Somatic Symptoms in Children and Adolescents with Obsessive-Compulsive Disorder: Associations with Clinical Characteristics and Cognitive-Behavioral Therapy Response

Despite being a core characteristic of anxiety disorders, little data have been reported on somatic symptoms (SSs) in youth with obsessive-compulsive disorder (OCD). Eighty-five children and adolescents with OCD were administered the Children’s Yale Brown ObsessiveCompulsive Scale and completed the Children’s Depression Inventory and Multidimensional Anxiety Scale for Children. Their parents completed the Child Behavior Checklist and Children’s Obsessive-Compulsive Impact Scale. A subset of youth (n = 62) completed a trial of cognitive-behavioral therapy. The frequency of specific SSs was examined in relation to age, gender, OCD symptom severity, child-rated symptoms of depression and anxiety, parent-proxy ratings of internalizing and externalizing problems, and functional impairment. Ninety-six percent of youth experienced at least one SS, with 67% reporting five or more SSs. Child-rated SSs were positively associated with parent-ratings of child SSs, child-rated anxiety and depression, and parent ratings of the children’s internalizing problems. Parent-rated SSs were positively related to parent-proxy ratings of internalizing problems and OCD-related impairment, clinician-rated OCD symptom severity, and child-rated generalized anxiety. Total and several specific SSs were reduced following cognitive-behavioral treatment. These results suggest that SSs are prevalent in youth with OCD, are associated with symptom severity, are reduced after participation in cognitive-behavioral therapy, and warrant attention during assessment and treatment.