{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T20:12:04Z","timestamp":1777493524247,"version":"3.51.4"},"reference-count":80,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T00:00:00Z","timestamp":1569888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,10,1]],"date-time":"2019-10-01T00:00:00Z","timestamp":1569888000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Child and Adolescent Psychopharmacology"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate the lifetime prevalence of infectious, inflammatory, and autoimmune disorders in a multisite study of probands with childhood-onset obsessive compulsive disorder (OCD) and their first-degree relatives.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Medical questionnaires were completed by 1401 probands and 1045 first-degree relatives in the OCD Collaborative Genetics Association Study. Lifetime prevalence of immune-related diseases was compared with the highest available population estimate and reported as a point estimate with 95% adjusted Wald interval. Worst-episode OCD severity and symptom dimensions were assessed with the Yale\u2013Brown Obsessive Compulsive Scale (YBOCS) and Symptom Checklist (YBOCS-CL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Probands reported higher-than-expected prevalence of scarlet fever (4.0 [3.1\u20135.2]% vs. 1.0%\u20132.0%,\n                      <jats:italic toggle=\"yes\">z<\/jats:italic>\n                      \u2009=\u20091.491,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20091389), encephalitis or meningitis (1.4 [0.9\u20132.1]% vs. 0.1%\u20130.4%,\n                      <jats:italic toggle=\"yes\">z<\/jats:italic>\n                      \u2009=\u20095.913,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20091393), rheumatoid arthritis (1.1 [0.6\u20132.0]% vs. 0.2%\u20130.4%,\n                      <jats:italic toggle=\"yes\">z<\/jats:italic>\n                      \u2009=\u20093.416,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009949) and rheumatic fever (0.6 [0.3\u20131.2]% vs. 0.1%\u20130.2%,\n                      <jats:italic toggle=\"yes\">z<\/jats:italic>\n                      \u2009=\u20093.338,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20091390), but not systemic lupus erythematosus, diabetes, asthma, multiple sclerosis, psoriasis, or inflammatory bowel disease. First-degree relatives reported similarly elevated rates of scarlet fever, rheumatic fever, and encephalitis or meningitis independent of OCD status. There was no association between worst-episode severity and immune-related comorbidities, although probands reporting frequent ear or throat infections had increased severity of cleaning-\/contamination-related symptoms (mean factor score 2.5\u2009\u00b1\u20090.9 vs. 2.3\u2009\u00b1\u20091.0,\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      \u2009=\u20093.183,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.002,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009822).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>These data suggest high rates of streptococcal-related and other immune-mediated diseases in patients with childhood-onset OCD and are consistent with epidemiological studies in adults noting familial clustering. Limitations include potential reporting bias and absence of a control group, underscoring the need for further prospective studies characterizing medical and psychiatric disease clusters and their interactions in children. Such studies may ultimately improve our understanding of OCD pathogenesis and aid in the development of adjunctive immune-modulating therapeutic strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/cap.2018.0140","type":"journal-article","created":{"date-parts":[[2019,6,6]],"date-time":"2019-06-06T16:13:21Z","timestamp":1559837601000},"page":"615-624","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":36,"title":["Immune-Related Comorbidities in Childhood-Onset Obsessive Compulsive Disorder: Lifetime Prevalence in the Obsessive Compulsive Disorder Collaborative Genetics Association Study"],"prefix":"10.1177","volume":"29","author":[{"given":"Clara","family":"Westwell-Roper","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine, British Columbia Children's Hospital, University of British Columbia, Vancouver, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyle A.","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jack","family":"Samuels","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O. 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