Psychotic vulnerability and its associations with clinical characteristics in children and adolescents with Obsessive-Compulsive Disorder

Abstract

Abstract Compared to peers, children, and adolescents with Obsessive-Compulsive Disorder (OCD) are at increased risk of developing psychotic disorders. Yet very few studies have examined early indicators of psychosis in pediatric OCD. In the present study, 52 pediatric outpatients (mean age = 15.66 [SD = 2.33], 59.6% girls) with a primary diagnosis of OCD were interviewed using the Schizophrenia Proneness Instrument Child and Adolescent version (SPI-CY), which is a comprehensive clinical interview assessing both Cognitive–Perceptual basic symptoms (COPER) and high-risk criterion Cognitive Disturbances (COGDIS). Associations between COPER/COGDIS symptoms and demographic and clinical characteristics were examined. COPER or COGDIS symptoms were present in 44% of participants, with no significant difference in frequency between girls and boys. Psychotic vulnerability was associated with an earlier age of OCD onset, greater OCD severity, and poorer insight. Further, it was strongly associated with worse psychosocial functioning and explained 22% of unique variance in this variable. Findings suggest that early indicators of psychosis are frequent in pediatric OCD and associated with more severe OCD and poorer functioning. Research examining how psychotic vulnerability in pediatric OCD is associated with short- and long-term outcome is needed.