Quality of life in children and adolescents with obsessive–compulsive disorder: a systematic review and meta-analysis

Obsessive-compulsive disorder (OCD) is a seriously impairing psychiatric condition that affects 1%-3% of youth. Investigating the quality of life (QOL) is an important issue for treatment planning of this disorder, as targeting symptoms without taking it into account may bias assessment and prognosis when the patient presents with reduced symptoms that do not correspond to improved QOL. However, QOL in young individuals with OCD has been understudied. This meta-analysis summarized current evidence that assessed differences in global, social and school QOL dimensions, between children/adolescents with OCD and screened controls. Age, sex and OCD severity were examined as moderators. Case-control studies were included if children/adolescents with primary OCD were compared with screened controls on validated self-reported QOL outcomes. Online databases (January 1966-January 2016) were searched. Five case-control studies were included (n=543, 17 effect sizes overall). On global QOL, a large effect size emerged (d=-1.16, P<0.001), suggesting that individuals with OCD had lower global QOL than controls. Moderate effect sizes emerged for school (d=-0.61, P<0.01) and social QOL (d=-0.54, P<0.01), respectively, indicating worse QOL on these domains for individuals with OCD. For samples with higher OCD severity, global QOL of individuals with OCD was lower than that for controls (β=-0.02, P<0.05). For samples with lower percentages of females, global QOL of individuals with OCD was more impaired (β=0.02, P<0.001). Age was not correlated with effect sizes. Assessment and treatment should target QOL for young males suffering from more severe OCD. The small number of included studies highlighted that QOL is under-recognized. Future research should focus on additional QOL domains and compare which ones are impaired among individuals with OCD compared with other psychiatric conditions. Overall, the results pointed out the importance of addressing QOL in both practice and research on assessment and treatment of children/adolescents with this condition.