The effect of emotion regulation difficulties and sensory sensitivity on disease burden and clinical presentation in patients with obsessive compulsive disorder

Objective: Sensory sensitivity and emotion regulation difficulties in patients with Obsessive-Compulsive Disorder (OCD) are crucial aspects in terms of disease management, treatment selection, and long-term outcome assessment. In this study, the aim is to assess the relationship between sensory sensitivity and emotion regulation difficulties among children and adolescents aged 11-16 diagnosed with OCD. Additionally, the study aims to investigate the correlation between sensory sensitivity, emotion regulation difficulties, OCD disease burden (number and severity of symptoms), and clinical presentation. Method: The research was conducted between June 2022 and April 2023 at the Department of Child and Adolescent Psychiatry, Faculty of Medicine, Karadeniz Technical University. Clinical assessment was based on DSM-5 diagnostic criteria and the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL), a semi-structured interview. The study included 44 individuals in the case group who were diagnosed with OCD according to the K-SADS-PL interview, agreed to participate, and met the eligibility criteria. Additionally, 44 individuals matched in terms of gender, age, and educational level were included in the study as the control group. For the evaluation of participants' sensory sensitivity, the Adolescent/Adult Sensory Profile (AASP) was utilized. The Difficulties in Emotion Regulation Scale (DERS) was employed to assess emotion regulation difficulties, and the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) was administered to evaluate OCD severity in the participants. Results: Among all participants in the study, 59.1% were female, and 40.9% were male. The mean age of all participants was 14.09±1.89, and there was no significant difference in terms of gender and age between the case and control groups. When comparing the case group and the control group in terms of Difficulties in Emotion Regulation Scale (DERS) total score, a significant difference was found between the groups (p=0.006). Subsequent correlation analysis revealed a positive correlation between DERS total score and OCD symptom severity (r=0.573, p<0.001), whereas this relationship was not statistically significant regarding the number of obsessions and compulsions (r=0.251, p=0.100). No significant relationship was observed between DERS scores and clinical presentation. When comparing the case and control groups in terms of sensory sensitivity, a significant difference was detected between the groups (p=0.007). Subsequent correlation analysis showed a positive correlation between sensory sensitivity and the number of obsessions and compulsions (r=0.310, p=0.040), (r=0.401, p=0.007), while this relationship was not statistically significant concerning OCD symptom severity (r=0.191, p=0.214). No significant relationship was found between sensory sensitivity and clinical presentation. Conclusion: The higher sensory sensitivity and emotion regulation difficulties in individuals with OCD compared to healthy controls, along with the association between sensory sensitivity and the number of OCD symptoms, and the stronger relationship between emotion regulation difficulties and the severity of OCD symptoms, as well as the lack of correlation between emotion regulation, sensory sensitivity, and clinical presentation, highlight the potential for offering new insights to mental health professionals in terms of both diagnostic assessment and various non-pharmacological complementary and alternative treatments for these children.