{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:35:09Z","timestamp":1787027709039,"version":"build-2736575974"},"reference-count":22,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2018,9,30]],"date-time":"2018-09-30T00:00:00Z","timestamp":1538265600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>In literature nothing is known about the clinical significance of Ultra High Risk (UHR) symptoms in children and adolescents with diagnosis of obsessive\u2013compulsive disorder (OCD). In this study, we examined the prevalence of UHR symptoms and their relationship with severity of obsessive\u2013compulsive symptomatology, global, social, and role functioning, and level of associated depressive symptoms in a clinical sample (n = 51) of children and adolescents aged between 8 and 17 years with a diagnosis of OCD. The prevalence of UHR symptoms in this sample was 43.1%. We divided the whole sample into two groups: children and adolescents with OCD and UHR symptoms (n = 22) and children and adolescents with OCD without UHR symptoms (n = 29). Our findings suggest that the group with OCD and UHR symptoms shows worse global, social, and role functioning than the group with OCD without UHR symptoms. No differences were found on the severity of obsessive\u2013compulsive symptomatology, the number of psychiatric diagnoses associated, and the level of depressive symptoms. The presence of UHR symptoms in children and adolescents with OCD could cause significant functional impairment and should be considered in order to plan specific and targeted therapeutic interventions.<\/jats:p>","DOI":"10.3390\/brainsci8100181","type":"journal-article","created":{"date-parts":[[2018,10,2]],"date-time":"2018-10-02T08:23:50Z","timestamp":1538468630000},"page":"181","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Prevalence and Clinical Significance of Symptoms at Ultra High Risk for Psychosis in Children and Adolescents with Obsessive\u2013Compulsive Disorder: Is There an Association with Global, Role, and Social Functioning?"],"prefix":"10.3390","volume":"8","author":[{"given":"Roberto","family":"Averna","sequence":"first","affiliation":[{"name":"Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Ges\u00f9, Piazza Sant\u2019Onofrio 4, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Pontillo","sequence":"additional","affiliation":[{"name":"Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Ges\u00f9, Piazza Sant\u2019Onofrio 4, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Demaria","sequence":"additional","affiliation":[{"name":"Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Ges\u00f9, Piazza Sant\u2019Onofrio 4, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Armando","sequence":"additional","affiliation":[{"name":"Office M\u00e9dico-P\u00e9dagogique Research Unit, Department of Psychiatry, University of Geneva School of Medicine, 1211 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ornella","family":"Santonastaso","sequence":"additional","affiliation":[{"name":"Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Ges\u00f9, Piazza Sant\u2019Onofrio 4, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Laura","family":"Pucciarini","sequence":"additional","affiliation":[{"name":"Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Ges\u00f9, Piazza Sant\u2019Onofrio 4, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Cristina","family":"Tata","sequence":"additional","affiliation":[{"name":"Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Ges\u00f9, Piazza Sant\u2019Onofrio 4, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8765-4047","authenticated-orcid":false,"given":"Francesco","family":"Mancini","sequence":"additional","affiliation":[{"name":"Scuola di Psicoterapia Cognitiva APC-SPC, Viale Castro Pretorio, 116, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Vicari","sequence":"additional","affiliation":[{"name":"Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Ges\u00f9, Piazza Sant\u2019Onofrio 4, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,9,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, American Psychiatric Association (APA). [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1089\/cap.2010.0040","article-title":"Treatment of pediatric obsessive compulsive disorder: A review","volume":"20","author":"Mancuso","year":"2010","journal-title":"J. Child Adolesc. Psychopharmacol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1358","DOI":"10.1001\/jama.2017.2200","article-title":"Obsessive\u2013compulsive disorder. advances in diagnosis and treatment","volume":"317","author":"Hirschtritt","year":"2017","journal-title":"JAMA"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1007\/s40263-013-0056-z","article-title":"Quality of life in obsessive\u2013compulsive disorder: Impact of the disorder and of treatment","volume":"27","author":"Subramaniam","year":"2013","journal-title":"CNS Drugs"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.cpr.2007.04.003","article-title":"Clinical predictors of response to cognitive-behavioral therapy for obsessive\u2013compulsive disorder","volume":"28","author":"Keeley","year":"2008","journal-title":"Clin. Psychol. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1017\/S1092852900020381","article-title":"Prevalence of psychotic disorders in patients with obsessive\u2013compulsive disorder","volume":"14","author":"Verhoeven","year":"2009","journal-title":"CNS Spectr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1007\/s00787-014-0614-z","article-title":"Brain changes in early-onset bipolar and unipolar depressive disorders: A systematic review in children and adolescents","volume":"23","author":"Serafini","year":"2014","journal-title":"Eur. Child Adolesc. Psychiatry"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1136\/bmj.1.5012.194","article-title":"Natural history of obsessional states; a study of 150 cases","volume":"1","author":"Pollitt","year":"1957","journal-title":"Br. Med. J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1192\/bjp.111.477.709","article-title":"Obsessional neurotics: A long-term follow-up","volume":"111","author":"Kringlen","year":"1965","journal-title":"Br. J. Psychiatry"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1192\/bjp.113.501.823","article-title":"A follow-up study of obsessional neurotics in Hong Kong Chinese","volume":"113","author":"Lo","year":"1967","journal-title":"Br. J. Psychiatry"},{"key":"ref_11","first-page":"38","article-title":"Associations of executive function with concurrent and prospective reports of obsessive\u2013compulsive symptoms in Schizophrenia","volume":"21","author":"Lysaker","year":"2009","journal-title":"JNCN"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/j.schres.2008.11.023","article-title":"Obsessive compulsive symptoms in the psychosis prodrome: Correlates of clinical and functional outcome","volume":"108","author":"Niendam","year":"2009","journal-title":"Schizophr. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1097\/00004583-199706000-00023","article-title":"Children\u2019s Yale-Brown Obsessive\u2013Compulsive Scale: Reliability and validity","volume":"36","author":"Scahill","year":"1997","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_14","unstructured":"McGlashan, T.H. (2008). Structured Interview for Prodromal Syndromes (SIPS), Yale University."},{"key":"ref_15","first-page":"980","article-title":"Schedule for affective disorders and Schizophrenia for school-age children-present and lifetime version (K-SADS-PL): Initial reliability and validity data","volume":"36","author":"Kaufman","year":"1997","journal-title":"JAACAP"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1176\/ajp.154.7.911","article-title":"Symptoms of obsessive\u2013compulsive disorder","volume":"154","author":"Leckman","year":"1997","journal-title":"Am. J. Psychiatry"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1001\/archpsyc.1983.01790100074010","article-title":"A children\u2019s global assessment scale (CGAS)","volume":"40","author":"Shaffer","year":"1983","journal-title":"Arch. Gen. Psychiatry"},{"key":"ref_18","unstructured":"Auther, A.M., Smith, C.W., and Cornblatt, B.A. (2006). Global Functioning: Social Scale (GF: Social), Zucker-Hillside Hospital."},{"key":"ref_19","unstructured":"Niendam, T.A., Bearden, C.E., Johnson, J.K., and Cannon, T.D. (2006). Global Functioning: Role Scale (GF: Role), University of California."},{"key":"ref_20","unstructured":"Kovacs, M. (1988). Children\u2019s Depression Inventory (CDI), OS Organizzazioni Speciali."},{"key":"ref_21","unstructured":"Wechsler, D. (2003). WISC-IV, Technical and Interpretive Manual, The Psychological Association."},{"key":"ref_22","unstructured":"Early Psychosis Guidelines Writing Group (2010). Australian Clinical Guidelines for Early Psychosis. A Brief Summary for Practitioners, Orygen. [2nd ed.]."}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/8\/10\/181\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T15:23:18Z","timestamp":1760196198000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/8\/10\/181"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,9,30]]},"references-count":22,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2018,10]]}},"alternative-id":["brainsci8100181"],"URL":"https:\/\/doi.org\/10.3390\/brainsci8100181","relation":{},"ISSN":["2076-3425"],"issn-type":[{"value":"2076-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,9,30]]}}}