Temper outbursts linked to depression in OCD children

By Mark Cowen, senior medwireNews Reporter

Temper outbursts are common in children with obsessive-compulsive disorder (OCD) and are associated with depression symptoms, UK researchers report.

Encouragingly, Georgina Krebs (South London and Maudsley NHS Foundation Trust, London) and team also found that cognitive behavioral therapy (CBT) significantly reduced temper tantrums, as well as OCD and depressive symptoms in such children.

The findings come from a study of 387 patients referred to a specialist pediatric OCD clinic between 2005 and 2011, and a community sample of 18,415 children from the British Child and Adolescent Mental Health Surveys of 1999 and 2004. Of the children in the community sample, 40 were diagnosed with OCD.

In the clinical sample, temper outbursts, as assessed using the Strengths and Difficulties Questionnaire, were endorsed by 38.5% of children and by 43.5% of their parents

In the community sample, temper outbursts were endorsed by 28.6% of children with OCD and by 38.5% of their parents. Temper outbursts were also significantly more common in children with OCD than in those without in both child (28.6 vs 11.7%) and parent (38.5 vs 11.3%) reports.

The severity of OCD symptoms, as assesses using the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS), was not a significant predictor of temper outbursts.

However, temper outbursts were significantly predicted by increased scores on the Beck Depression Inventory for Youth (BDI-Y). Indeed, in the clinical sample, temper outbursts were significantly more prevalent in children with clinical depression (BDI-Y T-score =55) than in those without, with respect to both child- (47.1 vs 29.1%) and parent-reported temper outbursts (42.9 vs 28.1%).

The researchers also note that child- and parent-reported temper outbursts decreased by 61% and 35%, respectively, after treatment with CBT in the clinical sample.

Krebs et al conclude in the Journal of Child Psychology and Psychiatry: "This study offers empirical evidence that temper outbursts are common in youth with OCD… and that they are particularly associated with depressed mood.

"Importantly, they improve with treatment and do not seem to influence the outcome of CBT for OCD."

They add: Future studies should examine the mechanisms underlying the association between temper outbursts and depressed mood in young people with OCD."

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