Supplementary Material for: Temperament Traits in Pediatric Obsessive-Compulsive Disorder in Relation to Tourette Syndrome and Attention-Deficit Hyperactivity Disorder

Introduction: Pediatric obsessive-compulsive disorder (OCD) is concurrent with disorders characterized by disinhibition: attention-deficit hyperactivity disorder (ADHD) and Tourette Syndrome (TS). This study explores the temperament profile of complex OCD phenotypes.
Methods: A clinical registry recorded demographic data, psychiatric diagnoses, and temperament traits, including novelty seeking (exploratory behaviors), harm avoidance (fear of uncertainty), reward dependence (sentimentality), and persistence (perseverance). Temperament was accrued from the Junior Temperament and Character Inventory (JTCI). Participants were divided into 1) OCD only; 2) OCD+ADHD or TS; 3) OCD+ADHD+TS to compare temperament.
Results: 126 youth with OCD (61.9% male, 88.9% White) ages 6-18 years (12.68 ± 3.05) express the highest novelty seeking in the complex disinhibition disorder group: OCD+ADHD+TS, while persistence is lowest in the same group. Harm avoidance is increased in all groups with respect to reference controls, irrespective of concurrent ADHD or TS. For the OCD+ADHD+TS group, contamination and washing symptoms have higher novelty seeking (p < 0.01), while counting and ordering have lower novelty seeking (p < 0.05). Harm avoidance is increased with aggressive, somatic, and checking symptoms in OCD only (p < 0.01), while persistence is increased with repeating and counting symptoms in the comorbid subtypes (OCD+ADHD or TS, OCD+ADHD+TS).
Discussion/Conclusion: The complex subtype, OCD+ADHD+TS, is associated with high novelty seeking and low persistence, while high harm avoidance is linked to pediatric OCD irrespective of ADHD or TS co-occurrence. In sum, disorders linked to disinhibition in pediatric OCD confer a unique temperament profile, further refining complex phenotypes of pediatric OCD for future research.