Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Methodol. Jan 20, 2022; 12(1): 54-63
Published online Jan 20, 2022. doi: 10.5662/wjm.v12.i1.54
Phenomenology of obsessive-compulsive disorder in children and adolescents: Sample from a tertiary care center in Istanbul, Turkey
Anil Cifter, Ayse Burcu Erdogdu
Anil Cifter, School of Medicine, Marmara University, Istanbul 34899, Turkey
Ayse Burcu Erdogdu, Department of Child and Adolescent Psychiatry, School of Medicine, Marmara University, Istanbul 34899, Turkey
Author contributions: Cifter A and Erdogdu AB designed the project and created data collection tools; Cifter A examined the patient files; Cifter A and Erdogdu AB did the analysis, interpreted the data and wrote the paper for publication; Erdogdu AB critically revised the paper.
Institutional review board statement: The study protocol was approved by the Marmara University School of Medicine Clinical Research Ethics Committee (Protocol No: 09.2019.360, date: April 5, 2019).
Informed consent statement: Written informed consent was obtained from parents or legal guardians of the patients.
Conflict-of-interest statement: None declared.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Anil Cifter, MD, School of Medicine, Marmara University, Marmara University Training and Research Hospital, Fevzi Çakmak Mah. Muhsin Yazıcıoğlu Cad. No. 10 Üst Kaynarca/Pendik, Istanbul 34899, Turkey.
Received: June 10, 2021
Peer-review started: June 10, 2021
First decision: July 31, 2021
Revised: August 5, 2021
Accepted: December 2, 2021
Article in press: December 2, 2021
Published online: January 20, 2022

Obsessive-compulsive disorder (OCD) is a heterogeneous disease in many respects and exhibits this diversity in terms of phenomenology. It also displays several different characteristics in children compared to adults.


To describe the socio-demographic and phenomenological features of children with OCD and to investigate the impact of these features on response to pharmacotherapy.


This retrospective study was carried out with 150 children and adolescents who had been diagnosed with OCD between 2014 and 2018. Data was collected by examining the files of the patients with diagnosis of OCD and similar disorders from the hospital database. Yale-Brown Obsessive-Compulsive Scale for Children was used for the assessment of obsession-compulsion subtypes. The Clinical Global Impression (CGI) scale was used to evaluate the severity of the disease (CGI-S) and global improvement (CGI-I). The predictors of treatment response were evaluated using linear regression analysis. The level of significance for all statistic tests was set as P < 0.05.


The sample was divided into prepubertal (44%) and adolescent (56%) age groups. The most prevalent obsessions were contamination and aggression obsessions, and the most frequent compulsions were washing and checking. While contamination was observed more commonly in the prepubertal age group, the religious obsession was seen more frequently in adolescents. Patients with aggression obsession presented a higher frequency of comorbid anxiety (P = 0.022) and mood (P = 0.047) disorder. CGI-I scores did not differ according to phenomenological subgroups (P > 0.05). A lower CGI-I score was linked to a lower CGI-S score (95% confidence interval 0.21-0.39, P < 0.001) and the prepubertal age of admission (95% confidence interval 0.03-0.87, P = 0.020).


The phenomenology of OCD shows differences depending on the age group and the comorbid psychiatric disorders. Earlier identification and treatment of OCD may help to prevent the impairment of the mental health of children and adolescents.

Keywords: Obsessive-compulsive disorder, Phenomenology, Comorbidity, Treatment response, Serotonin reuptake inhibitors

Core Tip: We aimed to analyze the socio-demographic and phenomenological features of children and adolescents with obsessive-compulsive disorder and to investigate the impact of these features on the pharmacotherapy response. Contamination was the commonest obsession, and washing-cleaning was the most common compulsion. The type of obsession varied with the age group: Contamination was seen more frequent in prepubertal age group, whereas the religious obsessions in adolescents. Aggression obsession was associated with the comorbid anxiety disorders and depression. The treatment response deteriorated with the increase in severity of disease and the age of admission. No difference was observed between the phenomenological subgroups in case of treatment response.