Articles

Prevalence Rates of Obsessive-Compulsive Symptoms and Psychiatric Comorbidity Among Adolescents in Iran

Abstract

Recent epidemiological studies show that obsessive-compulsive disorder (OCD) and its comorbidity with psychiatric problems is more prevalent among children and adolescents than was previously believed. The primary aim of the current study is to investigate the point-prevalence rate of obsessive compulsive symptoms in a sample of adolescent high school student in Iran. A two-stage epidemiological study was carried out through a clustered random sampling method. All participants went through a two-stage assessment procedure, in the first screening phase, the Maudsley Obsessive-Compulsive Inventory (MOCI) was administered to 909 randomly selected students (in the age range 14-18 years). Participants were considered possible sub-clinical or clinical OCD cases, if they obtained a score of MOCI≥15. In the second stage, the Symptoms Checklist -90-revised (SCL-90-R) was administered to student who fulfilled the screening criteria. The prevalence of OC symptoms was found to be 11.2 percent for the total sample. The most prevalent comorbid conditions were depression and anxiety with prevalence rates of 91.2 and 78.4 percent respectively. Gender, age, birth-order, parent's education and family income had no statistically significant association with OC symptoms. Further research in this area is warranted in order to establish a set of comprehensive global assessment and measurement tools, which would allow cross-cultural studies in the field of OCD.

American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-IV) (4 Ed.). Washington, DC: American Psychiatric Association 1994.

Freeman JB, Garcia AM, Fucci C, Karitani M, Miller L, Leonard HL. Family-based treatment of early-onsetobsessive-compulsive disorder. J Child Adolesc Psychopharmacol 2003;13 Suppl 1:S71-80.

Murray CJ, Lopez AD. The Global Burden of Disease: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. Cambridge, MA; Harvard School of Public Health, (Global Burden of Disease and Injury Series, vol. I), 1996.

Valderhaug R, Larsson B, Götestam KG, Piacentini J. An open clinical trial of cognitive-behaviour therapy in children and adolescents with obsessive-compulsive disorder administered in regular outpatient clinics. Behav Res Ther 2007;45(3):577-89.

Benazon NR, Ager J, Rosenberg DR. Cognitive behavior therapy in treatment-naive children and adolescents with obsessive-compulsive disorder: an open trial. Behav Res Ther 2002;40(5):529-39.

Fontenelle LF, Mendlowicz MV, Versiani M. The descriptive epidemiology of obsessive-compulsive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2006;30(3):327-37.

Skoog G, Skoog I. A 40-year follow-up of patients with obsessive-compulsive disorder [see commetns]. Arch Gen Psychiatry 1999;56(2):121-7.

Fontenelle LF, Hasler G. The analytical epidemiology of obsessive-compulsive disorder: risk factors and correlates. Prog Neuropsychopharmacol Biol Psychiatry 2008; 32(1):1-15.

Lewinsohn PM, Hops H, Roberts RE, Seeley JR, Andrews JA. Adolescent psychopathology: I. Prevalence and incidence of depression and other DSM-III-R disorders in high school students. J Abnorm Psychol 1993;102(1):133-44.

Roussos A, Francis K, Koumoula A, Richardson C, Kabakos C, Kiriakidou T, Karagianni S, Karamolegou K. The Leyton obsessional inventory - child version in Greek adolescents: standardization in a national school-based survey and two-year follow-up. Eur Child Adolesc Psychiatry 2003;12(2):58-66.

Wittchen HU, Nelson CB, Lachner G. Prevalence of mental disorders and psychosocial impairments in adolescents and young adults. Psychol Med 1998;28(1):109-26.

Canals J, Domènech E, Carbajo G, Bladé J. Prevalence of DSM-III-R and ICD-10 psychiatric disorders in a Spanish population of 18-year-olds. Acta Psychiatr Scand 1997;96(4):287-94.

Maina G, Albert U, Bogetto F, Ravizza L. Obsessivecompulsive syndromes in older adolescents. Acta Psychiatr Scand 1999;100(6):447-50.

Zohar AH. The epidemiology of obsessive-compulsive disorder in children and adolescents. Child Adolesc Psychiatr Clin N Am 1999;8(3):445-60.

Mohammadi MR, Ghanizadeh A, Rahgozar M, Noorbala AA, Davidian H, Afzali HM, Naghavi HR, Yazdi SA, Saberi SM, Mesgarpour B, Akhondzadeh S, Alaghebandrad J, Tehranidoost M. Prevalence of obsessive-compulsive disorder in Iran. BMC Psychiatry 2004;4:2.

Kaviani H, Ahmadi Abhari SA, Dehghan M, Mansournia MA, Khoramshahi M. Prevalence of anxiety disorders in Tehran city. Iran J Psychiatry Clin Psychol (Andeesheh Va Raftar) 2002;31(8):4-12. [Persian]

Mohammadi MR, Rahgozar M, Bagheri Yazdi SA, Naghavi HR, Pour Etemad HR. Epidemiological Study of Psychiatric Disorders in Tehran Province. Iran J Psychiatry Clin Psychol (Andeesheh Va Raftar) 2003;34(9):4-14. [Persian]

Sadeghi K, Saberi M, Assareh M. The epidemiology of mental illness in Kermanshah. Iran J Psychiatry Clin Psychol (Andeesheh Va Raftar) 2001;6(2/3):16-25. [Persian]

Attiullah N, Eisen JL, Rasmussen SA. Clinical features of obsessive-compulsive disorder. Psychiatr Clin North Am 2000;23(3):469-91.

Bryńska A, Wolańczyk T. Epidemiology and phenomenology of obsessive-compulsive disorder in nonreferred young adolescents: a Polish perspective. Eur Child Adolesc Psychiatry 2005;14(6):319-27.

Essau CA, Conradt J, Petermann F. Frequency, comorbidity, and psychosocial impairment of anxiety disorders in German adolescents. J Anxiety Disord 2000;14(3):263-79.

King NJ, Myerson NN, Inglis S, Jenkins M, Ollendick TH. Obsessive-compulsive behaviour in children and adolescents: a cross-sectional Australian study. J Paediatr Child Health 1995;31(6):527-31.

Zohar AH, Ratzoni G, Pauls DL, Apter A, Bleich A, Kron S, Rappaport M, Weizman A, Cohen DJ. An epidemiological study of obsessive-compulsive disorder and related disorders in Israeli adolescents. J Am Acad Child Adolesc Psychiatry 1992;31(6):1057-61.

Maggini C, Ampollini P, Gariboldi S, Cella PL, PeqlizzaL, Marchesi C. The Parma High School Epidemiological Survey: obsessive-compulsive symptoms. Acta Psychiatr Scand 2001;103(6):441-6.

Valleni-Basile LA, Garrison CZ, Waller JL, Addy CL, McKeown RE, Jackson KL, Cuffe SP. Incidence of obsessive-compulsive disorder in a community sample of young adolescents. J Am Acad Child Adolesc Psychiatry 1996;35(7):898-906.

Thomsen PH. Obsessive-compulsive disorder in children and adolescents. Self-reported obsessive-compulsive behaviour in pupils in Denmark. Acta Psychiatr Scand 1993;88(3):212-7.

Zohar AH, Bruno R. Normative and pathological obsessive-compulsive behavior and ideation in childhood: a question of timing. J Child Psychol Psychiatry 1997;38(8):993-9.

Thomsen PH. Children and adolescents with obsessivecompulsive disorder: an analysis of sociodemographic background. A case-control study. Psychopathology 1994;27(6):303-11.

Flament M, Whitaker A, Rapoport JL, Davies M, Berg CZ, Kalikow K, Sceery W, Sgaffer D. Obsessive compulsive disorder in adolescence: an epidemiological study. J Am Acad Child Adolesc Psychiatry 1988;27:764-71.

Douglass HM, Moffitt TE, Dar R, McGee R, Silva P. Obsessive-compulsive disorder in a birth cohort of 18- year-olds: prevalence and predictors. J Am Acad Child Adolesc Psychiatry 1995;34(11):1424-31.

Cilliçilli AS, Telcioglu M, Aşkin R, Kaya N, Bodur S, Kucur R. Twelve-month prevalence of obsessivecompulsivedisorder in Konya, Turkey. Compr Psychiatry 2004;45(5):367-74.

Snowdon J. Family-size and birth-order in obsessional neurosis. Acta Psychiatr Scand 1979;60(1):121-8.

Kayton L, Borge GF. Birth order and the obsessivecompulsive character. Arch Gen Psychiatry1967;17(6):751-4.

Nestadt G, Bienvenu OJ, Cai G, Samuels J, Eaton WW. Incidence of obsessive-compulsive disorder in adults. J Nerv Ment Dis 1998;186(7):401-6.

Geller D, Biederman J, Jones J, Park K, Schwartz S, Shapiro S, Coffey B. Is juvenile obsessive-compulsive disorder a developmental subtype of the disorder? A review of the pediatric literature. J Am Acad Child Adolesc Psychiatry 1998;37(4):420-7.

Horwath E, Weissman MM. The epidemiology and crossnational presentation of obsessive-compulsive disorder. Psychiatr Clin North Am 2000;23(3):493-507.

Antony MM, Downie F, Swinson RP. Diagnostic issues and epidemiology in obsessive-compulsive disorder. In: Swinson, RP, Antony MM, Rachman S, Richter MA, editor. Obsessive-Compulsive Disorder: Theory Research, and Treatment. New York: Guilford Press; 1998. p. 3-32.

Leonard HL, Swedo SE, Lenane MC, Rettew DC, Hamburger SD, Bartko JJ, Rapoport JL. A 2- to 7-year follow-up study of 54 obsessive-compulsive children and adolescents. Arch Gen Psychiatry 1993;50(6):429-39.

Hodgson RJ, Rachman S. Obsessional-compulsive complaints. Behav Res Ther 1977;15(5):389-95.

Rachman SJ, Hodgson RJ. Obsessions and Compulsions. Englewood Cliffs, NJ: Prentice-Hall: Prentics-Hall; 1980.

Ghassemzadeh H, Khamseh A, Ebrahimkhani N. Demographic variables and clinical features of obsessivecompulsive disorder in Iranian patients. 2nd ed. In: Ling BE, editor. Obsessive-Compulsive Disorder Research.New York: Nova Science Publishers, Inc; 2005. p. 243-71.

Ghassemzadeh H, Mojtabai R, Khamseh A, Ebrahimkhani N, Issazadegan AA, Saif-Nobakht Z. Symptoms of obsessive-compulsive disorder in a sample of Iranian patients. Int J Soc Psychiatry 2002;48(1):20-8.

Derogatis LR. Administration, Scoring and Procedures. SCL-90-R. Baltimore, MD: Clinical Psychometric Research; 1977.

Ismaili I. Psychometric properties of symptom checklist questionnaire-Revised (SCL-90-R) in Iranian student sample. A Dissertation presented to psychology Faculty on the University of Tehran for the Degree of MS, 2003.

Valleni-Basile LA, Garrison CZ, Waller JL, Addy CL, McKeown RE, Jackson KL, Cuffe SP. Incidence of obsessive-compulsive disorder in a community sample of young adolescents. J Am Acad Child Adolesc Psychiatry 1996;35(7):898-906.

Valleni-Basile LA, Garrison CZ, Jackson KL, Waller JL, McKeown RE, Addy CL, Cuffe SP. Frequency of obsessive-compulsive disorder in a community sample of young adolescents. J Am Acad Child Adolesc Psychiatry 1994;33(6):782-91.

Humaida MA, Ismail IA, Abd-Alfattah M, Eisa A. Prevalence rates of obsessive-compulsive symptoms, obsessive-compulsive disorder, and psychiatric comorbidity among secondary-school students in rural Egypt. Int J Ment Health Addict. [Online] 2004 Nov 7 [Accessed Oct 2007]; URL:http://www.ijmajournal. com/pdf/c01a19.pdf

Rasmussen SA, Eisen JL. The epidemiology and clinical features of obsessive compulsive disorder. Psychiatr Clin North Am 1992;15(4):743-58.

Apter A, Fallon TJ Jr, King RA, Ratzoni G, Zohar AH, Binder M, Weizman A, Leckman JF, Pauls DL, Kron S, Cohen DJ. Obsessive-compulsive characteristics: from symptoms to syndrome. J Am Acad Child Adolesc Psychiatry 1996;35(7):907-12.

Weissman MM, Bland RC, Canino GJ, Greenwald S, Hwu HG, Lee CK, Newman SC, Oakley-Browne MA, Rubio- Stipec M, Wickramaratne PJ. The cross national epidemiology of obsessive compulsive disorder. The Cross National Collaborative Group. J Clin Psychiatry 1994;55 Suppl:5-10.

Pauls DL, Alsobrook JP 2nd, Goodman W, Rasmussen S, Leckman JF. A family study of obsessive-compulsive disorder. Am J Psychiatry 1995;152(1):76-84.

Rapoport JL, editor. Obsessive-Compulsive Disorders in Children and Adolescents. Washington DC: American Psychiatric Press: p. 289-96.

Heyman I, Fombonne E, Simmons H, Ford T, Meltzer H, Goodman R. Prevalence of obsessive-compulsive disorder in the British nationwide survey of child mental health. Int Rev Psychiatry 2003;15(1-2):178-84.

Swedo SE, Rapoport JL, Leonard H, Lenane M, Cheslow D. Obsessive-compulsive disorder in children and adolescents. Clinical phenomenology of 70 consecutive cases. Arch Gen Psychiatry 1989;46(4):335-41.

Hanna GL. Demographic and clinical features of obsessive-compulsive disorder in children and adolescents. J Am Acad Child Adolesc Psychiatry 1995;34(1):19-27.

Last CG, Strauss CC. Obsessive-compulsive disorder in childhood. J Anxiety Dis 1989;3(4):295-305.

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IssueVol 49, No 10 (2011) QRcode
SectionArticles
Keywords
OC symptoms Adolescents Co morbidity Psychiatric problems Epidemiology

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How to Cite
1.
Shams G, Foroughi E, Esmaili Y, Amini H, Ebrahimkhani N. Prevalence Rates of Obsessive-Compulsive Symptoms and Psychiatric Comorbidity Among Adolescents in Iran. Acta Med Iran. 1;49(10):680-687.