Table 2.

Comparison of pediatric and adult-onset OCD (Geller et al., 2021).

Areas of investigation	Pediatric OCD	Adult-onset OCD
Prevalence	0.84% prevalence (1/3–1/2 remission rate)	1–3% prevalence
Age of onset	9–10 (with an SD of 2.5 years)	22–24 years
Gender ratio	F > M	F > M
OCD symptoms	Children-Intrusive fears of harm or loss of attachment figures. Hoarding. Symmetry and ‘just right’ phenomena. Fewer concrete cognitive obsessions. Adolescents-sexual, moral and religious themes, scrupulosity. Contamination fears.	Contamination, more stable over time and across fewer categories of obsessions/compulsion types.
Insight	Limited- only 63% have good or excellent insight	13.8–30.7% have poor to no insight
Comorbidity	Up to 80%- Mood and anxiety conditions, ADHD, Tic disorders, ODD, DMDD, ASD (~5%)	Mood and anxiety disorders
Family Role	Greater family involvement leads to worse OCD symptoms and greater functional impairment	Family accommodation also seen in relatives of adult-onset OCD but less direct involvement in rituals
Genetics	26% risk of OCD in a first degree relative	12% risk of OCD in a first degree relative
Adverse perinatal risk factors	Increased rates, especially in boys with OCD	Associated with an earlier age of OCD onset
Psychosocial stress	Increased rate of traumatic and stressful life events	Association with PTSD
Course and Outcome	Worse outcomes with co-morbid externalizing conditions and greater degrees of family accommodation. Overall higher rates of remission and symptoms becoming subclinical	Few cases of full remission over time

ASD, Autism Spectrum Disorder; ADHD, Attention-Deficit/Hyperactivity Disorder; ODD, Oppositional Defiant Disorder; DMDD, Disruptive Mood Dysregulation Disorder; PTSD, Posttraumatic Stress Disorder.