Obsessive-compulsive disorder in the elderly: A report from the International College of Obsessive-Compulsive Disorders (ICOCS)

Introduction: Obsessive-compulsive disorder (OCD) is a highly disabling condition, with frequent early onset. Adult/adolescent OCD has been extensively investigated, but little is known about prevalence and clinical characterization of geriatric patients with OCD (G-OCD >= 65 years). The present study aimed to assess prevalence of G-OCD and associated socio-demographic and clinical correlates in a large international sample. Methods: Data from 416 outpatients, participating in the ICOCS network, were assessed and categorized into 2 groups, age < vs >= 65 years, and then divided on the basis of the median age of the sample (age < vs >= 42 years). Socio-demographic and clinical variables were compared between groups (Pearson Chi-squared and t tests). Results: G-OCD compared with younger patients represented a significant minority of the sample (6% vs 94%, P < .001), showing a significantly later age at onset (29.4 +/- 15.1 vs 18.7 +/- 9.2 years, P < .001), a more frequent adult onset (75% vs 41.1%, P < .001) and a less frequent use of cognitive-behavioural therapy (CBT) (20.8% vs 41.8%, P < .05). Female gender was more represented in G-OCD patients, though not at a statistically significant level (75% vs 56.4%, P = .07). When the whole sample was divided on the basis of the median age, previous results were confirmed for older patients, including a significantly higher presence of women (52.1% vs 63.1%, P < .05). Conclusions: G-OCD compared with younger patients represented a small minority of the sample and showed later age at onset, more frequent adult onset and lower CBT use. Age at onset may influence course and overall management of OCD, with additional investigation needed.