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, 63 (2), 85-93

Presence and Predictive Value of Obsessive-Compulsive Symptoms in Anxiety and Depressive Disorders

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Presence and Predictive Value of Obsessive-Compulsive Symptoms in Anxiety and Depressive Disorders

Mieke Klein Hofmeijer-Sevink et al. Can J Psychiatry.

Abstract

Objective: Obsessive-compulsive symptoms (OCS) co-occur frequently with anxiety and depressive disorders, but the nature of their relationship and their impact on severity of anxiety and depressive disorders is poorly understood. In a large sample of patients with anxiety and depressive disorders, we assessed the frequency of OCS, defined as a Young Adult Self-Report Scale-obsessive-compulsive symptoms score >7. The associations between OCS and severity of anxiety and/or depressive disorders were examined, and it was investigated whether OCS predict onset, relapse, and persistence of anxiety and depressive disorders.

Methods: Data were obtained from the third (at 2-year follow-up) and fourth wave (at 4-year follow-up) of data collection in the Netherlands Study of Anxiety and Depression cohort, including 469 healthy controls, 909 participants with a remitted disorder, and 747 participants with a current anxiety and/or depressive disorder.

Results: OCS were present in 23.6% of the total sample, most notably in those with current combined anxiety and depressive disorders. In patients with a current disorder, OCS were associated with severity of this disorder. Moreover, OCS predicted (1) first onset of anxiety and/or depressive disorders in healthy controls (odds ratio [OR], 5.79; 95% confidence interval [CI], 1.15 to 29.14), (2) relapse in those with remitted anxiety and/or depressive disorders (OR, 2.31; 95% CI, 1.55 to 3.46), and (3) persistence in patients with the combination of current anxiety and depressive disorders (OR, 4.42; 95% CI, 2.54 to 7.70) within the 2-year follow-up period Conclusions: OCS are closely related to both the presence and severity of anxiety and depressive disorders and affect their course trajectories. Hence, OCS might be regarded as a course specifier signaling unfavorable outcomes. This specifier may be useful in clinical care to adapt and intensify treatment in individual patients.

Keywords: anxiety disorders; comorbidity; course; depressive disorders; obsessive-compulsive symptoms; prevalence; prognosis; severity.

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Items of the Young Adult Self-Report Scale, obsessive-compulsive symptoms (YASR-OCS).
Figure 2.
Figure 2.
Presence of obsessive-compulsive symptoms (OCS) across healthy controls, participants with a remitted anxiety and/or depressive disorder, and participants with a current anxiety and/or depressive disorder (N = 2125). Presence of OCS was defined as scores on the YASR-OCS > 7. YASR-OCS = Young Adult Self-Report Scale, obsessive-compulsive symptoms. Overall statistics: χ2: 473.74(df = 4), P < 0.001.

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