Article2014

The Relationship Between Adverse Childhood Experiences and Symptom Severity, Chronicity, and Comorbidity in Patients With Obsessive-Compulsive Disorder

Henny A. D. Visser · Agnes van Minnen · Harold J.G.M. van Megen · Merijn Eikelenboom · Adriaan W. Hoogendoorn · Maarten Kaarsemaker +2 more

53 citations0/0 files storedThe Journal of Clinical Psychiatry

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Obsessive-Compulsive Spectrum Disorders Psychoanalysis and Psychopathology Research Child Abuse and Trauma

Abstract

BACKGROUND: Studies on the relationship between adverse childhood experiences (ACEs) and obsessive-compulsive disorder (OCD) symptom severity are scarce. Available studies leave a considerable degree of uncertainty. The present study examines the relationship between ACEs and symptom severity, chronicity, and comorbidity in a sample of patients with OCD. METHOD: Baseline data of the Netherlands Obsessive Compulsive Disorder Association (NOCDA) study, in which 382 referred patients with DSM-IV-diagnosed OCD participated, were analyzed. ACEs (physical abuse, sexual abuse, witnessing interparental violence, maternal dysfunction, paternal dysfunction, and early separation from a parent) were measured using a structured interview. Data were collected between September 2005 and November 2009. RESULTS: None of the ACEs were related to OCD symptom severity or chronicity, nor was there a dose-response relationship between ACEs and OCD severity or chronicity, but results of linear regression analysis revealed that ACEs were related to comorbidity in patients with OCD (P < .001), in particular to comorbid affective disorders (P < .01), substance use disorders (P < .01), and eating disorders (P < .01), but not to comorbid anxiety disorders. CONCLUSIONS: Results of the study suggest that unlike in other psychiatric disorders, ACEs play no significant role in symptom severity and chronicity of OCD. This study was the first to reveal evidence for a relationship between ACEs and comorbidity in patients with OCD. Conclusions about trauma-relatedness of OCD based on studies finding higher trauma rates or severity among patients with OCD than among healthy controls, should be critically reconsidered, since presence of comorbidity might account for these differences.

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References

1998Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults 2004Validity of adult retrospective reports of adverse childhood experiences: review of the evidence 2001The role of childhood trauma in the neurobiology of mood and anxiety disorders: preclinical and clinical studies 1989The Yale-Brown Obsessive Compulsive Scale 2013Adult Psychiatric Outcomes of Bullying and Being Bullied by Peers in Childhood and Adolescence 2010Inter‐rater reliability of the Structured Clinical Interview for DSM‐IV Axis I Disorders (SCID I) and Axis II Disorders (SCID II)2004Neurobiological consequences of childhood trauma.2006The Brown Longitudinal Obsessive Compulsive Study

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