Risk factors for obsessive–compulsive symptoms. Follow-up of a community-based youth cohort


Environmental factors are at least as important as genetic factors for the development of obsessive–compulsive symptoms (OCS), but the identification of such factors remain a research priority. Our study aimed to investigate the association between a broad scope of potential risk factors and OCS in a large community cohort of children and adolescents. We evaluated 1877 participants and their caregivers at baseline and after 3 years to assess various demographic, prenatal, perinatal, childhood adversity, and psychopathological factors. Mean age at baseline was 10.2 years (SD 1.9) and mean age at follow-up was 13.4 years (SD 1.9). Reports of OCS at baseline and follow-up were analyzed using latent variable models. At preliminary regression analysis, 15 parameters were significantly associated with higher OCS scores at follow-up. At subsequent regression analysis, we found that eight of these parameters remained significantly associated with higher follow-up OCS scores while being controlled by each other and by baseline OCS scores. The significant predictors of follow-up OCS were: lower socioeconomic status (p = 0.033); lower intelligence quotient (p = 0.013); lower age (p < 0.001); higher maternal stress level during pregnancy (p = 0.028); absence of breastfeeding (p = 0.017); parental baseline OCS (p = 0.038); youth baseline anxiety disorder (p = 0.023); and youth baseline OCS scores (p < 0.001). These findings may better inform clinicians and policymakers engaged in the mental health assessment and prevention in children and adolescents.

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This work was supported by the National Institute of Developmental Psychiatry for Children and Adolescents, a science and technology institute funded by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq; National Council for Scientific and Technological Development; Grant number 573974/2008-0) and Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP; Research Support Foundation of the State of São Paulo; Grant numbers 2008/57896-8 and 2015/01587-0). The authors thank the children and families for their participation, which made this research possible.

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Pedro Macul Ferreira de Barros, Natalia Szejko, Natália Polga, Guaraci de Lima Requena, Ana Beatriz Ravagnani Salto, Daniel Fatori, Marcelo Camargo Batistuzzo, Marcelo Queiroz Hoexter, Eurípedes Constantino Miguel and Pedro Gomes de Alvarenga declare no conflicts of interest. Maria Conceição do Rosário has served on the speakers’ bureau of Novartis and Shire, and declares no potential conflicts of interest relating to this research. Luis Augusto Rohde has received grant or research support from, served as a consultant to, and served on the speakers’ bureau of Eli Lilly and Co., Janssen, Medice, Novartis, and Shire. The ADHD and Juvenile Bipolar Disorder Outpatient Programs chaired by Dr. Rohde have received unrestricted educational and research support from the following pharmaceutical companies: Eli Lilly and Co., Janssen, Shire, and Novartis. Dr. Rohde has received travel grants from Shire to take part in the 2018 American Psychological Association annual meeting and from Novartis to take part of the 2016 American Academy of Child and Adolescent Psychiatry annual meeting. He also has received authorship royalties from Oxford Press and ArtMed, and declares no potential conflicts of interest relating to this research. Guilherme Vanoni Polanczyk has served as a consultant or speaker to Shire, Teva, and Medice, has received royalties from Editora Manole, and declares no potential conflicts of interest relating to this research. James Frederick Leckman receives royalties from John Wiley and Sons, McGraw Hill, and Oxford University Press; is on the Advisory Boards for Brain and Behavior Research Foundation and How I Decide; has served as a consultant for Tasly Pharmaceuticals, Inc., and declares no potential conflicts of interest relating to this research.

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Macul Ferreira de Barros, P., do Rosário, M.C., Szejko, N. et al. Risk factors for obsessive–compulsive symptoms. Follow-up of a community-based youth cohort. Eur Child Adolesc Psychiatry 30, 89–104 (2021). https://doi.org/10.1007/s00787-020-01495-7

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  • Prenatal risk factors
  • Perinatal risk factors
  • Childhood adverse events
  • Obsessive–compulsive symptoms
  • Longitudinal study