Towards a definitive symptom structure of obsessive-compulsive disorder: A factor and network analysis of 87 distinct symptoms in 1366 individuals

Background The symptoms of obsessive-compulsive disorder (OCD) are highly heterogeneous and it is unclear what is the optimal way to conceptualize this heterogeneity. This study aimed to establish a comprehensive symptom structure model of OCD across the lifespan using factor and network analytic techniques. Methods A large multinational cohort of well-characterized children, adolescents, and adults diagnosed with OCD (N = 1366) participated in the study. All completed the Dimensional Yale-Brown Obsessive-Compulsive Scale, which contains an expanded checklist of 87 distinct OCD symptoms. Exploratory and confirmatory factor analysis were used to outline empirically supported symptom dimensions, and interconnections among the resulting dimensions were established using network analysis. Associations between dimensions and sociodemographic and clinical variables were explored using structural equation modeling (SEM). Results Thirteen first-order symptom dimensions emerged that could be parsimoniously reduced to eight broad dimensions, which were valid across the lifespan: Disturbing Thoughts, Incompleteness, Contamination, Hoarding, Transformation, Body Focus, Superstition, and Loss/Separation. A general OCD factor could be included in the final factor model without a significant decline in model fit according to most fit indices. Network analysis showed that Incompleteness and Disturbing Thoughts were most central (i.e. had most unique interconnections with other dimensions). SEM showed that the eight broad dimensions were differentially related to sociodemographic and clinical variables. Conclusions Future research will need to establish if this expanded hierarchical and multidimensional model can help improve our understanding of the etiology, neurobiology and treatment of OCD. © 2021 The Author(s). Published by Cambridge University Press

Comparison of Psychiatric Disorders Between Children with a History of Parental Divorce and Parental Death

Objective: This study is aimed to compare the rate of psychiatric diagnoses between children and adolescents with parentaldeath and parental divorce. The study additionally examines the differences in psychiatric diagnosis of children between preand post-parental divorce.Methods: The files of 4,160 children and adolescents referred to child psychiatry outpatient clinic between September 2014and September 2016 were examined retrospectively. Six hundred thirty eight children and adolescents with parental divorceor parental death were compared in terms of psychiatric disorders. The relationship between age, gender, living with motheror father, parental remarriage and psychopathology in children and adolescents was evaluated. Psychiatric diagnoses werecompared in cases with parental divorce before and after the divorce.Results: There were no significant differences between groups in terms of current psychiatric disorders. In both groups,disruptive behavior disorders were the most common diagnosis, followed by internalizing disorders such as depression andanxiety disorders. Younger age and living with the father were factors associated with psychiatric disorder in children.Discussion: Supportive approaches towards children with younger age and living with the father and their parents may beespecially important in reducing the risk of developing psychiatric disorder

Characteristics of children and their parents referred to a child psychiatry clinic of a state hospital for school readiness assessment

Ayaz, Muhammed (Arel Author)Amaç: Bu çalıümanın amacı, zorunlu okula baülama yaüındaki deùiüiklik sonucu okula hazır oluüluk deùerlendirmesi için çocuk ve ergen psikiyatrisi polikliniùine getirilen çocukların geliüimsel ve ruhsal durumlarını deùerlendirmek ve ebeveynlerinin sosyodemograÀ k özelliklerini incelemektir. Yöntem: Temmuz 2012-Ekim 2012 tarihleri arasında Tekirdaù Devlet Hastanesi çocuk ve ergen psikiyatrisi polikliniùine bu amaçla getirilen tüm çocukların (n=200) dosyaları geriye dönük taranarak incelenmiütir. Sonuçlar: Çalıümaya katılan çocukların ortalama yaüı 65.82 ± 5.5 ay idi. Çocukların annelerinin % 53.5’i (n=107) ortaokul ve daha düüük eùitim düzeyindeydi. Ailelerin % 91’i (n=181) 3000 TL altında bir ortalama aylık gelir düzeyine sahipti. Çocukların % 87.5’inin (n=175) anaokulu eùitimi almadıùı saptandı. Olguların % 13’üne (n=26) eksen I psikiyatrik bozukluk veya biliüsel alanda gecikme tanıları konuldu. Çocukların % 15’inin (n=30) kronik tıbbi bir hastalıùı mevcuttu ve % 61.5’inin (n=123) özbakım becerilerini tek baüına karüılayamadıùı tespit edildi. Tartıüma: Çocukların okula hazır oluüluklarını etkileyen pek çok faktör bulunmaktadır. Yeterli okul olgunluùunu saùlamak amaçlı okul öncesi eùitim programlarının yaygınlaütırılması ve evde öùrenme olanaklarının arttırılması önem arz etmektedir.Objective: The aim of this study was to assess developmental and mental states of children who were referred to a child and adolescent psychiatry outpatient clinic for school readiness assessment as a result of change in the starting age of compulsory schooling and to examine socio-demographic characteristics of the parents. Method: Medical À les of 200 cases that were referred to Tekirdag State Hospital's child psychiatry clinic for this purpose between dates July 2012 and October 2012 were reviewed retrospectively. Results: Mean age of children included was 65.82 ± 5.5 months. Fifty-three and half percent (n=107) of mothers had middle school or lower education level. Ninety-one percent of families (n=181) had an average monthly income under 3000 TL. Eighty-seven and half percent of children (n=175) were found to have not attended kindergarten. Thirteen percent of cases (n=26) were diagnosed with an axis 1 psychiatric disorder or cognitive delay. Fifteen percent of children (n = 30) had a chronic medical illness and 61.5 % (n=123) failed to fulÀ ll self-care skills alone. Discussion: There are many factors affecting the children's school readiness. Preschool education programs and learning opportunities at home should be increased and widened to whole community to provide school readiness adequately

Psychiatric disorders, developmental, and academic difficulties among children and adolescents at-risk for schizophrenia: a controlled study

OBJECTIVE: The aim of this study was to determine whether there are differences in the presence of developmental delays, academic difficulties, and current mental disorders between offspring of parents with schizophrenia (High risk: HR) and offspring of parents with no mental illness (control group) up to the age of 16 years. The relationship of existing differences with psychosocial difficulties of having a parent with schizophrenia was evaluated. METHOD: The sample of the study consisted of 35 HR and 30 control offspring aged 7–16 years. All parents were assessed using the SCID-I by a psychiatrist and offspring using the K-SADS-PL by a child psychiatrist. Information about the early developmental stages and academic difficulties of children were obtained through interviews with healthy parents. Emotional and behavioural problem levels of children were determined by the Strengths and Difficulties Questionnaire (SDQ), Swanson, Nolan, and Pelham-IV Questionnaire (SNAP-IV), the Screen for Child Anxiety Related Emotional Disorders (SCARED), and the Child Depression Inventory (CDI). All assessments were adjusted for socio-demographic variables. RESULTS: The rates of generalized anxiety disorders, delayed walking, delayed speech and reading difficulties, the levels of conduct problems (CP), depression, and school phobia were significantly higher in HR offspring than in control. When adjusted for socio-demographic variables, the presence of delayed speech and reading difficulties and only CP levels continued to be significantly higher in HR group (p  .05). CONCLUSION: Internalizing problems such as anxiety and depression are considered as a psychosocial result of having a schizophrenic parent. The higher rates of speech delay, reading difficulties, and CP level might be genetically associated with schizophrenia

Empathy and facial expression recognition in children with and without attention-deficit/hyperactivity disorder: Effects of stimulant medication on empathic skills in children with attention-deficit/hyperactivity disorder

WOS: 000403320200007PubMed ID: 28332851Objective: The aim of this study was to compare children and adolescents with attention-deficit/hyperactivity disorder (ADHD) to healthy children and adolescents in terms of state and trait empathy and emotion expression recognition skills. The goal was also to determine whether there are changes in emotion recognition and empathy measures in children with ADHD after methylphenidate (MPH) treatment. Methods: The research sample consisted of outpatient drug-naive children and adolescents between the age of 8 and 14 years (n = 65) with ADHD according to the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. criteria, and healthy children and adolescents of the same age (n = 61). Scores of the oppositional problems (OPs) and conduct problems (CPs) were obtained to evaluate their impact on children's empathy skills with the Child Behavior Checklist. Self-reported (Bryant Index of Empathy, BEI) and parent-reported (Griffith Empathy Measurement-Parent Rating, GEM-PR) scales were used to evaluate trait empathy. The Empathy Response Task (ERT) was used to evaluate state empathy, and the Diagnostic Analysis of Nonverbal Accuracy-2 (DANVA-2) was used to evaluate facial expression recognition skills. The scales and tests were repeated after 12 weeks of MPH treatment in the ADHD group. Results: There were no significant statistical differences in trait empathy skills evaluated by parent-reported and self-reported measures, ERT, and DANVA-2 scores. In self-reported measures, the girls had higher scores than boys. From the results of the regression analysis, it was concluded that OPs were not associated with the measures. However, CPs were associated with the scores of the BEI, GEM-PR, and the match scores of the ERT. The average dosage of MPH in the group with ADHD was 0.83 +/- 0.21 mg/(kg.d). While there was no change in the BEI and GEM-PR scores after 12 weeks of treatment, there was a significant increase in the ERT interpretation subscore and a significant decrease in the recognition error of anger and sadness expressions in the DANVA-2. Conclusions: The findings of our study suggest that children with ADHD have similar levels of trait and state empathy skills and facial expressions as healthy controls and CPs negatively affect their empathy skills. MPH treatment does not change trait empathy skills, yet there are some improvements in state empathy skills