The influence of age at onset and duration of illness on long-term outcome in patients with obsessive-compulsive disorder: A report from the International College of Obsessive Compulsive Spectrum Disorders (ICOCS)

Bernardo Dell'Osso, Beatrice Benatti, Massimiliano Buoli, A. Carlo Altamura, Donatella Marazziti, Eric Hollander, Naomi Fineberg, Dan J. Stein, Stefano Pallanti, Humberto Nicolini, Michael Van Ameringen, Christine Lochner, Georgi Hranov, Oguz Karamustafalioglu, Luchezar Hranov, Jose M. Menchon, Joseph Zohar

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31 Scopus citations


Several studies reported a negative effect of early onset and long duration of illness on long-term outcome in psychiatric disorders, including Obsessive-Compulsive Disorder (OCD). OCD is a prevalent, comorbid and disabling condition, associated with reduced quality of life and overall well-being for affected patients and related caregivers. The present multicenter naturalistic study sought to assess the influence of early onset and duration of illness on long-term outcome in a sample of 376 OCD out-patients worldwide, as part of the "International College of Obsessive-Compulsive Spectrum Disorders" (ICOCS) network. Binary logistic regressions were performed with age at the onset and duration of illness, as continuous independent variables, on a series of different outcome dependent variables, including lifetime number of hospitalizations and suicide attempts, poly-therapy and psychiatric comorbidity. Correlations in terms of disability (SDS) were analyzed as well. Results showed that a longer duration of illness (but not earlier age of onset) was associated with hospitalization (odds ratio=1.03, p=0.01), earlier age at onset with CBT (odds ratio=0.94, p<0.001) and both a later age at onset (odds ratio=1.05, p=0.02) and a shorter duration of illness (odds ratio=0.93, p=0.02) with panic disorder comorbidity. In addition, earlier age at onset inversely correlated with higher social disability (r=-0.12, p=0.048) and longer duration of illness directly correlated with higher disability in work, social and family life (r=0.14, p=0.017; r=0.13, p=0.035; r=0.14, p=0.02). The findings from the present large, multicenter study indicate early onset and long duration of illness as overall negative predictors of long-term outcome in OCD.

Original languageEnglish (US)
Pages (from-to)865-871
Number of pages7
JournalEuropean Neuropsychopharmacology
Issue number8
Publication statusPublished - Aug 1 2013



  • Duration of illness
  • Early onset
  • Long-term outcome
  • Obsessive compulsive disorder (OCD)

ASJC Scopus subject areas

  • Pharmacology
  • Neurology
  • Clinical Neurology
  • Psychiatry and Mental health
  • Biological Psychiatry
  • Pharmacology (medical)

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