Adults with early-onset obsessive-compulsive disorder

Objective: Obsessive-compulsive disorder (OCD) is a clinically heterogeneou s disorder with a bimodal age at onset and range of treatment outcomes. Thi s study attempted to ascertain the importance of the age at OCD symptom ons et for a better phenotypic precision. Therefore, the authors compared adult OCD patients with an early symptom onset to OCD patients with a later symp tom onset. Method: Forty-two adult outpatients with OCD were evaluated with semistruct ured interviews: 21 with symptom onset before the age of 10 (early-onset gr oup) and 21 with symptom onset after the age of 17 (late-onset group). Results: Early onset was associated with higher scores on the Yale-Brown Ob sessive Compulsive Scale, higher frequencies of tic-like compulsions, highe r frequency of sensory phenomena, and a higher rate of comorbid tic disorde rs. The early-onset group also responded less well to treatment with clomip ramine and selective serotonin reuptake inhibitors. Conclusions: The results indicate that age at onset may be an important fac tor in subtyping OCD and that the phenotypic differences found were not res tricted to childhood.