Irak Metehan, Flament Martine F
Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada.
Turk Psikiyatri Derg. 2007 Winter;18(4):293-301.
In this review paper, studies focusing on the neuropsychological characteristics of childhood-onset obsessive-compulsive disorder (OCD) were evaluated. The literature search covered the MedLine and PsycInfo databases through June 2006. The presented results are of those that focus on the processes of attention, memory, and executive functions related to the aspects of the measured instruments used. The aim of this review was to provide a general neuropsychological profile of childhood-onset OCD based on the reviewed studies. In general, results showed that there is no clear evidence that the neuropsychological aspects of childhood-onset OCD differ from those of adult-onset OCD. In parallel with this, the processes of attention and memory in OCD are observed to be selective and biased, and this bias is directed towards threat-relevant stimuli related to obsessions and compulsions. In addition, dysfunction in memory and visuospatial processes in OCD patients do not result from memory impairment per se, but rather from an impaired ability to apply efficiently elaborated strategies. In childhood-onset OCD, the various lines of evidence consistently include impairment of response suppression and motor inhibition abilities; there is less consistent evidence for reduced set shifting, fluency, conceptual thinking, and planning ability. Whereas clinical observation suggests that a central problem in OCD is at the meta-memory level and that people with OCD have less meta-cognitive ability, processing of meta-cognition in childhood-onset OCD has not been investigated adequately. Finally, the results of the reviewed studies were evaluated in terms of the effects of basic co-morbidity, such as depression, Tourette's disorder, tic disorder, and other confounding variables.
在这篇综述论文中，对聚焦于儿童期起病的强迫症（OCD）神经心理学特征的研究进行了评估。文献检索涵盖了截至2006年6月的MedLine和PsycInfo数据库。呈现的结果是那些聚焦于与所使用测量工具各方面相关的注意力、记忆和执行功能过程的研究结果。这篇综述的目的是基于所综述的研究提供儿童期起病的强迫症的一般神经心理学概况。总体而言，结果表明没有明确证据表明儿童期起病的强迫症的神经心理学方面与成人期起病的强迫症不同。与此同时，观察到强迫症患者的注意力和记忆过程具有选择性和偏向性，且这种偏向指向与强迫观念和强迫行为相关的威胁性刺激。此外，强迫症患者的记忆和视觉空间过程功能障碍并非源于记忆本身受损，而是源于有效运用精细策略的能力受损。在儿童期起病的强迫症中，各种证据一致表明存在反应抑制和运动抑制能力受损；关于定势转换、流畅性、概念性思维和计划能力下降的证据则不太一致。虽然临床观察表明强迫症的一个核心问题在于元记忆水平，且强迫症患者的元认知能力较低，但儿童期起病的强迫症中元认知的处理尚未得到充分研究。最后，根据诸如抑郁症、图雷特氏障碍、抽动障碍和其他混杂变量等基本共病的影响对所综述研究的结果进行了评估。
