Diler Rasim Somer, Avci Ayse
Child Psychiatry Department, Cukurova University Faculty of Medicine, Balcali, Adana, Turkey.
Croat Med J. 2002 Jun;43(3):324-9.
To assess clinical and demographic characteristics of Turkish children and adolescents with obsessive-compulsive disorder.
The study comprised 47 children and adolescents (31 boys and 15 girls) aged between 9 and 15 years, who were diagnosed with obsessive-compulsive disorder according to Diagnostic and Statistical Manual of Mental Disorders-IV. At the first interview, sociodemographic data of patients were recorded and Maudsley Obsession Compulsive Questionnaire (MOCQ), Child Depression Inventory (CDI), and State and Trait Anxiety Inventory for Children (STAI-C) were administered concurrently. Afterwards, the comorbid diagnosis and clinical characteristics of obsessive-compulsive disorder were investigated in detail during a psychiatric interview.
The obsessive-compulsive disorder prevalence among 1,739 outpatients seen for the first time at our clinics between January 1998 and April 1999 was 2.7% (n=47). Initial complaints with a content of obsession or compulsion were observed in only 14.9% (n=7) of the patients. Contamination (48.9%) and cleaning (68.1%) were the most common symptoms. Thirty-one patients (65.9%) had at least one comorbid disorder with obsessive-compulsive disorder, the most common being major depression (29.8%). There were no significant differences between the patients with and those without comorbid disorder in terms of MOCQ and subscales scores. Children under age of 13 had higher scores on cleanliness subscale on MOCQ, whereas children with migration history had higher state anxiety scores. There were no differences in STAI-C and CDI scores between boy and girls, children (<13 years) and adolescents (13 years), and firstborn and other children in a family.
Obsessive-compulsive disorder is a serious clinical problem in childhood and practitioners, pediatricians, and psychiatrists should explicitly ask about the presence of symptoms characteristic to obsessive-compulsive disorder. Given the high rates of various comorbid states, such as anxiety, mood and tic disorders, comorbidities should also be taken into account during psychiatric evaluation of a child patient.
评估患有强迫症的土耳其儿童及青少年的临床和人口统计学特征。
该研究纳入了47名年龄在9至15岁之间的儿童及青少年(31名男孩和15名女孩),他们根据《精神疾病诊断与统计手册》第四版被诊断为强迫症。在首次访谈时,记录患者的社会人口学数据,并同时进行莫兹利强迫症问卷(MOCQ)、儿童抑郁量表(CDI)以及儿童状态与特质焦虑量表(STAI-C)的测评。之后,在精神科访谈中详细调查强迫症的共病诊断及临床特征。
1998年1月至1999年4月期间,在我们诊所首次就诊的1739名门诊患者中,强迫症患病率为2.7%(n = 47)。仅有14.9%(n = 7)的患者最初的主诉内容为强迫观念或强迫行为。污染(48.9%)和清洁(68.1%)是最常见的症状。31名患者(65.9%)至少有一种与强迫症共病的疾病,最常见的是重度抑郁症(29.8%)。在MOCQ及其子量表得分方面,有共病和无共病的患者之间无显著差异。13岁以下儿童在MOCQ清洁子量表上得分较高,而有移民史的儿童状态焦虑得分较高。男孩与女孩、儿童(<13岁)与青少年(13岁)以及家庭中的长子与其他孩子在STAI-C和CDI得分上无差异。
强迫症在儿童期是一个严重的临床问题,从业者、儿科医生和精神科医生应明确询问是否存在强迫症的特征性症状。鉴于焦虑、情绪和抽动障碍等各种共病状态的高发生率,在对儿童患者进行精神科评估时也应考虑共病情况。