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Psychotic vulnerability in pediatric obsessive-compulsive disorder: associations with clinical features and treatment outcome in two clinical samples.

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Title: Psychotic vulnerability in pediatric obsessive-compulsive disorder: associations with clinical features and treatment outcome in two clinical samples.
Authors: Borrelli, Davide Fausto (AUTHOR), Højgaard, Davíð R. M. A. (AUTHOR), Storch, Eric A. (AUTHOR), Geller, Daniel A. (AUTHOR), Melin, Karin (AUTHOR), Thomsen, Per Hove (AUTHOR), Ivarsson, Tord (AUTHOR), Weidle, Bernhard (AUTHOR), Torp, Nor Christian (AUTHOR), Tonna, Matteo (AUTHOR), Cervin, Matti (AUTHOR)
Source: European Child & Adolescent Psychiatry. Nov2025, Vol. 34 Issue 11, p3449-3462. 14p.
Subjects: Scale analysis (Psychology), Research funding, Mental health services, T-test (Statistics), Data analysis, Mental health, Symptoms, Treatment effectiveness, Descriptive statistics, Schizophrenia, Chi-squared test, Obsessive-compulsive disorder in children, Statistics, Psychoses, Disease susceptibility, Comparative studies, Regression analysis, Comorbidity
Abstract: Children and adolescents with obsessive-compulsive disorder (OCD) are at increased risk of psychotic disorders; however, the manifestations and clinical implications of psychotic vulnerability among youth with OCD remain poorly understood. To address this gap, we examined the prevalence and clinical correlates of psychotic vulnerability in youth with OCD across two independent samples. Using the Thought Problems Scale of the Child Behavior Checklist (CBCL), we assessed 215 Scandinavian and 125 North American children and adolescents with OCD. Participants with and without psychotic vulnerability were compared in terms of several clinical features, assessed before and after cognitive-behavioral therapy (CBT). We examined whether psychotic vulnerability predicted outcome of CBT. Psychotic vulnerability was identified in 41.6% of the Scandinavian and 34.4% of the North American sample. In both samples, participants with psychotic vulnerability had poorer psychosocial functioning and more depressive symptoms at baseline. In the Scandinavian sample those with psychotic vulnerability had poorer psychosocial functioning and more severe anxiety symptoms post-treatment. In the Scandinavian sample, psychotic vulnerability was linked to the symmetry/hoarding dimension, while in the North American sample it was linked to the ordering and contamination-cleaning dimensions at baseline, and only to the contamination-cleaning dimension after treatment. Importantly, psychotic vulnerability did not predict CBT outcome in any of the samples. Our findings show that an in-depth second-level assessment of psychosis risk is merited in many cases of youth with OCD and suggest that treatment gains following CBT for pediatric OCD are similar in those with and without psychotic vulnerability. [ABSTRACT FROM AUTHOR]
Copyright of European Child & Adolescent Psychiatry is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Psychotic vulnerability in pediatric obsessive-compulsive disorder: associations with clinical features and treatment outcome in two clinical samples.
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  Data: <searchLink fieldCode="AR" term="%22Borrelli%2C+Davide+Fausto%22">Borrelli, Davide Fausto</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Højgaard%2C+Davíð+R%2E+M%2E+A%2E%22">Højgaard, Davíð R. M. A.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Storch%2C+Eric+A%2E%22">Storch, Eric A.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Geller%2C+Daniel+A%2E%22">Geller, Daniel A.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Melin%2C+Karin%22">Melin, Karin</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Thomsen%2C+Per+Hove%22">Thomsen, Per Hove</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ivarsson%2C+Tord%22">Ivarsson, Tord</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Weidle%2C+Bernhard%22">Weidle, Bernhard</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Torp%2C+Nor+Christian%22">Torp, Nor Christian</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Tonna%2C+Matteo%22">Tonna, Matteo</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cervin%2C+Matti%22">Cervin, Matti</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22European+Child+%26+Adolescent+Psychiatry%22">European Child & Adolescent Psychiatry</searchLink>. Nov2025, Vol. 34 Issue 11, p3449-3462. 14p.
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  Data: Children and adolescents with obsessive-compulsive disorder (OCD) are at increased risk of psychotic disorders; however, the manifestations and clinical implications of psychotic vulnerability among youth with OCD remain poorly understood. To address this gap, we examined the prevalence and clinical correlates of psychotic vulnerability in youth with OCD across two independent samples. Using the Thought Problems Scale of the Child Behavior Checklist (CBCL), we assessed 215 Scandinavian and 125 North American children and adolescents with OCD. Participants with and without psychotic vulnerability were compared in terms of several clinical features, assessed before and after cognitive-behavioral therapy (CBT). We examined whether psychotic vulnerability predicted outcome of CBT. Psychotic vulnerability was identified in 41.6% of the Scandinavian and 34.4% of the North American sample. In both samples, participants with psychotic vulnerability had poorer psychosocial functioning and more depressive symptoms at baseline. In the Scandinavian sample those with psychotic vulnerability had poorer psychosocial functioning and more severe anxiety symptoms post-treatment. In the Scandinavian sample, psychotic vulnerability was linked to the symmetry/hoarding dimension, while in the North American sample it was linked to the ordering and contamination-cleaning dimensions at baseline, and only to the contamination-cleaning dimension after treatment. Importantly, psychotic vulnerability did not predict CBT outcome in any of the samples. Our findings show that an in-depth second-level assessment of psychosis risk is merited in many cases of youth with OCD and suggest that treatment gains following CBT for pediatric OCD are similar in those with and without psychotic vulnerability. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of European Child & Adolescent Psychiatry is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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