Exploring the impact of childhood trauma on obsessive-compulsive disorder: A systematic review focused on adult populations

Background: Childhood trauma has been linked to various psychiatric disorders, including obsessive-compulsive disorder (OCD). However, the relationship between specific types of childhood trauma and their impact on the subtypes and severity of obsessive-compulsive symptoms remains poorly understood. This systematic review aims to consolidate current evidence on the potential associations between childhood trauma and obsessive-compulsive symptoms. Methods: We conducted a systematic search across four electronic databases, including PubMed, Web of Science, EMBASE, and PsycINFO, to identify studies examining the relationship between childhood trauma and obsessive-compulsive symptoms. Eligible studies were screened, data extracted, and methodological quality assessed. Results: The final selection consisted of 22 studies corresponding to 5603 individuals with a diagnosis of OCD (mean age: 29.8 ± 9.9 years; 52% females). The findings suggest that individuals with OCD frequently have childhood trauma. Emotional abuse and neglect were significantly associated with higher Yale-Brown Obsessive-Compulsive Scale scores and increased prevalence of religious, sexual, and aggressive obsessions. Two studies identified potential mechanisms linking trauma to OCD, including cerebellar remodeling and dysregulation of stress-response systems. Conclusions: Childhood trauma, particularly emotional abuse and neglect, appears to contribute to OCD severity and symptom specificity, with trauma histories being more pronounced in treatment-resistant cases. These findings highlight the importance of trauma-informed care in OCD assessment and treatment. Future research should address methodological heterogeneity, explore longitudinal pathways, and investigate neurobiological mechanisms to elucidate the trauma-OCD relationship further.