ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Anxiety and Stress Disorders
Earlier age at onset is associated with more severe sensory phenomena in drug-naive, comorbidity-free patients with obsessive-compulsive disorder
Makoto Kawahito 1
Keitaro Murayama 2
Hirofumi Tomiyama 2
Kenta Kato 2
Ko Matsukuma 1
Nami Nishida 1
Takuro Kamio 1
Kana Tsunoda 1
Kenta Sashikata 3
Mingi Kang 1
Ayaka Shuto 1
Shoma Tanaka 1
Tomohiro Nakao 1
1. Kyushu University, Fukuoka, Japan
2. Kyushu Daigaku Byoin, Fukuoka, Japan
3. Hokkaido Daigaku, Sapporo, Japan
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Abstract
Sensory phenomena (SP) are subjective experiences, such as feelings of discomfort or incompleteness, which often precede repetitive behaviors in patients with obsessive-compulsive disorder (OCD). Although previous studies have shown that SP are common in early-onset OCD, the relationship between age at onset and SP severity remains unclear. This cross-sectional study included 30 drug-naive patients with OCD, without comorbid psychiatric or medical/neurological disorders, and with at least one lifetime SP. SP severity was assessed using the University of São Paulo Sensory Phenomena Scale (USP-SPS). Multiple regression analysis was conducted to examine the association between age at onset and SP severity, controlling for sex, autistic traits, and obsessive-compulsive symptom severity. Sensitivity analyses evaluated illness duration and anxiety and used a two-part analysis to address the floor at USP-SPS = 0. Robustness was assessed using bias-corrected (BC) bootstrap 95% confidence intervals and influence diagnostics. Earlier age at onset was associated with greater SP severity (B = −0.171, p = 0.007; BC bootstrap 95% CI −0.300 to −0.064). Sensitivity analyses, including models additionally adjusting for illness duration or anxiety, and influence diagnostics, supported the robustness of this association. In a two-part analysis, autistic traits were associated with the presence of current SP, whereas earlier onset was associated with greater SP severity. Earlier onset of OCD was associated with more severe SP after adjustment for clinical covariates. These findings may be consistent with a neurodevelopmental contribution to SP severity in OCD. Further longitudinal and qualitative studies on SP are warranted.
Summary
Keywords
age at onset, Autism spectrum traits, Cross-sectional study, Obsessive-Compulsive Disorder, sensory phenomena
Received
24 December 2025
Accepted
20 February 2026
Copyright
© 2026 Kawahito, Murayama, Tomiyama, Kato, Matsukuma, Nishida, Kamio, Tsunoda, Sashikata, Kang, Shuto, Tanaka and Nakao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Keitaro Murayama
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