Functional impairment in South African children and adolescents with obsessive-compulsive disorder

Master Thesis


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University of Cape Town

This research aimed to increase current understanding of functional impairment in children and adolescents with Obsessive-Compulsive Disorder (OCD). Twenty-six South African children and adolescents with OCD participated in the study. The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (KSADS-PL), the Mini International Neuropsychiatric Interview For Children and Adolescents Version 5 (MINIKID5.0), the Children's Global Assessment Scale (CGAS), the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) and the Child Obsessive-Compulsive Impact Scale-Revised (COIS-R) were used to assess the children's and adolescent's past and current psychopathology, OCD symptom severity and OCD-related functional impairment. Findings suggest that most of the children (88.46%) in this study had one or more comorbid disorders. Parents and children agreed on very few of the rating items common the COIS-R-P and COIS-R-C. Parents, however, consistently reported higher rates of significant problems than did their children. Correlations between the various instruments revealed that parents are more accurate than their children in rating their child's global impairment and OCD-specific impairment. Therefore, collateral information from parents is vital for the clinician to accurately assess and fully understand the child's OCD-related functional impairment. Moreover, the number of comorbid disorders, and whether the child had ADHD or not, did not impact on the COIS-R total scores, suggesting that the COIS-R is a useful measure to assess OCD-specific impairment. Parents and children both reported that the most significant domain of impairment is the school domain. Moreover, parents reported that the most significant functional problem is "concentrating on his/her work" and children reported that the most significant functional problem is "getting good grades." Findings from studies such as this help clinicians to have a better understanding of childhood OCD-related functional impairment, which helps them to accurately diagnose and treat children with OCD.

Includes bibliographical references (leaves 109-115).