Ability in certain cognitive domains might be useful in distinguishing generalized anxiety disorder from obsessive-compulsive disorder in children, according to the findings of a study in Depression and Anxiety.

It is not always easy to differentiate between anxiety disorders in children, especially when 2 disorders share a number of characteristics, such as rumination, increased vigilance, and intolerance of uncertainty. A study was therefore conducted to compare participants who had already received clear diagnoses of either disorder with each other, as well as with controls, in order to identify cognitive differences between both groups.

The investigators recruited children with primary obsessive-compulsive disorder (n=28), children with primary generalized anxiety disorder (n=34), and typically developing controls (n=65). Participants’ working memory, visuospatial memory, planning ability, and cognitive flexibility were assessed using the Cambridge Neuropsychological Automated Battery.

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Children with obsessive-compulsive disorder required more turns overall to complete multistep problems, whereas children with generalized anxiety disorder were more likely to make reversal errors. Children with generalized anxiety disorder also took longer to identify visual patterns.

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Although both case groups demonstrated significantly worse cognitive functioning compared with controls, children’s cognition was further significantly impaired based on the anxiety type and specific skills. Children with generalized anxiety disorder struggled more with mental flexibility and visual processing, whereas children with obsessive-compulsive disorder exhibited poorer planning abilities.

In future research, the researchers suggested the use of parent- and self-report forms, neuroimaging, and other types of assessments measuring the same cognitive skills examined in their study.


Kim KL, Christensen RE, Ruggieri A, et al. Cognitive performance of youth with primary generalized anxiety disorder versus primary obsessive-compulsive disorder [published online October 29, 2018]. Depress Anxiety. doi: 10.1002/da.22848