Pinciotti Caitlin M, Rathouz Paul J, Guzick Andrew G, Shahidullah Jeffrey D, Bivins Emily J, Riddle David B, Onyeka Ogechi Cynthia, Storch Eric A, Goodman Wayne K, Franco Kelli, Rousseau Justin F, Newport D Jeffrey, Wagner Karen Dineen, Nemeroff Charles B
Baylor College of Medicine, Houston, TX, USA.
University of Texas at Austin, Austin, TX, USA.
J Mood Anxiety Disord. 2025 Mar 12;10:100117. doi: 10.1016/j.xjmad.2025.100117. eCollection 2025 Jun.
Childhood trauma exposure is associated with posttraumatic stress symptoms (PTSS) and suicidality, however it is also a risk factor for obsessive-compulsive disorder (OCD) in adults. Research examining the relationship between childhood trauma and OCD in youth is mixed, and there is a dearth of research examining the associations among OCD, PTSS, and suicidality. As a result, conclusions have been drawn from primarily cross-sectional adult samples. No study has examined the clinical characteristics associated with OCD in trauma-exposed youth, nor its associations with PTSS and suicidality over time. To address this gap, the present study used logistic regressions and generalized estimating equations in 2068 trauma-exposed youth aged 8-20 who completed assessments at baseline, 6-month, and 12-month follow-ups. In total, trauma-exposed youth with OCD ( = 222, 10.7 %) were more likely to be female (OR = 0.646), had more severe PTSS (OR = 1.032), and more psychiatric comorbidities (OR = 1.391) compared to trauma-exposed youth without OCD. Interpersonal traumas (OR = 1.549) and bullying (OR = 1.294) were associated with a greater likelihood of having OCD; however, these effects were nonsignificant when adjusting for other mental health symptoms. There was no evidence that OCD was associated with the trajectory of PTSS nor suicidality at 6- and 12-month follow-ups. Trauma-exposed youth with OCD may cross-sectionally have more severe clinical presentations overall, but OCD may not be related to the trajectory of these symptoms over time. Future research is needed to understand the directionality of clinical characteristics associated with pediatric OCD and whether interpersonal traumas convey risk uniquely for OCD or for distress in general.
童年期遭受创伤与创伤后应激症状（PTSS）及自杀行为有关，然而它也是成年人患强迫症（OCD）的一个风险因素。关于童年期创伤与青少年强迫症之间关系的研究结果不一，而且缺乏对强迫症、创伤后应激症状和自杀行为之间关联的研究。因此，主要是从横断面的成人样本中得出结论。尚无研究考察过遭受创伤的青少年中与强迫症相关的临床特征，也没有研究考察过其随时间与创伤后应激症状和自杀行为之间的关联。为填补这一空白，本研究对2068名年龄在8至20岁、在基线、6个月和12个月随访时完成评估的遭受创伤的青少年使用了逻辑回归和广义估计方程。总体而言，与未患强迫症的遭受创伤的青少年相比，患强迫症的遭受创伤的青少年（n = 222，10.7%）更可能为女性（比值比[OR]=0.646），有更严重的创伤后应激症状（OR = 1.032），以及更多的精神共病（OR = 1.391）。人际创伤（OR = 1.549）和欺凌（OR = 1.294）与患强迫症的可能性更大有关；然而，在对其他心理健康症状进行调整后，这些影响并不显著。没有证据表明强迫症与6个月和12个月随访时的创伤后应激症状轨迹或自杀行为有关。患强迫症的遭受创伤的青少年在横断面研究中总体上可能有更严重的临床表现，但强迫症可能与这些症状随时间的轨迹无关。未来需要开展研究，以了解与儿童强迫症相关的临床特征的方向性，以及人际创伤是否只为强迫症而非一般痛苦传递风险。
