RESEARCH - Obsessive-Compulsive Disorder (OCD)

Cognitive-Behavioral Treatment for Preschoolers
with Obsessive Compulsive Disorder

Principal Investigator: Golda S. Ginsburg, Ph.D.

Obsessive-compulsive disorder (OCD) affects 1-4 in 200 children and adolescents causing significant morbidity and disability. The average age of onset for pediatric OCD ranges from 9-12 years. Although cognitive-behavioral therapy (CBT) and pharmacotherapy are effective treatments for childhood OCD, not one clinical trial has included children younger than 7 years, leaving a large gap in our knowledge of how best to treat this young population. The present study addresses this gap in the treatment literature by refining and pilot-testing an innovative standardized treatment for reducing impairing obsessive-compulsive symptoms in young children (ages 4-7). This study is funded by the Obsessive Compulsive Foundation.

Genetics of Obsessive-Compulsive Disorder Using Child Probands

Principal Investigator: Marco Grados, M.D., M.P.H.

This NIH-funded research study is investigating the genetic basis of Obsessive Compulsive Diaorder (OCD) with a focus on children (ages 5-17 years old) and their relatives. The ultimate purpose of this study is to localize the genes that are responsible for causing OCD in children and adults. It is thought that studying children with OCD will increase the chance of locating genes due to the probable increased genetic loading present when children have OCD. The study consists of in-person interviews with the child, siblings, parents, and other available relatives. Statistical methods are used to locate or link genomic regions to the disease using available genetic marker maps. As the marker maps are becoming increasingly dense (at about 2 million markers in the genome at present) and genes are now located through the Human Genome Project database with relative ease it is plausible that genetic susceptibility genes or markers will be found in OCD in the next 5-10 years. The main limiting factor has been understanding the full clinical expression of the disorder or the phenotyping strategy. In this regard, a comprehensive phenotyping strategy is implemented in this project to cover OCD, Tourette's syndrome, and related disorders.

Publications

Grados MA, Samuels J, Shugart YY, Willour VL, Wang Y, Cullen B, Bienvenu OJ, Hoehn-Saric R, Valle D, Liang KY, Riddle MA, Wendland JR, Murphy DL, Nestadt G, Detera-Wadleigh S.Rare plus common SERT variants in obsessive-compulsive disorder. Mol Psychiatry. 2007 May;12(5):422-3.

Grados MA, Walkup J, Walford S.Genetics of obsessive-compulsive disorders: new findings and challenges.Brain Dev. 2003 Dec;25 Suppl 1:S55-61.

Grados MA, Riddle MA, Samuels JF, Liang KY, Hoehn-Saric R, Bienvenu OJ, Walkup JT, Song D, Nestadt G. The familial phenotype of obsessive-compulsive disorder in relation to tic disorders: the Hopkins OCD family study. Biol Psychiatry. 2001 Oct 15;50(8):559-65.

Cytokine in Childhood Obsessive-Compulsive Disorder

Principal Investigator: Marco Grados, M.D., M.P.H.

This study aims to understand pattern of cytokine expression in childhood Obsessive Compulsive Disorder (OCD). Monthly assessments over a 12-month period are conducted in order to measure the level of OCD symptoms, tic severity, and general psychiatric symptoms of children aged 5-17 years. Hospital visits at months 1, 4, 8 and 12 employ blood tests to determine the expression of cytokine networks, ASO titers and other immune-marker measures. In months 2, 3, 5, 6, 7, 9, 10 and 11 the same measures (blood tests and tests for OCD and tics) are administered in the home or by phone (alternate months). Additionally, if a dramatic worsening in symptoms occurs in intervening months additional blood samples are obtained. Thus this study aims to understand if OCD symptoms fluctuate in parallel with cytokine network changes or other immune measures using a longitudinal design.

Psychosocial Study of Childhood Obsessive-Compulsive Disorder

Principal Investigator: Marco Grados, M.D, M.P.H.

This study aims to understand the influence of individual psychopathology in children (ages 5-17 years) and parents, parent-child relationships and family functioning in families with children with OCD. The study is completed by self-report (mail) and interviews (phone) with families across the country. The questionnaires aim to provide an overall understanding of the environment which exists in families that have a child with OCD to better target interventions and measure the environmental component that may influence symptom expression.