Differences in OCD symptom presentations across age, culture, and gender: A quantitative review of studies using the Y-BOCS symptom checklist

Presentations of obsessive-compulsive disorder (OCD) have been found to differ between patients of different ages, cultures, and genders, but inconsistent findings have limited our understanding of how these demographic factors influence the expression of OCD. To address this gap, the present review utilized data from 51 studies (N = 9404 OCD patients) to determine how the frequencies of OCD presentations from the Yale-Brown Obsessive-Compulsive Scale Symptom Checklist differed across patient samples from different age groups (adults versus children), cultural regions (United States/Europe, South America, South Africa, Asia, and the Middle East) and gender compositions (proportions of males and females in the sample). For age-group comparisons, virtually all presentations were more common in child relative to adult OCD patients, but most differences disappeared when controlling for the total number of presentations endorsed in each sample. Similarly, while all presentation varied significantly across cultural regions, differences were again more modest when controlling for total OCD presentations, which also revealed symmetry obsessions and ordering compulsions to be the only presentations with frequencies that did not significantly differ across cultures. Finally, no symptom presentation covaried with sample gender composition except for sexual obsessions, which were more commonly endorsed in samples with more male patients. Collectively, these results indicate that OCD's major subtypes are fairly universal across different age groups, cultures, and genders and suggest that presentational differences across these demographics in previous OCD studies may have derived partly from disparities in nonspecific factors that altered the frequency of multiple OCD presentations.