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Obsessive-compulsive disorder in the elderly: A report from the International College of Obsessive-Compulsive Spectrum Disorders (ICOCS) - 24/11/17

Doi : 10.1016/j.eurpsy.2017.06.008 
B. Dell’Osso a, b, B. Benatti a, , C.I. Rodriguez b, C. Arici a, C. Palazzo a, A.C. Altamura a, E. Hollander c, N. Fineberg d, D.J. Stein e, H. Nicolini f, g, N. Lanzagorta g, D. Marazziti h, S. Pallanti i, M. Van Ameringen j, C. Lochner k, O. Karamustafalioglu l, L. Hranov m, M. Figee n, L. Drummond o, J. Grant p, D. Denys n, D. Cath q, J.M. Menchon r, J. Zohar s
a Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’Granda, Ospedale Maggiore Policlinico, 20122 Milano, Italy 
b Department of Psychiatry and Behavioral Sciences, Stanford University, 94305 Stanford, CA, USA 
c Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine and Montefiore Medical Center, 10467 New York, USA 
d Mental Health Unit, Hertfordshire Partnership Foundation Trust, Queen Elizabeth II Hospital, AL7 4HQ Welwyn Garden City, UK 
e MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry and Mental Health, University of Cape Town, 7935 Cape Town, South Africa 
f Genomics of Psychiatric and Neurodegenerative Diseases Laboratory, National Institute of Genomic Medicine (INMEGEN), 03100 Mexico City, Mexico 
g Carracci Medical Group, 03100 Mexico City, Mexico 
h Dipartimento di Medicina Clinica e Sperimentale, Sezione di Psichiatria, Università di Pisa, 56126 Pisa, Italy 
i Department of Psychiatry, University of Florence, and Institute of Neurosciences, 50121 Florence, Italy 
j Department of Psychiatry and Behavioural Neurosciences, McMaster University, ON L8S 4L8 Hamilton, Canada 
k MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, University of Stellenbosch, 7599 Stellenbosch, South Africa 
l Department of Psychiatry, Sisli Eftal Teaching and Research Hospital, 34371 Istanbul, Turkey 
m University Multiprofile Hospital for Active Treatment in Neurology and Psychiatry Sveti Naum, 1797 Sofia, Bulgaria 
n Department of Psychiatry, Academic Medical Center, University of Amsterdam, 1105 Amsterdam, Netherlands 
o National and Trustwide Services for OCD/BDD, SW London and St George's NHS Trust, SW17 7DJ London, UK 
p Department of Psychiatry & Behavioral Neuroscience, University of Chicago, 60607 Chicago, USA 
q Department of Clinical and Health Psychology, Utrecht University, 3512 Utrecht, The Netherlands 
r Psychiatry Unit at Hospital Universitari de Bellvitge, 08907 Barcelona, Spain 
s Department of Psychiatry, Chaim Sheba Medical Center, 52621 Tel Hashomer, Israel 

?Corresponding authorDepartment of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milano. Via Francesco Sforza 35, 20122 Milano, Italy. Fax: +02 55033140

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Abstract

Introduction

Obsessive-compulsive disorder (OCD) is a highly disabling condition, with frequent early onset. Adult/adolescent OCD has been extensively investigated, but little is known about prevalence and clinical characterization of geriatric patients with OCD (G-OCD=65years). The present study aimed to assess prevalence of G-OCD and associated socio-demographic and clinical correlates in a large international sample.

Methods

Data from 416 outpatients, participating in the ICOCS network, were assessed and categorized into 2 groups, age<vs=65years, and then divided on the basis of the median age of the sample (age<vs=42years). Socio-demographic and clinical variables were compared between groups (Pearson Chi-squared and t tests).

Results

G-OCD compared with younger patients represented a significant minority of the sample (6% vs 94%, P<.001), showing a significantly later age at onset (29.4±15.1 vs 18.7±9.2years, P<.001), a more frequent adult onset (75% vs 41.1%, P<.001) and a less frequent use of cognitive-behavioural therapy (CBT) (20.8% vs 41.8%, P<.05). Female gender was more represented in G-OCD patients, though not at a statistically significant level (75% vs 56.4%, P=.07). When the whole sample was divided on the basis of the median age, previous results were confirmed for older patients, including a significantly higher presence of women (52.1% vs 63.1%, P<.05).

Conclusions

G-OCD compared with younger patients represented a small minority of the sample and showed later age at onset, more frequent adult onset and lower CBT use. Age at onset may influence course and overall management of OCD, with additional investigation needed.

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Keywords : Obsessive-compulsive disorder (OCD), Geriatric obsessive-compulsive disorder, Prevalence, Age at onset


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