Cross-sectional comparison of the clinical characteristics of adults with early-onset and late-onset obsessive compulsive disorder

J Affect Disord. 2012 Feb;136(3):498-504. doi: 10.1016/j.jad.2011.11.001. Epub 2011 Nov 25.


Background: Age at onset (AAO) in obsessive compulsive disorder (OCD) may differentiate genetically and clinically heterogeneous subtypes. The current cross-sectional study compared the characteristics of early-onset OCD (onset age≤18 years) and late-onset OCD (onset age>18 years). The AAO cut-off was based on the onset distribution observed in our systematically recruited patients with OCD.

Methods: Six hundred and two (including 339 men and 263 women) outpatients meeting DSM-IV criteria of OCD were recruited from the Shanghai Mental Health Center and were screened by a battery of instruments: Yale-Brown Obsessive Compulsive Scale (YBOCS) attached Y-BOCS Symptom Checklist, Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA), and State-Trait Anxiety Inventory (STAI). The demographic and clinical characteristics of the 275 early-onset patients were compared to those of the 327 late-onset patients.

Results: Compared to patients with late-onset OCD, early-onset patients with OCD were significantly more likely to be male (66.9% vs. 47.4%, X2=23.1, p<0.001), to have a positive family history of mental illnesses (26.5% vs. 19.0%, X2=4.9, p=0.026), and to have a longer duration of illness [80.0 (SD=80.7) vs. 65.5 (SD=78.3) months, t600=3.17, p=0.002]. Early-onset patients also had significantly higher scores on the HAMA, HAMD, STAI2, and obsessive in Y-BOCS. The sexual and symmetry/exactness obsessions and the washing/cleaning compulsions were significantly more prevalent in the early-onset group.

Conclusions: The study of a large sample from mainland China confirms the findings from previous studies and supports the hypothesis that early-onset OCD is a demographically and clinically distinct subtype of OCD.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Aged
  • Child
  • China
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Obsessive-Compulsive Disorder / epidemiology
  • Obsessive-Compulsive Disorder / psychology*
  • Young Adult