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Obsessive-compulsive disorder in children and adolescents

Published online by Cambridge University Press:  06 August 2018

Mark Riddle
Mark Riddle*
Affiliation:
Division of Child and Adolescent Psychiatry, Johns Hopkins Medical Institutions, Children's Center, Suite 346, 600 North Wolfe Street, Baltimore, MD 21287–3325, USA. Fax: +1 410–955-8691; email: [email protected]
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Abstract

Background Obsessive-compulsive disorder (OCD) is a common psychiatric condition that usually emerges during childhood or adolescence. Over 80% of individuals with OCD have their onset before age 18 years. Epidemiologic studies suggest a prevalence of 1 -2 for adolescents.

Method This article reviews current knowledge of paediatric OCD in the following areas: age of onset, nosology and classification, subtypes, prevalence, aetiology, pathophysiology, assessment, prognosis and treatment.

Results Essential components of treatment include long-term commitment, care management and illness education. Specific components of treatment include cognitive-behavioural therapy, parent behaviour management training and medication.

Conclusions The most effective treatments are selective serotonin reuptake inhibitors (e.g. fluvoxamine, sertraline) and exposure/response prevention.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 173 , Issue S35: New perspectives in research and treatment of obsessive-compulsive disorder , August 1998 , pp. 91 - 96
Copyright
Copyright © 1998 The Royal College of Psychiatrists 

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References

American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM-IV). Washington, DC: American Psychiatric Press.Google Scholar
Berthier, M. L., Kulisevsky, J., Gironell, A., et al (1992) A family study of obsessive-compulsive disorder. Archives of General Psychiatry, 49, 362–368.Google Scholar
Black, D. W. (1996) Epidemiology and genetics of OCD: a review and discussion of future directions and research. CNS Spectrums, 1, 10–16.Google Scholar
Black, D. W., Noyes, R. Jr, Goldstein, R. B., et al (1992) A family study of obsessive-compulsive disorder. Archives of General Psychiatry, 49, 362–368.CrossRefGoogle ScholarPubMed
Carey, G. & Gottesman, I. I. (1981) Twin and family studies of anxiety, phobic, and obsessive disorders. In Anxiety: New Research and Changing Concepts (eds Klein, D. F. & Rabkin, J.), pp. 117–136. New York: Raven Press.Google Scholar
Deveaugh-Geiss, J., Moroz, G., Biederman, J., et al (1992) Clomipramine hydrochloride and adolescent obsessive-compulsive disorder – a multicenter trial. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 45–49.CrossRefGoogle ScholarPubMed
Flament, M. F., Rapoport, J. L., Berg, C. Z., et al (1985) Clomipramine treatment of childhood obsessive-compulsive disorder: a double-blind controlled study. Archives of General Psychiatry, 42, 977–983.Google Scholar
Flament, M. F., Whitaker, A., Rapoport, J. L., et al (1988) Obsessive-compulsive disorder in adolescence: An epidemiological study. Journal of the American Academy of Child and Adolescent Psychiatry 27, 764–771.Google Scholar
Fyer, A. J., Mannuzza, S., Chapman, T. F., et al (1993) A direct interview family study of social phobia. Archives of General Psychiatry, 50, 286–293.Google Scholar
Greist, J. H. (1996) New developments in behaviour therapy for obsessive-compulsive disorder. International Clinical Psychopharmacology, 11 (suppl. 5), 63–73.Google Scholar
Herdy, G. V., Zabriske, J. B., Chapman, F., et al (1992) A rapid test for the detection of a B-cell marker (D8/17) in rheumatic fever patients. Brazilian Journal of Medical and Biological Research, 25, 789–794.Google ScholarPubMed
Husby, G., Van De Rijn, I., Zabriske, J. B., et al (1976) Antibodies reacting with cytoplasm of subthalamic and caudate nuclei neurons in chorea and acute rheumatic fever. Journal of Experimental Medicine, 144, 1094–1110.CrossRefGoogle ScholarPubMed
Insel, T. R. (1992) Toward a neuroanatomy of obsessive-compulsive disorder. Archives of General Psychiatry 49, 739–744.Google Scholar
Khanna, A. K., Buskirk, D. Williams, R. C., et al (1989) Presence of non-HLA B cell antigen in rheumatic fever patients as defined by a monoclonal antibody. Journal of Clinical Investigation, 83, 1710–1716.CrossRefGoogle ScholarPubMed
Leckman, J. F., Goodman, W. K., North, W. G., et al (1994) Elevated cerebrospinal fluid levels of oxytocin in obsessive-compulsive disorder. Comparison with Tourette's syndrome and healthy controls. Archives of General Psychiatry, 51, 782–792.Google Scholar
Leckman, J. F., Grice, D. E., Boardman, J., et al (1997) Symptoms of obsessive-compulsive disorder. American Journal of Psychiatry, 154, 911–917.Google ScholarPubMed
Lenane, M. C., Swedo, S. E., Leonard, H., et al (1990) Psychiatric disorders in first degree relatives of children and adolescents with obsessive compulsive disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 407–412.Google Scholar
Leonard, H. L., Swedo, S. E., Rapoport, J. L., et al (1989) Treatment of childhood obsessive-compulsive disorder with clomipramine and desipramine: a double-blind crossover comparison. Archives of General Psychiatry, 46, 1088–1092.CrossRefGoogle Scholar
Leonard, H. L., Goldberger, E. L., Rapoport, J. L., et al (1990) Childhood rituals: normal development or obsessive-compulsive symptoms. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 17–23.CrossRefGoogle ScholarPubMed
Leonard, H. L., Swedo, S. E., Lenane, M. C., et al (1991) A double-blind substitution during long-term clomipramine treatment in children and adolescents with obsessive-compulsive disorder. Archives of General Psychiatry, 48, 922–927.CrossRefGoogle ScholarPubMed
Leonard, H. L., Swedo, S. E., Lenane, M. C., et al (1993) A 2- to 7-year follow-up study of 54 obsessive-compulsive children and adolescents. Archives of General Psychiatry, 50, 429–439.CrossRefGoogle ScholarPubMed
Lewis, A. (1936) Problems of obsessional illness. Proceedings of the Royal Society of Medicine, 29, 325–336.Google Scholar
March, J. S., Mulle, K. & Herbel, B. (1994) Behavioral psychotherapy for children and adolescents with obsessive-compulsive disorder: an open trial of a new protocol-driven package. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 333–341.CrossRefGoogle ScholarPubMed
March, J. S., Leonard, H. L. & Swedo, S. E. (1995) Pharmacotherapy of obsessive-compulsive disorder. In Child and Adolescent Psychiatric Clinics of North America: Pediatric Psychopharmacology I (ed. Riddle, M. A.), pp. 217–236. Philadelphia, PA: W B. Saunders.Google Scholar
McDougle, C. J., Goodman, W. K., Leckman, J. F., et al (1993) The efficacy of fluvoxamine in obsessive-compulsive disorder: effects of comorbid chronic tic disorder. Journal of Clinical Psychopharmacology, 13, 354–358.CrossRefGoogle ScholarPubMed
McDougle, C. J., Goodman, W. K., et al (1994) Haloperidol addition in fluvoxamine-refractory obsessive-compulsive disorder. A double-blind, placebo-controlled study in patients with and without tics. Archives of General Psychiatry, 51, 302–308.Google Scholar
McDougle, C. J., Naylor, S. T., Cohen, D. J., et al (1996) A double-blind, placebo-controlled study of fluvoxamine in adults with autistic disorder. Archives of General Psychiatry, 53, 1001–1008.CrossRefGoogle ScholarPubMed
Murphy, T. K., Goodman, W. K., Fudge, M. W., et al (1997) B lymphocyte antigen D8/17: a peripheral marker for childhood-onset obsessive-compulsive disorder and Tourette's syndrome. American Journal of Psychiatry, 154, 402–407.Google Scholar
Patterson, G. & Forgatch, M. (1987) Parents and Adolescents Living Together. Eugene, OR: Castalia Publishing.Google Scholar
Pauls, D. L. & Leckman, J. F. (1986) The inheritance of Gilles de la Tourette's syndrome and associated behaviors. Evidence for autosomal dominant transmission. New England Journal of Medicine, 315, 993–997.CrossRefGoogle ScholarPubMed
Pauls, D. L., Alsobrook, J. P., Goodman, W., et al (1995) A family study of obsessive-compulsive disorder. American Journal of Psychiatry, 152, 76–84.Google Scholar
Rachman, S. J. & Hodgson, R. J. (1980) Obsessions and Compulsions. Englewood Cliffs, NJ: Prentice Hall.Google Scholar
Rapoport, J. L. (1989) Obsessive-Compulsive Disorder in Children and Adolescents. Washington, DC: American Psychiatric Press.Google Scholar
Riddle, M. A., Scahill, L., King, R., et al (1990) Obsessive-compulsive disorder in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 766–772.CrossRefGoogle ScholarPubMed
Riddle, M. A., King, R. A., Hardin, M. T., et al (1992) Double blind crossover trial of fluoxetine and placebo in children and adolescents with obsessive-compulsive disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 1062–1069.Google Scholar
Rosenberg, D. R., Averbach, D., O'Hearn, K., et al (1998) Response inhibition abnormalities in pediatric obsessive compulsive disorder. Archives of General Psychiatry, 54, 831–838.CrossRefGoogle Scholar
Swedo, S. E. (1994) Sydenham's chorea: A model for childhood autoimmune neuropsychiatric disorders. Journal of the American Medical Association, 272, 1788–1791.CrossRefGoogle Scholar
Swedo, S. E., Rapoport, J. L., Cheslow, D. L., et al (1989) High prevalence of obsessive-compulsive symptoms in patients with Sydenham's chorea. American Journal of Psychiatry, 146, 246–249.Google Scholar
Swedo, S. E., Leonard, H. L., Schapiro, M. B., et al (1993) Sydenham's chorea: physical and psychological symptoms of St Vitus dance. Pediatrics, 91, 706–713.Google ScholarPubMed
Swedo, S. E., Leonard, H. L., Mittleman, B. B., et al (1997) Identification of children with pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections by a marker associated with rheumatic fever. American Journal of Psychiatry, 154, 110–112.Google ScholarPubMed
Swedo, S. E., Leonard, H. L., Mittleman, B. B., et al (1998) Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS): clinical description of the first 50 cases. American Journal of Psychiatry, 155, 264–271.Google Scholar
Tien, A. Y., Pearlson, G. D., Machlin, S. R., et al (1992) Oculo-motor performance in obsessive-compulsive disorder. American Journal of Psychiatry, 149, 641–646.Google Scholar
Towbin, K. E. & Riddle, M. A. (1996) Obsessive-compulsive disorder. In Ch/7d and Adolescent Psychiatry: A Comprehensive Textbook (ed. Lewis, M.), pp. 684–693. Baltimore: Williams & Wilkins.Google Scholar
Valleni-Basile, L. A., Garrison, C. Z., Jackson, K. L., et al (1994) Frequency of obsessive-compulsive disorder in a community sample of young adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 782–791.Google Scholar
Zohar, A. H., Ratzoni, G., Pauls, D. L., et al (1992) An epidemiological study of obsessive-compulsive disorder and related disorder in Israeli adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 1057–1061.Google Scholar
Zohar, A. H., Pauls, D. L., Ratzoni, G., et al (1997) Obsessive-compulsive disorder with and without tics in an epidemiological sample of adolescents. American Journal of Psychiatry, 154, 274–276.Google Scholar
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