Objective: To examine prevalence of sleep problems among children and adolescents with obsessive-compulsive disorder (OCD) as rated by their parents and the role of comorbidity.
Methods: Children and adolescents with OCD (n=185) referred to specialized OCD unit were compared with children from child and adolescent psychiatry (CAP) outpatient units (n=177) and a school sample (GP) (n=317). All were assessed by parents on the Child Behaviour Checklist (CBCL).
Results: Sleep problems were common in both the OCD (28.8 %) and CAP (20.3%) groups compared with the GP group (5.4%). While the OCD group significantly more often had less sleep than the CAP group (11.7% vs. 6.8%), small differences were found between these two groups for nightmares (5.9%, vs. 6.8% n.s.). Comparing the OCD and CAP groups on total sleep problem scores, OCD was a weak while the CBCL syndrome scales Thought problems (which includes OCD symptoms), Anxiety/Depressed, Somatic problems and Aggressive behaviour were strong predictors indicating that comorbidity rather than OCD might be especially important.
Conclusion: Sleep problems are common among children and adolescents with OCD as well as among regular CAP outpatients. In OCD patients, the total comorbid symptom burden predicts sleep problems to a greater extent than the OCD itself. A thorough assessment of sleep problems and their causes are needed for all outpatients referred to child and adolescent psychiatric service.