric morbidity in adulthood including personality disorde rs was assessed and predictors in childhood for the course of obsessive-com pulsive symptoms were examined. The total study group consisted of the enti re patient population treated for OCD at our departments for child and adol escent psychiatry between 1980 and 1991. We reassessed 55 patients personal ly by way of structured interviews. The mean age of onset of OCD was 12.5 y ears and the mean follow-up time was 11.2 years. At the follow-up investiga tion 71% of the patients met the criteria for some form of psychiatric diso rder, while 36% were still suffering from OCD. Of the patients with a prese nt diagnosis of OCD 70% had at least one further clinical disorder (especia lly anxiety and affective disorders). The most frequent personality disorde rs diagnosed were obsessive-compulsive (25.5%), avoidant (21.8%), and paran oid (12.7%) personality disorders. In-patient treatment, terminating treatm ent against advice and ties in childhood or adolescence significantly corre lated with more severe OC symptoms in adulthood.