OBJECTIVE Obsessive-compulsive symptoms (OCS) are common throughout development and often considered developmentally appropriate. We evaluated the prevalence and phenotypic heterogeneity of self-reported OCS in a large community youth sample not ascertained for seeking mental-health help. We aimed to identify patterns in OCS that are associated with serious psychopathology and may thus represent a "red flag" that merits psychiatric evaluation. METHOD Data were analyzed from youth from the Philadelphia Neurodevelopmental Cohort (N = 7,054, aged 11-21 years, 54% female). Participants underwent structured psychiatric interviews, including screening for OCS (8 obsessions, 8 compulsions, and hoarding) and other major psychopathology domains. Factor analysis was conducted to identify clustering of OCS presentation. Regression models were used to investigate association of OCS with threshold lifetime diagnoses of obsessive-compulsive disorder (OCD), depressive episode, psychosis, and suicide ideation. RESULTS OCS were common in non-mental health-seeking individuals (38.2%), although only 3% met threshold OCD criteria. OCS were more common in female participants and postpuberty. Factor analyses resulted in 4 factors: F1 - Bad Thoughts; F2 - Repeating/Checking; F3 - Symmetry; F4 - Cleaning/Contamination; and Hoarding as a separate item. All OCS were associated with higher rates of OCD, depression, psychosis, and suicide ideation. However, endorsement of F1 symptoms, prevalent in more than 20% of the sample, showed the most substantial associations with major psychiatric conditions. CONCLUSION OCS are common in community youth. Although for most youths OCS symptoms may be benign, some patterns of OCS are associated with major psychiatric conditions. These findings may help to identify youth at risk for serious psychopathology.

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社区青年中的强迫症症状：典型发展还是精神病理学的红旗？

目的强迫症（OCS）在整个发育过程中很常见，通常被认为在发育上是适当的。我们在未确定为寻求心理健康帮助的大型社区青年样本中评估了自我报告的OCS的患病率和表型异质性。我们旨在确定OCS中与严重精神病理学相关的模式，因此可能代表值得进行精神病学评估的“危险信号”。方法数据来自费城神经发育队列的青年（N = 7,054，年龄11-21岁，女性54％）。参加者进行了结构化的精神病学访谈，包括筛查OCS（8次强迫，8次强迫和ions积）和其他主要精神病理学领域。进行因子分析以鉴定OCS表达的聚类。回归模型用于调查OCS与强迫症（OCD），抑郁发作，精神病和自杀意念的阈值终生诊断的关联。结果OCS在非精神健康患者中很常见（38.2％），尽管只有3％符合OCD阈值标准。OCS在女性参与者和青春期后更为常见。因素分析得出4个因素：F1-不良思想；F2-重复/检查；F3-对称性；F4-清洁/污染；和Ho积作为一个单独的项目。所有OCS与强迫症，抑郁症，精神病和自杀意念的发生率较高相关。但是，对F1症状的认可（在超过20％的样本中普遍存在）显示出与主要精神疾病的关系最为密切。结论OCS在社区青年中很常见。尽管对于大多数年轻人来说，OCS症状可能是良性的，但某些类型的OCS与主要的精神疾病有关。这些发现可能有助于确定有严重精神病理危险的青年。