Clinical presentation and comorbidities of obsessive compulsive disorders in children and adolescents presenting to a tertiary care hospital in Sri Lanka

Abstract

BAKGROUND: Obsessive compulsive disorder (OCD) in children differs from adults in that children do not show ego dystonicity, rarely have pure obsessions and commonly have pure compulsions with hidden obsessions. Comorbid psychiatric diagnoses are seen in more than 50% of children with OCD. AIMS: To describe the socio-demographic factors, clinical presentations and psychiatric comorbidities of children with OCD in a Sri Lanka setting, and to determine the factors associated with comorbidities. METHODS: A retrospective descriptive study design was used. Data was collected from clinic records of all patients diagnosed to have OCD at the child guidance clinic of Lady Ridgeway Hospital for Children, Colombo during the 3-year period from 2013-2016. RESULTS: Fifty two children were included in the study. The mean age of the children was 9.2 years. Males accounted for 71.2%. The majority (55.8%) had both obsessions and compulsions. Multiple obsessions were seen in 15.4% and multiple rituals in 26.9%. The most common theme was contamination (61.5%). Washing was the most common ritual (50%). Comorbidities were present in 55.7%, with attention deficit hyperactivity disorder (ADHD) (17.3%) being the most common. Of the participants, 90.4% had impairments related to OCD. There was a significant association between the gender and the age of the child (p=0.029) in the 5-10 year age group, boys were 5 times more common than girls, while the proportion of boys and girls were equal in children aged more than 10 years. Conclusion: Comorbidities are common in childhood OCD, and all children with OCD should be screened for comorbidities.