Thomsen P H, Mikkelsen H U
Institute of Psychiatric Demography, Arhus Psychiatric Hospital, Denmark.
Acta Psychiatr Scand. 1991 Apr;83(4):262-6. doi: 10.1111/j.1600-0447.1991.tb05537.x.
To find children and adolescents with obsessive-compulsive disorder (OCD), a review was made of all the charts of the 4594 nonretarded, nonpsychotic patients treated at the Children's Psychiatric Hospital in Risskov, Denmark, as in- or outpatients from 1970 to 1986. Sixty-one children and adolescents (37 boys and 24 girls) fulfilled the DSM-III criteria for OCD. The frequency of OCD in a child psychiatric clientele was 1.33%, which supports earlier findings. Only 8 of the 61 children were actually discharged with a diagnosis of OCD (ICD-8 diagnosis). Most children were diagnosed as neurosis infantilis and about one fifth received a diagnosis of maladjustment. The possible reasons for this are discussed. It is concluded that it is hardly a matter of underdiagnosing OCD, but more likely an attempt to look upon the obsessive-compulsive symptoms as transient phenomena and perhaps an unwillingness among clinicians to use the diagnosis of OCD, which is often connected with a bad prognosis. Boys and girls with OCD did not differ significantly on important demographic items.
为了找出患有强迫症（OCD）的儿童和青少年，我们查阅了丹麦里斯科夫市儿童精神病院1970年至1986年期间收治的4594名非智力发育迟缓、非精神病患者的所有病历，这些患者包括门诊和住院患者。61名儿童和青少年（37名男孩和24名女孩）符合DSM - III强迫症标准。儿童精神科患者中强迫症的发病率为1.33%，这支持了早期研究结果。61名儿童中只有8名最终被诊断为强迫症（ICD - 8诊断）出院。大多数儿童被诊断为儿童神经症，约五分之一被诊断为适应不良。文中讨论了出现这种情况的可能原因。得出的结论是，这几乎不是强迫症诊断不足的问题，而更可能是将强迫症状视为短暂现象的一种倾向，也许还存在临床医生不愿使用强迫症诊断的情况，因为强迫症诊断往往与不良预后相关。患有强迫症的男孩和女孩在重要人口统计学项目上没有显著差异。
