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小儿强迫症:初级保健中的管理重点

Pediatric obsessive-compulsive disorder: management priorities in primary care.

作者信息

Gilbert Andrew R, Maalouf Fadi T

机构信息

Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA.

出版信息

Curr Opin Pediatr. 2008 Oct;20(5):544-50. doi: 10.1097/MOP.0b013e32830f93d9.

Abstract

PURPOSE OF REVIEW

Obsessive-compulsive disorder (OCD) is a severe neuropsychiatric condition with a substantial prevalence in childhood and adolescence. Our understanding of the etiopathogenesis of pediatric OCD continues to grow, along with diagnostic and treatment approaches. The present study attempts to provide a parsimonious review of important studies of pediatric OCD with particular emphasis on studies over the last year.

RECENT FINDINGS

Consistent with many other pediatric conditions, OCD in childhood and adolescence has distinct yet overlapping features with the adult-onset type. It appears that OCD is a multidimensional disorder with substantial comorbidity with other neuropsychiatric disorders that may affect its course and treatment. Although its pathophysiology remains to be fully elucidated, evidence suggests that OCD likely results from a complex interaction between multiple genetic variants and nongenetic factors. Meanwhile, evidence supporting the efficacy of selective serotonin reuptake inhibitors, augmentation strategies affecting other neurotransmitter systems, and cognitive behavioral therapy for the treatment of pediatric OCD continues to emerge.

SUMMARY

Results from the studies reviewed here reflect the heterogeneity of pediatric OCD. It is clear that clinicians need to consider specific symptoms, comorbid conditions, and the rapidly evolving clinical research when working with children and adolescents with OCD.

摘要

综述目的

强迫症(OCD)是一种严重的神经精神疾病,在儿童和青少年中具有相当高的患病率。随着诊断和治疗方法的不断发展,我们对儿童强迫症病因发病机制的理解也在持续深入。本研究旨在对儿童强迫症的重要研究进行简要综述,特别关注过去一年的研究。

最新发现

与许多其他儿科疾病一样,儿童期和青少年期的强迫症与成人起病型具有不同但重叠的特征。强迫症似乎是一种多维疾病,与其他神经精神疾病有大量共病,这可能会影响其病程和治疗。尽管其病理生理学仍有待充分阐明,但有证据表明,强迫症可能是多种基因变异与非遗传因素之间复杂相互作用的结果。与此同时,支持选择性5-羟色胺再摄取抑制剂、影响其他神经递质系统的增效策略以及认知行为疗法治疗儿童强迫症有效性的证据不断涌现。

总结

此处综述的研究结果反映了儿童强迫症的异质性。显然,临床医生在治疗患有强迫症的儿童和青少年时,需要考虑特定症状、共病情况以及快速发展的临床研究。

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