The Impact of Pediatric Obsessive-Compulsive Disorder on School Attendance and School Functioning: A Case for Supported Education

School-related functional impairment is common in children and adolescents with obsessive-compulsive disorder (OCD). However, little is known about the characteristics of youth with OCD who struggle in school, whether these struggles interfere with treatment outcomes, and whether treatment improves school-related function. Among 385 youth with OCD at a specialist clinic (mean age [sd] = 13.7 [2.5]; 63.1% girls), 21.6% had partial or no school attendance at intake. Among those who received specialist treatment (n = 322), clinical outcomes were similar in those with no or partial attendance vs. those with full attendance, although the latter group needed fewer treatment sessions and were less likely to take psychotropic medication. At post-treatment, 10.5% still had partial or no school attendance, and 22.8% of youths and 33.3% of parents reported significant school impairment, regardless of response status. Some youth with OCD may benefit from specific supported education and return to school strategies to complement regular evidence-based interventions.