Psychotic Vulnerability in Adolescents With Obsessive-Compulsive Disorder: First Longitudinal Evidence From a Prospective Pilot Study

IF 2.3 4区医学 Q3 PSYCHIATRY

Early Intervention in Psychiatry Pub Date : 2026-08-05 DOI:10.1111/eip.70244

Davide Fausto Borrelli, Luca Gambolò, Anna Di Donna, Carlo Marchesi, Matteo Tonna

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Abstract

Aim

Childhood-onset Obsessive-Compulsive Disorder (OCD) has been associated with an increased vulnerability to psychosis, yet no prospective studies have examined this risk in paediatric populations.

Methods

In this pilot prospective study, 59 adolescents with a primary diagnosis of OCD were assessed at baseline for psychotic vulnerability, measured through Cognitive-Perceptual basic symptoms (COPER) and the high-risk criterion Cognitive Disturbances (COGDIS), as well as for OCD severity and psychosocial functioning. The number of subjects who developed a first episode of psychosis (FEP) during the 18-month follow-up period was evaluated. Logistic regression and moderation analyses were performed.

Results

During the follow-up period, 18.6% of participants presented with a FEP. These patients were older and displayed poorer psychosocial functioning compared with those who did not develop a FEP. Logistic regression identified higher COPER symptoms and lower psychosocial functioning as the only significant predictors of FEP. Although moderation effects were not statistically significant, exploratory simple slopes suggested that both COPER and COGDIS symptoms were more strongly associated with psychosis onset in adolescents with lower psychosocial functioning.

Conclusions

This study highlights a notable rate of progression to psychosis among adolescents with OCD over an 18-month period. Despite methodological limitations, our findings offer preliminary evidence that COPER symptoms and impaired psychosocial functioning are key risk factors in adolescents with OCD for progression to psychosis.

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青少年强迫症患者的精神脆弱性：来自前瞻性先导研究的首个纵向证据。

目的：儿童期发病的强迫症（OCD）与精神病易感性增加有关，但没有前瞻性研究检查儿科人群的这种风险。方法：在这项前瞻性先导研究中，对59名初次诊断为强迫症的青少年进行精神病易感性基线评估，通过认知-知觉基本症状（COPER）和高危标准认知障碍（COGDIS）以及强迫症严重程度和心理社会功能进行测量。在18个月的随访期间，评估出现首次精神病发作（FEP）的受试者数量。进行了Logistic回归和适度分析。结果：在随访期间，18.6%的参与者出现FEP。与未发生FEP的患者相比，这些患者年龄较大，表现出较差的社会心理功能。Logistic回归发现较高的COPER症状和较低的社会心理功能是FEP的唯一显著预测因子。虽然调节效应在统计学上不显著，但探索性简单斜率表明，在心理社会功能较低的青少年中，COPER和COGDIS症状与精神病发作的相关性更强。结论：本研究强调了强迫症青少年在18个月的时间内发展为精神病的显著率。尽管方法上存在局限性，但我们的研究结果提供了初步证据，表明COPER症状和心理社会功能受损是强迫症青少年发展为精神病的关键危险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Early Intervention in Psychiatry 医学-精神病学

CiteScore

4.80

自引率

5.00%

发文量

112

审稿时长

6-12 weeks

期刊介绍： Early Intervention in Psychiatry publishes original research articles and reviews dealing with the early recognition, diagnosis and treatment across the full range of mental and substance use disorders, as well as the underlying epidemiological, biological, psychological and social mechanisms that influence the onset and early course of these disorders. The journal provides comprehensive coverage of early intervention for the full range of psychiatric disorders and mental health problems, including schizophrenia and other psychoses, mood and anxiety disorders, substance use disorders, eating disorders and personality disorders. Papers in any of the following fields are considered: diagnostic issues, psychopathology, clinical epidemiology, biological mechanisms, treatments and other forms of intervention, clinical trials, health services and economic research and mental health policy. Special features are also published, including hypotheses, controversies and snapshots of innovative service models.