Obsessive-compulsive disorder in children and adolescents

1998 ◽  
Vol 173 (S35) ◽  
pp. 91-96 ◽  
Author(s):  
Mark Riddle
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Age Of Onset ◽  
Current Knowledge ◽  
Management Training ◽  
Behavioural Therapy ◽  
Epidemiologic Studies ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Essential Components

BackgroundObsessive-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 1-2for adolescents.MethodThis 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.ResultsEssential 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.ConclusionsThe most effective treatments are selective serotonin reuptake inhibitors (e.g. fluvoxamine, sertraline) and exposure/response prevention.

scholarly journals Schizophrenia with Co-morbid Obsessive-Compulsive Disorder: A Case Series

2021 ◽  
pp. 69-74
Author(s):  
Prakash B. Behere ◽  
Pooja Raikar ◽  
Debolina Chowdhury ◽  
Aniruddh P. Behere ◽  
Richa Yadav
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Negative Symptoms ◽  
Age Of Onset ◽  
Case Series ◽  
Post Traumatic Stress ◽  
Obsessive Compulsive ◽  
Course Of Illness ◽  
Obsessive Compulsive Symptoms ◽  
Compulsive Disorder

The frequency of co-morbidities like Obsessive Compulsive Disorder (OCD) is common in schizophrenia. Some studies have reported earlier age of onset, more positive and negative symptoms, more depressive symptoms, and worse prognosis in such patients. The phenomenology and management of OCD in schizophrenia is understudied. Evidence claims that the course of illness of both schizophrenia and bipolar disorders may be affected by obsessive-compulsive disorder whereas in other cases antipsychotic induced obsessive-compulsive symptoms have been observed. A meta-analysis of of schizophrenia and its co-morbid psychiatric conditions, found a prevalence of 12.1% for obsessive compulsive disorder, 9.8% for panic disorders, 12.4% for post-traumatic stress disorder and 14.9% for social phobia. SGAs like amisulpride and aripiprazole are found to be useful in the treatment of comorbid OCD in schizophrenia due to their negligible serotonergic properties. A combination of selective serotonin reuptake inhibitors (SSRI) with antipsychotics has been recommended by the American Psychiatric Association (APA) for treatment of comorbid OCD in schizophrenia. Escitalopram at a dose of 20 mg/day has been found to be beneficial in such cases while psychosis worsened with the use of fluvoxamine and clomipramine. Below is a series of seven cases of schizophrenia with co-morbid obsessive-compulsive symptoms who are on treatment for their illness from the psychiatric outpatient department of a rural hospital in central India.

scholarly journals Treated depression in adolescents: predictors of outcome at 28 weeks

2009 ◽  
Vol 194 (4) ◽  
pp. 334-341 ◽  
Author(s):  
Paul Wilkinson ◽  
Bernadka Dubicka ◽  
Raphael Kelvin ◽  
Chris Roberts ◽  
Ian Goodyer
Keyword(s):  
Major Depression ◽  
Obsessive Compulsive Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Adolescent Depression ◽  
Controlled Trial ◽  
Psychosocial Care ◽  
Behavioural Therapy ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

BackgroundThere is great heterogeneity of clinical presentation and outcome in paediatric depression.AimsTo identify which clinical and environmental risk factors at baseline and during treatment predicted major depression at 28-week follow-up in a sample of adolescents with depression.MethodOne hundred and ninety-two British adolescents with unipolar major depression were enrolled in a randomised controlled trial (the Adolescent Depression Antidepressants and Psychotherapy Trial, ADAPT). Participants were treated for 28 weeks with routine psychosocial care and selective serotonin reuptake inhibitors (SSRIs), with half also receiving cognitive–behavioural therapy (CBT). Full clinical and demographic assessment was carried out at baseline and 28 weeks.ResultsDepression at 28 weeks was predicted by the additive effects of severity, obsessive–compulsive disorder and suicidal ideation at entry together with presence of at least one disappointing life event over the follow-up period.ConclusionsClinicians should assess for severity, suicidality and comorbid obsessive–compulsive disorder at presentation and should monitor closely for subsequent life events during treatment.

Pharmacological management of comorbid obsessive–compulsive disorder and chronic non-affective psychosis

2020 ◽  
pp. 1-13
Author(s):  
Itoro Udo ◽  
Carol McDaniel ◽  
Chidi Chima
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Evidence Base ◽  
Behavioural Therapy ◽  
Current Evidence ◽  
Obsessive Compulsive ◽  
Pharmacological Management ◽  
Targeted Interventions ◽  
Compulsive Disorder ◽  
Before And After

SUMMARY The comorbidity of obsessive–compulsive symptoms (OCS) in the context of schizophrenia is often not recognised by clinicians, and patients may not report these symptoms until they become severe. However, there is a reported prevalence of 10–24% for obsessive–compulsive disorder (OCD) in schizophrenia and related disorders. The onset of OCS/OCD has been noted to occur both before and after the diagnosis of schizophrenia or schizoaffective disorder. It has also been known to occur following commencement of treatment with antipsychotic medications, especially clozapine. Current literature provides limited guidance for treatment. Review of the current evidence supports: addition of selective serotonin reuptake inhibitors (SSRIs) to antipsychotics; addition of aripiprazole, amisulpride or lamotrigine; or reduction in the dosage of clozapine. There is also evidence supporting the addition of cognitive–behavioural therapy and electroconvulsive therapy (ECT). The SSRIs that are evidenced to be useful are fluvoxamine, escitalopram, sertraline and paroxetine. More studies are needed to expand the evidence base. Early targeted interventions are recommended.

scholarly journals Defining functional brain networks underlying obsessive–compulsive disorder (OCD) using treatment-induced neuroimaging changes: a systematic review of the literature

2021 ◽  
pp. jnnp-2020-324478
Author(s):  
Kelly R. Bijanki ◽  
Yagna J. Pathak ◽  
Ricardo A. Najera ◽  
Eric A. Storch ◽  
Wayne K Goodman ◽  
...  
Keyword(s):  
Treatment Response ◽  
Obsessive Compulsive Disorder ◽  
Functional Neuroimaging ◽  
Current Knowledge ◽  
Brain Regions ◽  
Behavioural Therapy ◽  
Anterior Cingulate ◽  
Therapeutic Interventions ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

Approximately 2%–3% of the population suffers from obsessive–compulsive disorder (OCD). Several brain regions have been implicated in the pathophysiology of OCD, but their various contributions remain unclear. We examined changes in structural and functional neuroimaging before and after a variety of therapeutic interventions as an index into identifying the underlying networks involved. We identified 64 studies from 1990 to 2020 comparing pretreatment and post-treatment imaging of patients with OCD, including metabolic and perfusion, neurochemical, structural, functional and connectivity-based modalities. Treatment class included pharmacotherapy, cognitive–behavioural therapy/exposure and response prevention, stereotactic lesions, deep brain stimulation and transcranial magnetic stimulation. Changes in several brain regions are consistent and correspond with treatment response despite the heterogeneity in treatments and neuroimaging modalities. Most notable are decreases in metabolism and perfusion of the caudate, anterior cingulate cortex, thalamus and regions of prefrontal cortex (PFC) including the orbitofrontal cortex (OFC), dorsolateral PFC (DLPFC), ventromedial PFC (VMPFC) and ventrolateral PFC (VLPFC). Modulating activity within regions of the cortico-striato-thalamo-cortical system may be a common therapeutic mechanism across treatments. We identify future needs and current knowledge gaps that can be mitigated by implementing integrative methods. Future studies should incorporate a systematic, analytical approach to testing objective correlates of treatment response to better understand neurophysiological mechanisms of dysfunction.

Anxiety and the Spectrum of Obsessive-Compulsive Disorder

CNS Spectrums ◽  
2008 ◽  
Vol 13 (S14) ◽  
pp. 4-5 ◽  
Author(s):  
Donald W. Black
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Obsessive Compulsive Disorder ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Age Of Onset ◽  
The Other ◽  
Specific Response ◽  
Obsessive Compulsive ◽  
Important Place ◽  
Compulsive Disorder

This supplement to CNS Spectrums focuses on the obsessive-compulsive spectrum of disorders and their relationship to anxiety. Hollander and others pioneered the concept of the obsessive-compulsive spectrum in the early 1990s, and have described its breadth and overlap with other psychiatric disorders. While its place in the psychiatric nomenclature is uncertain, the obsessive-compulsive spectrum is intertwined with the anxiety disorders in both its symptoms and biologic substrates.Obsessive-compulsive disorder (OCD) has an important place at the center of the spectrum. While currently classified in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition as an anxiety disorder, OCD is distinct from these conditions in the International Classification of Diseases. There is a strong rationale for its separation from the anxiety disorders. First, OCD often begins in childhood, whereas other anxiety disorders typically have a later age of onset. OCD has a nearly equal gender distribution, unlike the other anxiety disorders, which are more common in women. Studies of psychiatric comorbidity show that, unlike the other anxiety disorders, persons with OCD generally tend not to have elevated rates of substance misuse. Family studies suggest that first-degree relatives of persons with OCD have an elevated prevalence of OCD-related disorders including body dysmorphic disorder, hypochondriasis, and grooming disorders, but not other anxiety disorders except for generalized anxiety disorder. The brain circuitry that mediates OCD appears to be different from that involved in other anxiety disorders. Lastly, OCD is unique with regard to its specific response to selective serotonin reuptake inhibitors, while noradrenergic medications, effective in the anxiety and mood disorders, are largely ineffective. On the other hand, the benzodiazepines, which have little effect on OCD, are often effective for the other anxiety disorders.

Age of Onset for Obsessive-Compulsive Disorder

1990 ◽  
Author(s):  
W. E. Minichiello ◽  
L. Baer ◽  
M. A. Jenike ◽  
A. Holland
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Age Of Onset ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

scholarly journals The Fourth IOCDC

CNS Spectrums ◽  
2000 ◽  
Vol 5 (S4) ◽  
pp. 4-4
Author(s):  
Eric Hollander ◽  
Joseph Zohar ◽  
Donatella Marazziti
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Brain Stimulation ◽  
Current Knowledge ◽  
Active Role ◽  
Cortical Inhibition ◽  
Obsessive Compulsive ◽  
Future Directions ◽  
Compulsive Disorder ◽  
Ablative Surgery

The Fourth International Obsessive Compulsive Disorder Conference (IOCDC) was held February 10–12, 2000, on the beautiful island of St. Thomas. The IOCDC is an annual meeting which brings together the world's leading experts in obsessive-compulsive disorder (OCD) and related disorders in a small workshop setting to present recent research advances, discuss gaps in our current knowledge, and plan or international approaches that address these knowledge gaps. The IOCDC meetings have been held on islands on both sides of the Atlantic—Capri, Guadeloupe, Madeira, and now St. Thomas.The International Organizing Committee consists of Eric Hollander, MD (USA), Joseph Zohar, MD (Israel), and Donatella Marazziti, MD (Italy). The proceedings are generously supported by an unrestricted educational grant from Solvay Pharmaceuticals Inc. and Solvay Pharmaceuticals, and we would like to acknowledge the very important contributions of Chantal Vekens and Mary Blangiardo of Solvay. Also, an mportant part of the success of these meetings stems from the very active role of the chairpersons and cochairpersons of the workshops who lead the discussions, who synthesize the future directions and prepare the manuscripts that result from these discussions that appear in this academic supplement.The meeting led off with a state-of-the-art plenary address by Mark George, MD (USA), describing how new methods of brain stimulation are improving research and therapy in OCD and promise to revolutionize neuropsychiatric research and herapy over the next decade. He describes how transcranial magnetic stimulation (TMS) is used to test the circuits in OCD and test electrophysiologic evaluations of cortical inhibition n OCD. Newer techniques that are less invasive than ablative surgery and appear promising in OCD therapy include vagus nerve stimulation and deep brain stimulation.

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