Aim: the aim of the study is to evaluate the socio-demographic and clinical features with
prognostic value in predicting evolution in severe OCD.
Materials and methods: patients with a main diagnosis of OCD were recruited according
to DSM-IV criteria. Socio-demographic and clinical features were assessed by mean of a semistructured
interview and clinical rating scales (Y-BOCS, HAM-A, HAM-D and SCID-II).
Two subgroups were compared according to the severity of symptoms (severe vs mild-moderate).
Results: the total sample was made up of 450 OCD subjects aged 34.5±12.1, with a mean age
of onset 22.3±9.1; 215 subjects (47.8%) were females. Patients with severe OCD (Y-BOCS ≥
32) showed a more insidious onset and a more chronic course compared to patients with mildmoderate
symptoms. Other predictors of increased OCD severity were washing and hoarding
compulsions. Lastly, the severity of the obsessive-compulsive condition was higher when it
was associated either with mood disorders or with Axis II disorders (particularly Cluster A).
Discussion: our study shows a correlation between severe OCD and severity predictors such
as functional impairment and mood disorders. Furthermore washing and hoarding symptoms,
lifetime comorbity with mood disorders and Cluster A personality disorders seem to predict
OCD severity
