SEXUAL OBSESSIONS IN PEDIATRIC OBSESSIVE-COMPULSIVE DISORDER: CLINICAL CHARACTERISTICS AND TREATMENT OUTCOMES

Authors

  • Lorena Fernández de la Cruz M.Sc.,

    Corresponding author
    1. National and Specialist OCD and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, United Kingdom
    2. Department of Psychiatry and Legal Medicine, Autonomous University of Barcelona, Barcelona, Spain
    • King's College London, Institute of Psychiatry, London, United Kingdom
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  • Faye Barrow B.Sc.,

    1. National and Specialist OCD and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, United Kingdom
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  • Koen Bolhuis B.Sc.,

    1. King's College London, Institute of Psychiatry, London, United Kingdom
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  • Georgina Krebs DClinPsy,

    1. National and Specialist OCD and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, United Kingdom
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  • Chloe Volz CPsychol,

    1. National and Specialist OCD and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, United Kingdom
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  • Eriko Nakatani M.D.,

    1. Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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  • Isobel Heyman M.B.B.S., Ph.D.,

    1. King's College London, Institute of Psychiatry, London, United Kingdom
    2. National and Specialist OCD and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, United Kingdom
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  • David Mataix-Cols Ph.D.

    1. King's College London, Institute of Psychiatry, London, United Kingdom
    2. National and Specialist OCD and Related Disorders Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, United Kingdom
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  • Conflict of interest: The authors have no competing interests to declare.

Correspondence to: Lorena Fernández de la Cruz, King's College London, Institute of Psychiatry, PO Box 69, De Crespigny Park, London SE5 8AF, United Kingdom. E-mail: lorena.fernandez_de_la_cruz@kcl.ac.uk

Abstract

Background

Sexual obsessions are common in adults with obsessive-compulsive disorder (OCD), cause great distress, and are sometimes misinterpreted as indicating risk to others. Little is known about the prevalence, clinical correlates, and prognosis of such symptoms in young people.

Methods

Three hundred and eighty-three patients referred to a specialist pediatric OCD clinic were administered a series of measures at intake and, for those treated at the clinic, again after treatment. Patients with and without sexual obsessions were compared on socio-demographic and clinical characteristics. Mixed model analyses of variance compared treatment outcomes in both groups.

Results

A quarter of patients had sexual obsessions at baseline (age range 8–17); they had slightly more severe OCD symptoms and were more depressed than those without sexual obsessions. Aggressive and religious obsessions, magical thinking, fear of saying certain things, repeating rituals, superstitious games, mental rituals, and the need to tell, ask, or confess were more frequent in participants with sexual obsessions. Crucially, no differences in treatment outcome were found between the groups.

Conclusions

Sexual obsessions are common in pediatric OCD, even in very young children. Although they may be associated with particular clinical features, they do not interfere with treatment response. The occurrence of sexual obsessions in children should be recognized and these symptoms understood as ordinary, nonthreatening OCD symptoms, which pose no risk to others. They respond to the standard treatment strategies, so children and families should receive the usual message of optimism regarding the chances of recovery.

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