Compulsive Disorder In Children Research Articles

Prevalence and Correlates of the Concurrence of Autism Spectrum Disorder and Obsessive Compulsive Disorder in Children and Adolescents: A Systematic Review and Meta-Analysis.

Autism spectrum disorder (ASD) and obsessive compulsive disorder (OCD) are two common and impairing neurodevelopmental conditions with partial symptomatic overlap. The aim of this study is to systematically and meta-analytically examine the following: (i) the prevalence of an OCD diagnosis among young people with ASD, (ii) the prevalence of an ASD diagnosis among young people with OCD, and (iii) the clinical and therapeutic implications of such comorbidity. A multistep literature search was performed from database inception until 17 November 2023. This PRISMA/MOOSE-compliant systematic review, registered in PROSPERO (CRD42023480543), identified studies reporting on the prevalence, sociodemographic, psychopathologic, prognostic, and therapeutic correlates of OCD and ASD concurrence in children and adolescents. A quantitative meta-analysis with random effects was conducted to analyse the pooled prevalence of OCD among samples with a mean age of < 18 years old with ASD and the prevalence of ASD among individuals under 18 with OCD. Sensitivity analyses were performed to investigate the effect of diagnostic criteria and different continents. Meta-regression analyses were conducted to examine the effect of gender, age, IQ, and OCD severity scores. A narrative review of the clinical and therapeutical implications of the comorbidity was provided. 42 studies were selected for the systematic review (SR), and 31 of them were also included in one of the meta-analyses. The pooled prevalence of OCD among ASD youth samples (n = 8916, mean age = 10.6 ± 1.6; 16.4% female) was 11.6% (95% confidence intervals [CI] = 6.9%; 18.8%), and the pooled prevalence of ASD among OCD children and adolescent samples (n = 6209, mean age = 14.1 ± 1.4; 45.7% female) was 9.5% (95% CI = 6.0%; 14.7%). Meta-regressions found a statistically higher prevalence of ASD among samples with a lower prevalence of females (β = -4.7; 95%CI = -8.6; -0.8). Children with both OCD and ASD present higher rates of functional impairment, psychopathology, and other comorbidities, compared to youth with either of the disorders alone. OCD and ASD are highly concurrent conditions in youth, with symptomatic, prognostic, severity, and therapeutic implications. Future research should focus on conducting longitudinal cohort studies prospectively to determine development trajectories, along with randomized controlled trials to assess the efficacy of specific therapeutic interventions.

Obsessive–Compulsive Disorder in Children and Adolescents

Obsessive–compulsive disorder (OCD) in children and adolescents is a neurobehavioral condition that can lead to functional impairment in multiple domains and decreased quality of life. We review the clinical presentation, diagnostic considerations, and common comorbidities of pediatric OCD. An overview of the biological and psychological models of OCD is provided along with a discussion of developmental considerations in youth. We also describe evidence-based treatments for OCD in childhood and adolescence, including cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) and pharmacotherapy. Finally, research evaluating the delivery of CBT in different formats and modalities is discussed, and we conclude with suggestions for future research directions. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 20 is May 2024. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Designing a Deep Learning Hybrid Using CNN and Inception V3 Transfer Learning to Detect the Aggression Level of Deep Obsessive Compulsive Disorder in Children

The usage of Artificial intelligence in medical arena has proved to be a game changer in the detection and diagnosis of several medical conditions. In the current digital era, children with stressful medical issues are suffering from Deep Obsessive-Compulsive Disorder (DOCD). This kind of mental stress occurs in children because of the continuous usage of gadgets such as mobile phone, playing games using play stations, watching videos on tablets, etc. In most of the possibilities, single children are the ones affected with several obsessions such as stubborn activities, fighting for selfish priorities and so on. In medical terms, these kinds of complex behavioral changes are identified as DOCD. Genetic behaviors sometimes in a few group of children are also noticed as a modality difference. As symptoms are psychiatric impairment, such a child remains isolated, abnormal silence, being obsessive and repeating irrelevant words, high stress or anxiety. All medical challenges could be treated as healthcare research metrics and the gradual increase in DOCD disorder among children of this generation can be considered too. Early detection of DOCD is essential as it can help in early diagnosis but techniques to do so is unavailable currently. Deep learning-an artificial intelligence method can be utilized to detect DOCD, diagnose and treat it and bring about a positive character in children. Behavior changes in children can be classified and detected using transfer learning algorithms. In COVID-19 pandemic situation, 3% of DOCD has increased to 10-15% as a disorder. This information is retrieved from children by monitoring negative activities, unusual behavior such as nail biting, removing spectacles and placing them in the wrong place, watching tablets, mobile phones and television for more hours. Using Convolutional Neural Networks (CNN), input such as MRI (Magnetic resonance Imaging) is used for experimenting the variations in behavior with the high dimension that are analyzed from the image dataset. Using Transfer Learning with Inception V3-, CNN generalization of misophonia level can be statistically analyzed to avoid overfitting problems. By employing AI techniques, the aggression level can be predicted using data augmentation method with better accuracy and a low error rate than the existing systems. In the research it is observed that using the model employing Inception-V3 transfer learning CNN a better prediction of aggression levels can be achieved in comparison to the existing CNN model used.

Changes in Symptoms and Severity of Obsessive Compulsive Disorder in Children and Adolescent Patients following the Covid-19 Pandemic

ABSTRACT The need to stay at home and follow the rules of personal hygiene for protection are generally stimuli that can increase the anxiety of obsessive compulsive disorder (OCD) patients during covid-19 pandemic. The aim of this study was to examine how this situation has changed the disorder severity and symptoms in OCD patients. This multi-centre study included 73 OCD patients aged 7-17 years, who had been followed up for at least 8 weeks before the pandemic. The range and severity of symptoms were evaluated with the Children's Yale-Brown Obsessive Compulsive Scale (CYB-OCS). The disorder severity scores evaluated in the 8th week of treatment were compared with disorder severity scores after the pandemic, and a statistically significant difference was determined (p=0.04). There was seen to be an increase in contamination, ilness and sexual obsessions after the pandemic compared to the 8th week of treatment. The study results showed that pandemic-origin stress had a negative effect on young OCD patients. There should be advance planning of how treatment processes will not be interrupted and how children with mental health problems can be helped in times of stress, such as natural disaster and pandemics, which affect the whole population and therefore, children

Co-occurrence, Assessment and Treatment of Obsessive Compulsive Disorder in Children and Adults With Autism Spectrum Disorder.

This review aims to give an update on research in the past 5years regarding the co-occurrence, assessment and treatment of obsessive compulsive disorder (OCD) in individuals with autism spectrum disorder (ASD). Recent findings affirm not only a high prevalence of OCD amongst individuals with ASD (and vice versa) but also notable variability in assessment methods and results. There remain limited validated measures with which to assess OCD in those with ASD, which are often difficult to differentiate. Adapted and function-based CBT programs specifically designed for ASD demonstrate promising results, but additional randomised controlled trials are needed. Though some exciting progress has been made in the area of treatment of OCD in ASD, progress remains hampered by inconsistent measurement of OCD in ASD. Future priorities include development of brief, valid assessment tools and determining the efficacy and effectiveness of newly developed and adapted treatment programs.

Family-Based Psychological Treatment for Obsessive Compulsive Disorder in Children and Adolescents: A Meta-analysis and Systematic Review.

A significant number of children and adolescents with obsessive compulsive disorder (OCD) demonstrate poor response to the current gold standard treatment, cognitive behaviour therapy (CBT) with exposure and response prevention (ERP). Recent findings suggest that family variables affect treatment response highlighting the need for a meta-analytic review of the precise impact of family variables on OCD-related symptoms and processes. The current review and meta-analysis examined the effect of family-based interventions on OCD symptom and family factor outcomes for children and adolescents with OCD. The moderating effects of the degree of parental involvement and number of family factors targeted in treatment were investigated. An extensive literature search identified 37 eligible studies (1727 OCD participants). Large significant pooled mean effect sizes for OCD symptoms and Family Accommodation (FA), respectively, were obtained at posttest (g = 1.56; g = 1.00) and follow-up (g = 1.69; g = 1.98). Moderator analyses indicated that the number of family factors targeted in treatment significantly moderated outcomes on measures of FA (z = 2.21, p = 0.03), but not on Children's/Yale-Brown Obsessive Compulsive Scale (C/Y-BOCS) outcomes. FA has been significantly correlated with OCD symptom severity and poorer treatment outcomes, and there is data to suggest that FA may mediate OCD symptom outcomes (e.g.,Piacentini et al. in J Am Acad Child Adolesc Psychiatry 50:1149-1161, 2011). Findings show that the greater the number of family factors targeted, the greater the reduction in FA at post, highlighting the importance of addressing a range of family factors in child OCD treatment to optimise outcomes.

Measurement Issues: The measurement of obsessive compulsive disorder in children and young people in clinical practice.

If left untreated, obsessive compulsive disorder (OCD) can cause significant distress and impact on functioning throughout the lifespan. Despite the severity of the disorder, there is often a significant delay between the onset of symptoms and successful treatment. This is in part due to delays in recognising OCD symptoms in young people, particularly if the symptom forms are less common. Once OCD is accurately diagnosed, cognitive behavioural therapy (CBT) is known to be an efficacious treatment, sometimes in combination with medication, producing good long-term prognosis. It is therefore important to accurately detect OCD in children and young people so that they can be offered timely intervention. Use of the best tools in clinical and research settings improves detection and diagnosis, as well as enabling the tracking of progress through treatment. The aim of this current paper was to review measurement tools for OCD in young people with a focus on the practicalities of using tools in busy child mental health clinical settings. To discover what measurement tools are available for OCD in young people, we conducted a pragmatic literature of measurement tools for OCD in young people. We searched PsycINFO, Med-Line and the Cochrane databases for reports relating to the measurement of OCD. Additionally, we sought information from the National Institute for Health and Care Excellence (NICE) guidance, the Child Outcomes Research Consortium (CORC) website and the Children and Young People's Improving Access to Psychological Therapies (CYP IAPT) Programme. We also reviewed large trials and meta-analyses of the treatment of OCD in young people and communicated with relevant researchers/clinicians. Seventeen questionnaire measurement tools, with variable psychometric properties, and four commonly used semistructured clinician administered interview measures were identified. There are several measurement tools with good psychometric properties that are useful for initial screening/identification of OCD, as well as formal diagnosis, symptom tracking and treatment evaluation. With the availability of brief screens, as well as online diagnostic measures, such tools should not be a burden on clinical practice, but rather a helpful aid to support clinicians' assessment and treatment of OCD.

Obsessive compulsive disorder in children and teens

Obsessive compulsive disorder in children and teens

Clinical presentation and comorbidities of obsessive compulsive disorders in children and adolescents presenting to a tertiary care hospital in Sri Lanka

Background Obsessive compulsive disorder (OCD) in children differs from adults in that children do not show ego dystonicity, rarely have pure obsessions and commonly have pure compulsions with hidden obsessions. Comorbid psychiatric diagnoses are seen in more than 50% of children with OCD. Aims To describe the socio-demographic factors, clinical presentations and psychiatric comorbidities of children with OCD in a Sri Lanka setting, and to determine the factors associated with comorbidities. Methods A retrospective descriptive study design was used. Data was collected from clinic records of all patients diagnosed to have OCD at the child guidance clinic of Lady Ridgeway Hospital for Children, Colombo during the 3-year period from 2013-2016. Results Fifty two children were included in the study. The mean age of the children was 9.2 years. Males accounted for 71.2%. The majority (55.8%) had both obsessions and compulsions. Multiple obsessions were seen in 15.4% and multiple rituals in 26.9%. The most common theme was contamination (61.5%). Washing was the most common ritual (50%). Comorbidities were present in 55.7%, with attention deficit hyperactivity disorder (ADHD) (17.3%) being the most common. Of the participants, 90.4% had impairments related to OCD. There was a significant association between the gender and the age of the child (p=0.029) in the 5-10 year age group, boys were 5 times more common than girls, while the proportion of boys and girls were equal in children aged more than 10 years. Conclusion Comorbidities are common in childhood OCD, and all children with OCD should be screened for comorbidities.

Obsessive–compulsive disorder in children and adolescents

Obsessive–compulsive disorder (OCD) in children and adolescents is an impairing condition consisting of repetitive, intrusive thoughts (obsessions) and distressing repetitive acts (compulsions) for the child. Although it is one of the more common serious mental illnesses, it continues to be shrouded in shame and secrecy. The shame surrounding the condition, in combination with a lack of recognition of its defining symptoms, can lead to delays of several years before diagnosis, yet it is highly responsive to treatment once recognised. Children with OCD frequently present to non-psychiatrists. It is important that paediatricians familiarize themselves with the characteristic symptoms. This review summarizes current research regarding the epidemiology and aetiology of OCD, the assessment of childhood-onset OCD, as well as its psychological and pharmacological management and potential future treatments.

Obsessive Compulsive Inventory-Child Version (OCV-CI) to Evaluate Obsessive Compulsive Disorder in Children With Early Stages of Chronic Kidney Disease: A Case Control Study.

Background:Chronic kidney disease (CKD) is a common medical condition among children and obsessive-compulsive disorder (OCD) is a frequent, chronic, costly, and disabling disorder among them.Objectives:The aim of this study was to investigate obsessive-compulsive disorder (OCD) in children with early stages of CKD, and to compare it with the occurrence of OCD in healthy children.Patients and Methods:In this case-control study, we evaluated 160 children aged 7 to 17 years old who were visited in the pediatric clinics of Amir-Kabir hospital, Arak, Iran. The control group consisted of 80 healthy children and the case group included 80 children with Stage 1 to 3 CKD. The ages and sex of the children in the two groups were matched. OCD in children was evaluated using the obsessive compulsive inventory-child version (OCI-CV).Results:The mean scores of doubting/checking (case: 3.52 ± 2.54, control: 2.5 ± 2.32, P = 0.007) and ordering (case: 2.59 ± 1.81, control: 1.5 ± 2.56, P = 0.005) in the children with CKD was significantly higher than in the healthy ones. Moreover, the mean total scores for the OCI-CV of the children with CKD at 15.32 ± 7.69 was significantly higher than the scores of the healthy ones at 11.12 ± 2.54 (P = 0.021). There was a significant correlation between the CKD duration and doubting/checking (P = 0.004, correlation coefficient (CC): 0.4), obsessing (P = 0.06, CC: 0.02), washing (P = 0.031, CC: 0.8), ordering (P = 0.001, CC: 0.2), and the total scores of the OCI-CV questionnaire (P = 0.04, CC: 0.4).Conclusions:The risk of OCD in children with CKD is significantly higher than that in healthy children. Although the results seem to suggest that psychiatric intervention can be helpful in treating OCD in children with CKD, further investigation into the medical condition is required so as to obtain more definitive conclusions.

Incidence of obsessive-compulsive disorder in children with nonmonosymptomatic primary nocturnal enuresis.

Introduction:Enuresis is defined as the repeated voiding of urine into clothes or bed at least twice a week for at least 3 consecutive months in a child who is at least 5 years of age. The behavior is not due exclusively to the direct physiologic effect of a substance or a general medical condition. Diurnal enuresis defines wetting, whereas awake and nocturnal enuresis refers to voiding during sleep. Primary enuresis occurs in children who have never been consistently dry through the night, whereas secondary enuresis refers the resumption of wetting after at least 6 months of dryness. Monosymptomatic enuresis has no associated daytime symptoms, and nonmonosymptomatic enuresis, which is more common, often has at least one subtle daytime symptom. Monosymptomatic enuresis is rarely associated with significant organic underlying abnormalities. Obsessive–compulsive disorder (OCD) is a chronic disabling illness characterized by repetitive, ritualistic behaviors over which the patients have little or no control. The purpose of this study was to investigate the relationship between OCD and nonmonosymptomatic nocturnal enuresis (NMNE).Materials and Methods:In this case–control study, we evaluated 186 children aged 6–17 years old who were visited in the pediatric clinics of Amir Kabir Hospital, Arak, Iran. The control group included 93 healthy children, and the case group included 93 age- and sex-matched children with stage 1–3 chronic kidney disease (CKD). Then, the children's behavioral status was evaluated using the Children's Yale-Brown Obsessive–Compulsive Scale.Results:The difference in compulsion was significant (P = 0.021), whereas the difference in obsession was significant between the two groups (P = 0.013). The most common symptom in CKD children with compulsion was silent repetition of words.Conclusion:Compulsive and obsessive are more common in NMNE versus healthy children. The observed correlation between compulsive-obsessive and NMNE makes psychological counseling mandatory in children with NMNE.

Comorbid bipolar disorder and obsessive-compulsive disorder in children and adolescents: Treatment implications.

Apparent comorbidity between bipolar disorder (BD) and obsessive–compulsive disorder (OCD) is a common condition in psychiatry with higher prevalence rates in youths (23.2%, 95% confidence interval [CI] = [11.5%, 41.3%]) compared to adults (13.56%, 95% CI = [10.4%, 16.25%]) (Amerio et al., 2015). The meaning of this comorbidity has not been clarified yet. The treatment of BD-OCD patients remains a great challenge since the gold standard for one disease (serotonin reuptake inhibitors [SRIs] for OCD) can worsen the other (antidepressants can cause mania and/or more mood episodes in BD; Amerio et al., 2014a). The literature on pharmacologic or psychotherapeutic approaches especially in pediatric BD-OCD patients is limited. Therefore, we updated our recent systematic review (Amerio et al., 2014b) and focused specifically on the treatment of BD-OCD comorbidity in children and adolescents. Studies were identified by searching the electronic databases MEDLINE, EMBASE and PsycINFO. We combined the search strategy of free text terms and exploded MeSH headings for the topics of BD, OCD and treatment combined as follows: ((((((‘Therapeutics’[Mesh]) OR treatment*) OR therap*) OR pharmacotherap*) OR psychotherap*)) AND (((((((((‘Bipolar Disorder’[Mesh]) OR Bipolar disorder) OR BD) OR Bipolar) OR Manic depressive disorder) OR Manic depressive) OR Manic)) AND ((((‘Obsessive-Compulsive Disorder’ [Mesh]) OR OCD) OR Obsessivecompulsive) OR Obsessive-compulsive disorder))). Studies published in English through 31 August 2015 were included. Further studies were retrieved from reference listing of relevant articles and consultation with experts in the field. Seven studies were selected (Table 1). In all selected studies, BD-OCD patients received mood stabilizers (lithium, divalproex sodium). In the largest study, 42.1% of comorbid patients required a combination of multiple mood stabilizers and 10.5% a combination of mood stabilizers with atypical antipsychotics (quetiapine, risperidone, aripiprazole). Addition of antidepressant (clomipramine) to mood stabilizers led to clinical remission of both conditions in only one study. In other cases, antidepressants (escitalopram) seemed prone to cause more manic/hypomanic episodes in BD-OCD than in non-comorbid patients. The evidence so far on BD-OCD nosology supports the view that the majority of cases of comorbid BD-OCD are in fact BD cases (Amerio et al., 2014a). Osler’s view that medicine should be treatment of diseases, not of symptoms, is consistent with the approach of mood stabilization as a first objective in apparent BD-OCD patients, as opposed to immediate treatment with SRIs.

Obsessive Compulsive Disorder in Children

Obsessive compulsive disorder (OCD) is a type of anxiety disorder characterized by recurrent, intrusive, unwanted thoughts. Research indicates a genetic predisposition for OCD. Many people with OCD have one or more family members who also have it or who may have other anxiety disorders influenced by the brain's serotonin levels, such as panic disorder. An estimated 1% of children in the United States are diagnosed with OCD, and it is characterized by a pattern of rituals and obsessive thinking that occur for at least one hour or more daily; results in significant distress for the child; and interferes with the child's ability to function. A combination of medications and cognitive behavioral therapy are recommended.

Intensive Cognitive Behavioural Treatment for Obsessive Compulsive Disorder in Children and Adolescents

Preliminary evidence for the efficacy of intensive treatments for childhood OCD is promising. This is an important area of research as traditional weekly CBT for OCD is costly, time intensive and is often challenging for families to access. This review explores the evidence base for intensive treatments for childhood OCD and following this, provides a description of a novel intensive treatment approach that combines prolonged intensive ERP sessions, similar to the one-session treatment for specific phobia, with CBT delivered over the computer via webcam (W-CBT) for one-month maintenance. Future research directions are also discussed.

P.4.c.006 Diagnostic and treatment particularities of early-onset obsessive–compulsive disorder in children

P.4.c.006 Diagnostic and treatment particularities of early-onset obsessive–compulsive disorder in children

706 – 110 years after first report of obsessive compulsive disorder in childhood - where do we stand?

Introduction First case report of paediatric obsessive compulsive disorder (OCD) was presented by Janet in 1903. Since then many more reports of OCD in children and adolescents have been published. OCD in adult patients has been studied in the last decades but studies for pediatric OCD only began in the last 20 years. Objectives To review the most recent knowledge on the characteristics, epidemiology, pathophysiology and treatment of pediatric OCD. Methods Review literature published on MEDLINE/Pubmed database in English language using “obsessive compulsive disorder in childhood”, “obsessive compulsive disorder in children and adolescents”, “OCD in childhood”, “OCD in children and adolescents” and “pediatric OCD” as key-words. Results OCD is common among children and adolescents, with prevalence of 1-3% that often becomes a chronic condition. OCD onset has a bimodal age distribution with one peak at age 11 and other peak in early adulthood. There is a male preponderance in affected children, high comorbidity with psychiatric disorders mainly with tic disorders and attention deficit hyperactivity disorder, higher familiality and higher rates of aggressive/harm obsessions and religious obsessions. The current etiologic model most commonly accepted points to a dysfunction of cortico-striato-thalamic loops. Cognitive behavioural therapy (CBT) and a combination of CBT with a selective serotonin reuptake inhibitor are the treatments of choice for pediatric OCD. Conclusions Pediatric OCD seems to be an OCD subtype with similarities but also with important differences from adultonset OCD. Further research is still needed to better elucidate the genetics and the exact pathophysiology of pediatric OCD.

Trastorno obsesivo compulsivo en niños y adolescentes

BackgroundObsessive-compulsive disorder (OCD) in children and adolescents is a complex disease. It is considered the fourth most common psychiatric disorder in the world, with relevant biopsychosocial morbidity and a prevalence of 1–3% of the world population; it is defined by the World Health Organization as the tenth most disabling illness. ObjectiveTo review approaches in the scientific literature and updates on natural history, course, diagnosis, and treatment of OCD in children and adolescents. MethodSearch in PubMed and LILACS databases, from 2005. ResultsNo Colombian update articles dealing with this subject were found and international articles showed inconclusive results on the various topics of natural history, course, diagnosis, and treatment of obsessive compulsive disorder in children and adolescents. Conclusions: This is a chronic disorder with intense anxiety, high comorbidity, and no accurate predictors of prognosis. The social image of the perfect child and the lack of awareness about their condition restricts their care and improvement.

Traumatic events and obsessive compulsive disorder in children and adolescents: Is there a link?

Background: The extant literature supports an association between psychological trauma and development of OCD in adults, and this link is a plausible mediator for environment–gene interactions leading to phenotypic expression of OCD. Objective: To explore the relationship between OCD and traumatic life events in children and adolescents. Methods: We examined the prevalence of traumatic life events and PTSD in a large sample of systematically assessed children with OCD. OCD symptoms and severity were assessed using the Children's Yale Brown Obsessive Compulsive Scale (CY-BOCS) in those with and without concurrent PTSD. Results: Rate of PTSD and trauma exposure was higher in children with OCD than in a comparable control group of non-OCD youth matched for age, gender and SES. Children with concurrent PTSD had more intrusive fears and distress and less control over their rituals than children with OCD but without PTSD. Total CY-BOCS scores were higher in those with concurrent PTSD. Specific type of OCD symptoms was not altered by a PTSD diagnosis. Conclusions: A history of psychologically traumatic events may be over-represented in children with OCD. Given the need to search for non-genetic factors that may lead to onset of OCD, better and more systematic methods to obtain and quantify psychologically traumatic life events are needed in clinical populations.

Obsessive–compulsive disorder in children and adolescents. Symptom dimensions in a naturalistic setting

Background: Obsessive–compulsive disorder (OCD) is a frequent and clinically heterogeneous disorder. The complex clinical presentation can be summarized using a few consistent and temporally stable symptom dimensions. Only few studies in children and adolescents have examined the importance of symptom dimensions. Aims: This retrospective study was undertaken to describe the relation between symptom dimensions, pattern of comorbidity and family disposition, in a sample of Danish children and adolescents with OCD assessed in a naturalistic setting. Methods: A retrospective study of children and adolescents (n=83) diagnosed with OCD in the period 1998–2004, at the Psychiatric Hospital for Children and Adolescents, Risskov, Denmark. Information from clinical records was systematically collected and Children's Yale–Brown Obsessive–compulsive Scale (CY-BOCS) scores and symptom checklists were obtained. Results: High scores on the symmetry/ordering dimension were related to OCD in first-degree relatives and high scores on the aggressive/checking dimension were associated to comorbidity with tic disorders. We showed a correlation between limited insight and younger age. Conclusion: This is one of the first studies to examine symptom dimensions in children and adolescents in naturalistic settings. The results were comparable with those in adult studies, showing an association between the occurrence of the symmetry/ordering dimension and family OCD and the occurrence of the aggressive/checking dimension and comorbid tic disorders. In small children, insight into symptoms may be limited.