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Can J Psychiatry. 2018 Feb;63(2):85-93. doi: 10.1177/0706743717711170. Epub 2017 May 16.

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

Author information

1
1 Mental Health Care Institute GGZ Centraal, Amersfoort, the Netherlands.
2
2 GGZ inGeest/Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands.
3
3 Altrecht Academic Anxiety Center, Utrecht, the Netherlands.
4
4 Department of Clinical and Health Psychology, Utrecht University, Utrecht, the Netherlands.
5
5 GGz Drenthe, Department of Specialized Training & University Medical Center Groningen, Department of Psychiatry & Rob Giel Onderzoekscentrum, Groningen, the Netherlands.

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

PMID:
28511595
PMCID:
PMC5788131
DOI:
10.1177/0706743717711170
[Indexed for MEDLINE]
Free PMC Article

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