2024
The trajectory of anxiety symptoms during the transition from childhood to young adulthood is predicted by IQ and sex, but not polygenic risk scores
Salto A, Salum G, Hoffmann M, Santoro M, Zugman A, Pan P, Belangero S, Ito L, Doretto V, Croci M, Brañas M, de Giusti C, Da Silva‐Jr F, Ribeiro S, Miguel E, Leckman J. The trajectory of anxiety symptoms during the transition from childhood to young adulthood is predicted by IQ and sex, but not polygenic risk scores. JCPP Advances 2024 DOI: 10.1002/jcv2.12268.Peer-Reviewed Original ResearchAnxiety symptomsIntelligence quotientTrajectory class membershipPolygenic risk scoresTrajectory classesLate adolescenceCourse of anxiety symptomsScreen for Child Anxiety Related DisordersTrajectories of anxiety symptomsBrazilian High-Risk CohortYoung adulthoodEffect of intelligence quotientAnxiety related disordersHigh-decreasing classClass membershipLongitudinal studyConfirmatory factor analysisGrowth mixture modelingIncidence of anxiety symptomsInternalizing symptomatologyLow-increasing classHigher IQCognitive abilitiesAnxiety riskFactor analysisAn evaluation of treatment response and remission definitions in adult obsessive-compulsive disorder: A systematic review and individual-patient data meta-analysis
Ramakrishnan D, Farhat L, Vattimo E, Levine J, Johnson J, Artukoglu B, Landeros-Weisenberger A, Zangen A, Pelissolo A, de B Pereira C, Rück C, Costa D, Mataix-Cols D, Shannahoff-Khalsa D, Tolin D, Zarean E, Meyer E, Hawken E, Storch E, Andersson E, Miguel E, Maina G, Leckman J, Sarris J, March J, Diniz J, Kobak K, Mallet L, Vulink N, Amiaz R, Fernandes R, Shavitt R, Wilhelm S, Golshan S, Tezenas du Montcel S, Erzegovesi S, Baruah U, Greenberg W, Kobayashi Y, Bloch M. An evaluation of treatment response and remission definitions in adult obsessive-compulsive disorder: A systematic review and individual-patient data meta-analysis. Journal Of Psychiatric Research 2024, 173: 387-397. PMID: 38598877, DOI: 10.1016/j.jpsychires.2024.03.044.Peer-Reviewed Original ResearchConceptsYale-Brown Obsessive-Compulsive ScaleObsessive-compulsive disorderCGI-IRandomized-controlled trialsAdult obsessive-compulsive disorderClinical Global Impression ImprovementObsessive-Compulsive ScaleTreatment responseIndividual-patient data meta-analysisPosttreatment scoresEvaluation of treatment responseMeta-analysis of randomized-controlled trialsFirst-line therapyCGIIndividual participant dataMeta-analysisNovel treatment modalitiesExpert consensusIndividual participant data meta-analysisSystematic reviewDisordersData meta-analysisPosttreatmentRemission definitionsImpressive improvement
2020
Risk factors for obsessive–compulsive symptoms. Follow-up of a community-based youth cohort
Macul Ferreira de Barros P, do Rosário MC, Szejko N, Polga N, Requena GL, Ravagnani B, Fatori D, Batistuzzo MC, Hoexter MQ, Rohde LA, Polanczyk GV, Leckman JF, Miguel EC, de Alvarenga PG. Risk factors for obsessive–compulsive symptoms. Follow-up of a community-based youth cohort. European Child & Adolescent Psychiatry 2020, 30: 89-104. PMID: 32076869, DOI: 10.1007/s00787-020-01495-7.Peer-Reviewed Original ResearchConceptsObsessive-compulsive symptomsRisk factorsAbsence of breastfeedingOCS scoresBaseline anxiety disordersPotential risk factorsLarge community cohortLow socioeconomic statusRegression analysisMental health assessmentMaternal stress levelsLower intelligence quotientCommunity cohortChildhood adversityLower ageHigher OCS scoresAnxiety disordersPsychopathological factorsSocioeconomic statusGenetic factorsSignificant predictorsBaselineHealth assessmentScoresAge
2019
Kundalini Yoga Meditation Versus the Relaxation Response Meditation for Treating Adults With Obsessive-Compulsive Disorder: A Randomized Clinical Trial
Shannahoff-Khalsa D, Fernandes RY, de B. Pereira C, March JS, Leckman JF, Golshan S, Vieira MSR, Polanczyk GV, Miguel EC, Shavitt RG. Kundalini Yoga Meditation Versus the Relaxation Response Meditation for Treating Adults With Obsessive-Compulsive Disorder: A Randomized Clinical Trial. Frontiers In Psychiatry 2019, 10: 793. PMID: 31780963, PMCID: PMC6859828, DOI: 10.3389/fpsyt.2019.00793.Peer-Reviewed Original ResearchY-BOCS scoresFirst-line therapyObsessive-compulsive disorderClinical trialsSecondary measuresY-BOCSShort Form-36 Health SurveyBaseline Y-BOCS scoresCompulsive ScaleGreater improvementRelative efficacyClinical Global ImpressionEffective treatment scheduleYale-Brown Obsessive Compulsive ScaleHigh psychosocial impairmentBeck Depression InventoryBeck Anxiety InventoryLife-long disorderObsessive Compulsive ScaleYale-Brown ObsessiveYoga meditationLine therapyPrimary outcomeTreat analysisReuptake inhibitorsF36. Obsessive-Compulsive symptoms, Polygenic Risk Score and Thalamic Development in Children From the Brazilian High-Risk Cohort Study
Ravagnani B, Hoexter M, Santoro M, Leckman J, Pan P, Salum G, Jackowski A, Hampson M, do Rosário M, Belangero S, Alvarenga P, de Barros P, Miguel E, Zugman A. F36. Obsessive-Compulsive symptoms, Polygenic Risk Score and Thalamic Development in Children From the Brazilian High-Risk Cohort Study. Biological Psychiatry 2019, 85: s226. DOI: 10.1016/j.biopsych.2019.03.573.Peer-Reviewed Original ResearchThe impact of attention deficit hyperactivity disorder in obsessive‐compulsive disorder subjects
Blanco‐Vieira T, Santos M, Ferrão YA, Torres AR, Miguel EC, Bloch MH, Leckman JF, do Rosario MC. The impact of attention deficit hyperactivity disorder in obsessive‐compulsive disorder subjects. Depression And Anxiety 2019, 36: 533-542. PMID: 30990937, DOI: 10.1002/da.22898.Peer-Reviewed Original ResearchConceptsAttention deficit hyperactivity disorderAdult OCD patientsObsessive-compulsive disorderDeficit hyperactivity disorderOCD patientsClinical characteristicsExact testFeatures of ADHDHyperactivity disorderSubgroup of patientsAdult obsessive-compulsive disorderComorbid attention deficit hyperactivity disorderSpecific clinical featuresCross-sectional studyObsessive-compulsive disorder (OCD) subjectsLogistic regression analysisFisher's exact testBrazilian Research ConsortiumMann-Whitney testAdult patientsRheumatic feverDevelopment of interventionsClinical featuresObsessive-compulsive spectrum disordersLifetime prevalence
2018
Adaptive treatment strategies for children and adolescents with Obsessive-Compulsive Disorder: A sequential multiple assignment randomized trial
Fatori D, de Bragança Pereira CA, Asbahr FR, Requena G, Alvarenga PG, de Mathis MA, Rohde LA, Leckman JF, March JS, Polanczyk GV, Miguel EC, Shavitt RG. Adaptive treatment strategies for children and adolescents with Obsessive-Compulsive Disorder: A sequential multiple assignment randomized trial. Journal Of Anxiety Disorders 2018, 58: 42-50. PMID: 30025255, DOI: 10.1016/j.janxdis.2018.07.002.Peer-Reviewed Original ResearchConceptsGroup cognitive behavioral therapySequential multiple assignmentTreatment failureInitial treatmentBaseline Yale-Brown ObsessiveChildhood OCDEffective initial treatmentProvision of treatmentCompulsive Scale scoresCognitive behavioral therapyAdaptive treatment strategiesYale-Brown ObsessiveSame regimenObsessive-compulsive disorderTreatment strategiesSymptom reductionPrimary analysisScale scoreFluoxetineTime pointsWeeksTreatmentChildrenEffect sizeTrials
2017
The Child Behavior Checklist—Obsessive-Compulsive Subscale Detects Severe Psychopathology and Behavioral Problems Among School-Aged Children
Saad LO, do Rosario MC, Cesar RC, Batistuzzo MC, Hoexter MQ, Manfro GG, Shavitt RG, Leckman JF, Miguel EC, Alvarenga PG. The Child Behavior Checklist—Obsessive-Compulsive Subscale Detects Severe Psychopathology and Behavioral Problems Among School-Aged Children. Journal Of Child And Adolescent Psychopharmacology 2017, 27: 342-348. PMID: 28151703, PMCID: PMC5439443, DOI: 10.1089/cap.2016.0125.Peer-Reviewed Original ResearchConceptsObsessive-compulsive symptomsPsychiatric comorbidityPredictive valueBehavioral problemsDSM-IV psychiatric diagnosesPresence of OCSGroup of patientsHigh-risk cohortSignificant obsessive-compulsive symptomsNegative predictive valuePositive predictive valueHigh rateSeverity of OCSRisk cohortSchool-Aged ChildrenDepressive disorderFunctional impairmentPsychiatric diagnosisChild Behavior ChecklistComorbiditiesSevere psychopathologyBeing AssessmentScreening toolPediatric OCDAnxiety disorders
2014
Cross-Disorder Genome-Wide Analyses Suggest a Complex Genetic Relationship Between Tourette’s Syndrome and OCD
Yu D, Mathews CA, Scharf JM, Neale BM, Davis LK, Gamazon ER, Derks EM, Evans P, Edlund CK, Crane J, Fagerness JA, Osiecki L, Gallagher P, Gerber G, Haddad S, Illmann C, McGrath LM, Mayerfeld C, Arepalli S, Barlassina C, Barr CL, Bellodi L, Benarroch F, Berrió GB, Bienvenu OJ, Black DW, Bloch MH, Brentani H, Bruun RD, Budman CL, Camarena B, Campbell DD, Cappi C, Silgado JC, Cavallini MC, Chavira DA, Chouinard S, Cook EH, Cookson MR, Coric V, Cullen B, Cusi D, Delorme R, Denys D, Dion Y, Eapen V, Egberts K, Falkai P, Fernandez T, Fournier E, Garrido H, Geller D, Gilbert DL, Girard SL, Grabe HJ, Grados MA, Greenberg BD, Gross-Tsur V, Grünblatt E, Hardy J, Heiman GA, Hemmings SM, Herrera LD, Hezel DM, Hoekstra PJ, Jankovic J, Kennedy JL, King RA, Konkashbaev AI, Kremeyer B, Kurlan R, Lanzagorta N, Leboyer M, Leckman JF, Lennertz L, Liu C, Lochner C, Lowe TL, Lupoli S, Macciardi F, Maier W, Manunta P, Marconi M, McCracken JT, Mesa Restrepo SC, Moessner R, Moorjani P, Morgan J, Muller H, Murphy DL, Naarden AL, Nurmi E, Ochoa WC, Ophoff RA, Pakstis AJ, Pato MT, Pato CN, Piacentini J, Pittenger C, Pollak Y, Rauch SL, Renner T, Reus VI, Richter MA, Riddle MA, Robertson MM, Romero R, Rosário MC, Rosenberg D, Ruhrmann S, Sabatti C, Salvi E, Sampaio AS, Samuels J, Sandor P, Service SK, Sheppard B, Singer HS, Smit JH, Stein DJ, Strengman E, Tischfield JA, Turiel M, Valencia Duarte AV, Vallada H, Veenstra-VanderWeele J, Walitza S, Wang Y, Weale M, Weiss R, Wendland JR, Westenberg HG, Shugart YY, Hounie AG, Miguel EC, Nicolini H, Wagner M, Ruiz-Linares A, Cath DC, McMahon W, Posthuma D, Oostra BA, Nestadt G, Rouleau GA, Purcell S, Jenike MA, Heutink P, Hanna GL, Conti DV, Arnold PD, Freimer NB, Stewart SE, Knowles JA, Cox NJ, Pauls DL. Cross-Disorder Genome-Wide Analyses Suggest a Complex Genetic Relationship Between Tourette’s Syndrome and OCD. American Journal Of Psychiatry 2014, 172: 82-93. PMID: 25158072, PMCID: PMC4282594, DOI: 10.1176/appi.ajp.2014.13101306.Peer-Reviewed Original ResearchConceptsGenome-wide association studiesSingle nucleotide polymorphismsPolygenic score analysisGene expression levelsGenetic architecturePhenotypic varianceCombined genome-wide association studyFunctional variantsPolygenic componentPolygenic signalSignificant polygenic componentExpression levelsGWAS summary statisticsAncestry-matched controlsBrain gene expression levelsComplex genetic relationshipsHeritable neurodevelopmental disorderTrue functional variantsParent-child triosGWAS signalsIndividual single nucleotide polymorphismsWide analysisGenetic variationUnderlying genetic susceptibilityAssociation studiesCopy Number Variation in Obsessive-Compulsive Disorder and Tourette Syndrome: A Cross-Disorder Study
McGrath LM, Yu D, Marshall C, Davis LK, Thiruvahindrapuram B, Li B, Cappi C, Gerber G, Wolf A, Schroeder FA, Osiecki L, O'Dushlaine C, Kirby A, Illmann C, Haddad S, Gallagher P, Fagerness JA, Barr CL, Bellodi L, Benarroch F, Bienvenu OJ, Black DW, Bloch MH, Bruun RD, Budman CL, Camarena B, Cath DC, Cavallini MC, Chouinard S, Coric V, Cullen B, Delorme R, Denys D, Derks EM, Dion Y, Rosário MC, Eapen V, Evans P, Falkai P, Fernandez TV, Garrido H, Geller D, Grabe HJ, Grados MA, Greenberg BD, Gross-Tsur V, Grünblatt E, Heiman GA, Hemmings SM, Herrera LD, Hounie AG, Jankovic J, Kennedy JL, King RA, Kurlan R, Lanzagorta N, Leboyer M, Leckman JF, Lennertz L, Lochner C, Lowe TL, Lyon GJ, Macciardi F, Maier W, McCracken JT, McMahon W, Murphy DL, Naarden AL, Neale BM, Nurmi E, Pakstis AJ, Pato MT, Pato CN, Piacentini J, Pittenger C, Pollak Y, Reus VI, Richter MA, Riddle M, Robertson MM, Rosenberg D, Rouleau GA, Ruhrmann S, Sampaio AS, Samuels J, Sandor P, Sheppard B, Singer HS, Smit JH, Stein DJ, Tischfield JA, Vallada H, Veenstra-VanderWeele J, Walitza S, Wang Y, Wendland JR, Shugart YY, Miguel EC, Nicolini H, Oostra BA, Moessner R, Wagner M, Ruiz-Linares A, Heutink P, Nestadt G, Freimer N, Petryshen T, Posthuma D, Jenike MA, Cox NJ, Hanna GL, Brentani H, Scherer SW, Arnold PD, Stewart SE, Mathews CA, Knowles JA, Cook EH, Pauls DL, Wang K, Scharf JM. Copy Number Variation in Obsessive-Compulsive Disorder and Tourette Syndrome: A Cross-Disorder Study. Journal Of The American Academy Of Child & Adolescent Psychiatry 2014, 53: 910-919. PMID: 25062598, PMCID: PMC4218748, DOI: 10.1016/j.jaac.2014.04.022.Peer-Reviewed Original Research
2013
Partitioning the Heritability of Tourette Syndrome and Obsessive Compulsive Disorder Reveals Differences in Genetic Architecture
Davis LK, Yu D, Keenan CL, Gamazon ER, Konkashbaev AI, Derks EM, Neale BM, Yang J, Lee SH, Evans P, Barr CL, Bellodi L, Benarroch F, Berrio GB, Bienvenu OJ, Bloch MH, Blom RM, Bruun RD, Budman CL, Camarena B, Campbell D, Cappi C, Silgado J, Cath DC, Cavallini MC, Chavira DA, Chouinard S, Conti DV, Cook EH, Coric V, Cullen BA, Deforce D, Delorme R, Dion Y, Edlund CK, Egberts K, Falkai P, Fernandez TV, Gallagher PJ, Garrido H, Geller D, Girard SL, Grabe HJ, Grados MA, Greenberg BD, Gross-Tsur V, Haddad S, Heiman GA, Hemmings SM, Hounie AG, Illmann C, Jankovic J, Jenike MA, Kennedy JL, King RA, Kremeyer B, Kurlan R, Lanzagorta N, Leboyer M, Leckman JF, Lennertz L, Liu C, Lochner C, Lowe TL, Macciardi F, McCracken JT, McGrath LM, Restrepo S, Moessner R, Morgan J, Muller H, Murphy DL, Naarden AL, Ochoa WC, Ophoff RA, Osiecki L, Pakstis AJ, Pato MT, Pato CN, Piacentini J, Pittenger C, Pollak Y, Rauch SL, Renner TJ, Reus VI, Richter MA, Riddle MA, Robertson MM, Romero R, Rosàrio MC, Rosenberg D, Rouleau GA, Ruhrmann S, Ruiz-Linares A, Sampaio AS, Samuels J, Sandor P, Sheppard B, Singer HS, Smit JH, Stein DJ, Strengman E, Tischfield JA, Duarte A, Vallada H, Van Nieuwerburgh F, Veenstra-VanderWeele J, Walitza S, Wang Y, Wendland JR, Westenberg HG, Shugart YY, Miguel EC, McMahon W, Wagner M, Nicolini H, Posthuma D, Hanna GL, Heutink P, Denys D, Arnold PD, Oostra BA, Nestadt G, Freimer NB, Pauls DL, Wray NR, Stewart SE, Mathews CA, Knowles JA, Cox NJ, Scharf JM. Partitioning the Heritability of Tourette Syndrome and Obsessive Compulsive Disorder Reveals Differences in Genetic Architecture. PLOS Genetics 2013, 9: e1003864. PMID: 24204291, PMCID: PMC3812053, DOI: 10.1371/journal.pgen.1003864.Peer-Reviewed Original ResearchConceptsGenome-wide complex trait analysisExpression quantitative trait lociGenetic architectureGenetic correlationsGenome-wide common variant dataQuantitative trait lociComplex trait analysisDistinct genetic architecturesGenomic architectureGenomic elementsFunctional annotationMinor allele frequencyTrait lociPrevious heritability estimatesMAF binsGWAS studiesGene expressionTrait analysisHeritabilityGenetic overlapVariant dataHeritability estimatesAllele frequenciesCommon variationSNPs
2012
Trajectory in obsessive-compulsive disorder comorbidities
de Mathis MA, Diniz JB, Hounie AG, Shavitt RG, Fossaluza V, Ferrão Y, Leckman JF, de Bragança Pereira C, do Rosario MC, Miguel EC. Trajectory in obsessive-compulsive disorder comorbidities. European Neuropsychopharmacology 2012, 23: 594-601. PMID: 22921470, DOI: 10.1016/j.euroneuro.2012.08.006.Peer-Reviewed Original ResearchConceptsObsessive-compulsive disorderHigher lifetime frequencyOCD patientsFirst diagnosisTic disordersSeparation anxiety disorderLifetime frequencyObsessive-compulsive disorder (OCD) comorbidityAnxiety disordersOnset of OCDDistribution of comorbiditiesSpecific comorbid diagnosesLifetime psychiatric diagnosesPost-traumatic stress disorderFirst comorbiditySymptom onsetClinical courseClinical presentationPsychiatric comorbidityDisorder comorbidityOCD courseBeck AnxietyComorbid disordersPsychiatric disordersComorbidities
2011
Early interventions to prevent mental disorders - learning lessons from the field of psychosis
Moriyama TS, Miguel EC, Leckman J. Early interventions to prevent mental disorders - learning lessons from the field of psychosis. Brazilian Journal Of Psychiatry 2011, 33: s125-s128. PMID: 22286563, DOI: 10.1590/s1516-44462011000600001.Peer-Reviewed Original Research
2010
Obsessive–compulsive disorder: a review of the diagnostic criteria and possible subtypes and dimensional specifiers for DSM‐V
Leckman JF, Denys D, Simpson HB, Mataix‐Cols D, Hollander E, Saxena S, Miguel EC, Rauch SL, Goodman WK, Phillips KA, Stein DJ. Obsessive–compulsive disorder: a review of the diagnostic criteria and possible subtypes and dimensional specifiers for DSM‐V. Depression And Anxiety 2010, 27: 507-527. PMID: 20217853, PMCID: PMC3974619, DOI: 10.1002/da.20669.Peer-Reviewed Original Research
2009
Validation of the University of São Paulo Sensory Phenomena Scale:Initial Psychometric Properties
Rosario MC, Prado HS, Borcato S, Diniz JB, Shavitt RG, Hounie AG, Mathis ME, Mastrorosa RS, Velloso P, Perin EA, Fossaluza V, Pereira CA, Geller D, Leckman J, Miguel E. Validation of the University of São Paulo Sensory Phenomena Scale:Initial Psychometric Properties. CNS Spectrums 2009, 14: 315-323. PMID: 19668122, DOI: 10.1017/s1092852900020319.Peer-Reviewed Original ResearchConceptsOpen clinical interviewClinical InterviewYale-Brown ObsessiveObsessive-compulsive disorderFourth Edition Axis I DisordersEarly-onset OCD patientsYale Global Tic Severity ScaleSensory phenomenaCompulsive ScaleOCD patientsOCD subjectsAxis I DisordersTic Severity ScaleSão Paulo Sensory Phenomena ScaleSignificant differencesBeck Depression InventoryBeck Anxiety InventorySeverity scoreI disordersInter-rater reliabilityInitial psychometric propertiesSeverity ScalePremonitory urgesPatientsDepression InventoryPerfectionism and sensory phenomena: phenotypic components of obsessive-compulsive disorder
Lee JC, Prado HS, Diniz JB, Borcato S, da Silva CB, Hounie AG, Miguel EC, Leckman JF, do Rosário MC. Perfectionism and sensory phenomena: phenotypic components of obsessive-compulsive disorder. Comprehensive Psychiatry 2009, 50: 431-436. PMID: 19683613, DOI: 10.1016/j.comppsych.2008.11.007.Peer-Reviewed Original Research
2006
The Dimensional Yale–Brown Obsessive–Compulsive Scale (DY-BOCS): an instrument for assessing obsessive–compulsive symptom dimensions
Rosario-Campos MC, Miguel EC, Quatrano S, Chacon P, Ferrao Y, Findley D, Katsovich L, Scahill L, King RA, Woody SR, Tolin D, Hollander E, Kano Y, Leckman JF. The Dimensional Yale–Brown Obsessive–Compulsive Scale (DY-BOCS): an instrument for assessing obsessive–compulsive symptom dimensions. Molecular Psychiatry 2006, 11: 495-504. PMID: 16432526, DOI: 10.1038/sj.mp.4001798.Peer-Reviewed Original Research
2005
A family study of early‐onset obsessive‐compulsive disorder
do Rosario‐Campos M, Leckman JF, Curi M, Quatrano S, Katsovitch L, Miguel EC, Pauls DL. A family study of early‐onset obsessive‐compulsive disorder. American Journal Of Medical Genetics Part B Neuropsychiatric Genetics 2005, 136B: 92-97. PMID: 15892140, DOI: 10.1002/ajmg.b.30149.Peer-Reviewed Original ResearchConceptsObsessive-compulsive disorderRecurrence riskChronic ticsFirst-degree family membersChildhood-onset obsessive-compulsive disorderDiagnosis of OCDChronic tic disorderStandardized semi-structured interviewFirst-degree relativesEarly-onset casesOnset obsessive-compulsive disorderDSM-IV criteriaEarly-onset obsessive-compulsive disorderBest-estimate processRandom digit dialingHigh comorbid ratesAge of onsetFamily studiesHigh genetic loadingMean ageSpecialty clinicTic disordersComorbid ratesValid subgroupsCase relatives
2004
Obsessive-compulsive disorder phenotypes: implications for genetic studies
Miguel EC, Leckman JF, Rauch S, do Rosario-Campos MC, Hounie AG, Mercadante MT, Chacon P, Pauls DL. Obsessive-compulsive disorder phenotypes: implications for genetic studies. Molecular Psychiatry 2004, 10: 258-275. PMID: 15611786, DOI: 10.1038/sj.mp.4001617.Peer-Reviewed Original Research
2001
Adults With Early-Onset Obsessive-Compulsive Disorder
Rosario-Campos MC, Leckman JF, Mercadante MT, Shavitt RG, Prado HS, Sada P, Zamignani D, Miguel EC. Adults With Early-Onset Obsessive-Compulsive Disorder. American Journal Of Psychiatry 2001, 158: 1899-1903. PMID: 11691698, DOI: 10.1176/appi.ajp.158.11.1899.Peer-Reviewed Original ResearchConceptsSymptom onsetObsessive-compulsive disorderSelective serotonin reuptake inhibitorsOCD patientsSerotonin reuptake inhibitorsEarlier symptom onsetEarly-onset groupLater symptom onsetOnset obsessive-compulsive disorderYale-Brown Obsessive Compulsive ScaleComorbid tic disordersAdult OCD patientsObsessive Compulsive ScaleReuptake inhibitorsAdult outpatientsTic disordersTreatment outcomesOCD symptom onsetBimodal ageEarly onsetHeterogeneous disorderCompulsive ScaleDisordersAgePatients