Children with OCD demonstrated marked domain-specific functional impairments, particularly during school, after school, and nighttime routines, with distinct psychosocial factors including behavioral problems, sibling presence, and anxiety symptoms associated with time-specific functioning.
Children with OCD scored significantly lower than community norms across all QCD functional domains.
The largest functional impairments in children with OCD were observed during nighttime, school, after-school, and overall (total QCD) domains.
Higher behavioral problem scores predicted better functioning in the morning and evening periods.
A greater number of siblings predicted poorer morning functioning in children with OCD.
Higher anxiety scores were significantly associated with better nighttime functioning in children with OCD.
Depressive symptoms were not significantly associated with overall functioning in children with OCD.
The study identified time-of-day-specific patterns of functional impairment in children with OCD, suggesting a need for targeted, time-sensitive interventions.
This research suggests that children with obsessive-compulsive disorder (OCD) experience significant difficulties in daily functioning compared to children in the general community, and that these difficulties are not uniform throughout the day. Using parent-reported questionnaires from 136 children with OCD (average age about 11.5 years), the researchers found that the biggest gaps between children with OCD and their peers occurred during school hours, after-school time, and at night — all showing very large differences. The study used effect sizes (a measure of how large a difference is) in the range of 1.90 to 2.10, which are considered very large in behavioral research. The researchers also found that different factors were linked to functioning at different times of day. For example, having more siblings at home was linked to worse morning functioning, while higher levels of anxiety were paradoxically associated with better nighttime functioning, and higher behavioral problem scores were linked to better morning and evening functioning. Interestingly, depressive symptoms did not show a significant relationship with functioning in any time period. These findings suggest that the relationship between OCD symptoms, anxiety, family environment, and daily life is complex and varies depending on the time of day. This research suggests that when clinicians, parents, or educators try to support children with OCD, it may be helpful to think about which specific parts of the day are most challenging rather than treating daily difficulties as a single uniform problem. Identifying that school time, after school, and nighttime routines are particularly affected could help focus support efforts. The finding that family factors like sibling presence matter — at least in the morning — also points to the potential importance of considering the home environment when helping children with OCD manage their daily lives.
Usami M, Sasaki Y, Ichikawa M, Matsudo M, Hashimoto A, Kusanish S, et al.. (2026). Time-of-day differences in daily functioning in children with obsessive-compulsive disorder.. Scientific reports. https://doi.org/10.1038/s41598-026-37027-7