Anxiety during the long-term course of obsessive-compulsive disorder

• Published in: Journal of affective disorders Vol. 345; pp. 311 - 319
• Main Authors: Rickelt, J., Viechtbauer, W., Marcelis, M., van den Heuvel, O.A., van Oppen, P., Eikelenboom, M., Schruers, K.
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 15-01-2024
• Subjects: Anxiety; Co-occurring symptoms; Longitudinal study; Obsessive-compulsive disorder; Obsessive-compulsive symptoms; Obsessive-compulsive disorder; Anxiety; Co-occurring symptoms; Obsessive-compulsive symptoms; Longitudinal study
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2023.10.078

The study aimed to investigate anxiety and its relation with obsessive-compulsive symptoms during the long-term course of obsessive-compulsive disorder (OCD).
We used data from the Netherlands OCD Association (NOCDA) study, which included 419 participants with OCD (aged 18–79 years). Severity of obsessive-compulsive symptoms and anxiety at baseline and after two, four, and six years were entered into three models, which were analyzed using structural equation modeling: 1) the cross-lagged model, which assumes that anxiety and obsessive-compulsive symptoms are two distinct groups of symptoms interacting directly on the long-term; 2) the stable traits model, which assumes that anxiety and obsessive-compulsive symptoms result from two distinct latent factors, which are stable over the time and interact with each other; and 3) the common factor model, which assumes that anxiety and obsessive-compulsive symptoms are presentations of the same latent factor.
The cross-lagged model and the stable traits model both were valid models with a good model fit. The common factor model had a poor model fit and was rejected.
The duration of OCD varied widely between the participants (0–64 years). The majority experienced obsessive-compulsive symptoms since several years, which may have affected results on the course of anxiety and the interaction between anxiety and obsessive-compulsive symptoms.
Anxiety and obsessive-compulsive symptoms in OCD patients do not result from a shared underlying factor but are distinct, interacting symptom groups, probably interacting by distinct latent factors.
•Anxiety plays a role during the long-term course of OCD.•Anxiety and obsessive-compulsive symptoms do not result from a shared latent factor.•Anxiety and obsessive-compulsive symptoms interact during the long-term course.•Anxiety is related to obsessions/checking and contamination/washing OCD symptoms.