Sleep problems as reported by parents in Swedish children and adolescents with obsessive-compulsive disorder (OCD), child psychiatric outpatients and school children.

OBJECTIVE

To examine prevalence of sleep problems among children and adolescents with obsessive-compulsive disorder (OCD) as rated by their parents and the role of comorbidity.

METHODS

Children and adolescents with OCD (n=185) referred to specialized OCD unit were compared with children from child and adolescent psychiatry (CAP) outpatient units (n=177) and a school sample (GP) (n=317). All were assessed by parents on the Child Behaviour Checklist (CBCL).

RESULTS

Sleep problems were common in both the OCD (28.8 %) and CAP (20.3%) groups compared with the GP group (5.4%). While the OCD group significantly more often had less sleep than the CAP group (11.7% vs. 6.8%), small differences were found between these two groups for nightmares (5.9%, vs. 6.8% n.s.). Comparing the OCD and CAP groups on total sleep problem scores, OCD was a weak while the CBCL syndrome scales Thought problems (which includes OCD symptoms), Anxiety/Depressed, Somatic problems and Aggressive behaviour were strong predictors indicating that comorbidity rather than OCD might be especially important.

CONCLUSION

Sleep problems are common among children and adolescents with OCD as well as among regular CAP outpatients. In OCD patients, the total comorbid symptom burden predicts sleep problems to a greater extent than the OCD itself. A thorough assessment of sleep problems and their causes are needed for all outpatients referred to child and adolescent psychiatric service.