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

Published online by Cambridge University Press:  23 March 2020

B. Dell’Osso ,
B. Benatti ,
C.I. Rodriguez ,
C. Arici ,
C. Palazzo ,
A.C. Altamura ,
E. Hollander ,
N. Fineberg ,
D.J. Stein  and
H. Nicolini
...Show all authors
B. Dell’Osso
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’Granda, Ospedale Maggiore Policlinico, 20122Milano, Italy Department of Psychiatry and Behavioral Sciences, Stanford UniversityStanford, CA94305, USA
B. Benatti*
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’Granda, Ospedale Maggiore Policlinico, 20122Milano, Italy
C.I. Rodriguez
Affiliation:
Department of Psychiatry and Behavioral Sciences, Stanford UniversityStanford, CA94305, USA
C. Arici
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’Granda, Ospedale Maggiore Policlinico, 20122Milano, Italy
C. Palazzo
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’Granda, Ospedale Maggiore Policlinico, 20122Milano, Italy
A.C. Altamura
Affiliation:
Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’Granda, Ospedale Maggiore Policlinico, 20122Milano, Italy
E. Hollander
Affiliation:
Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine and Montefiore Medical Center, 10467New York, USA
N. Fineberg
Affiliation:
Mental Health Unit, Hertfordshire Partnership Foundation Trust, Queen Elizabeth II Hospital, AL7 4HQWelwyn Garden City, UK
D.J. Stein
Affiliation:
MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry and Mental Health, University of Cape Town, 7935Cape Town, South Africa
H. Nicolini
Affiliation:
Genomics of Psychiatric and Neurodegenerative Diseases Laboratory, National Institute of Genomic Medicine (INMEGEN), 03100Mexico City, Mexico Carracci Medical Group, 03100Mexico City, Mexico
N. Lanzagorta
Affiliation:
Carracci Medical Group, 03100Mexico City, Mexico
D. Marazziti
Affiliation:
Dipartimento di Medicina Clinica e Sperimentale, Sezione di Psichiatria, Università di Pisa, 56126Pisa, Italy
S. Pallanti
Affiliation:
Department of Psychiatry, University of Florence, and Institute of Neurosciences, 50121Florence, Italy
M. Van Ameringen
Affiliation:
Department of Psychiatry and Behavioural Neurosciences, McMaster University, ON L8S 4L8Hamilton, Canada
C. Lochner
Affiliation:
MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, University of Stellenbosch, 7599Stellenbosch, South Africa
O. Karamustafalioglu
Affiliation:
Department of Psychiatry, Sisli Eftal Teaching and Research Hospital, 34371Istanbul, Turkey
L. Hranov
Affiliation:
University Multiprofile Hospital for Active Treatment in Neurology and Psychiatry Sveti Naum, 1797Sofia, Bulgaria
M. Figee
Affiliation:
Department of Psychiatry, Academic Medical Center, University of Amsterdam, 1105Amsterdam, Netherlands
L. Drummond
Affiliation:
National and Trustwide Services for OCD/BDD, SW London and St George's NHS Trust, SW17 7DJLondon, UK
J. Grant
Affiliation:
Department of Psychiatry & Behavioral Neuroscience, University of Chicago, 60607Chicago, USA
D. Denys
Affiliation:
Department of Psychiatry, Academic Medical Center, University of Amsterdam, 1105Amsterdam, Netherlands
D. Cath
Affiliation:
Department of Clinical and Health Psychology, Utrecht University, 3512Utrecht, The Netherlands
J.M. Menchon
Affiliation:
Psychiatry Unit at Hospital Universitari de Bellvitge, 08907Barcelona, Spain
J. Zohar
Affiliation:
Department of Psychiatry, Chaim Sheba Medical Center, 52621Tel Hashomer, Israel
*
*Corresponding author. Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milano. Via Francesco Sforza 35, 20122 Milano, Italy. Fax: +02 55033140. E-mail address:[email protected] (B. Benatti).
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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 = 65 years). 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 = 65 years, and then divided on the basis of the median age of the sample (age < vs = 42 years). 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 ± 9.2 years, 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.

Keywords

Obsessive-compulsive disorder (OCD)Geriatric obsessive-compulsive disorderPrevalenceAge at onset
Type
Original article
Information
European Psychiatry , Volume 45 , September 2017 , pp. 36 - 40
Copyright
Copyright © European Psychiatric Association 2017

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