Klein R G, Rapoport J L
New York State Psychiatric Institute, New York.
Encephale. 1990 Jul-Aug;16 Spec No:317-20.
The research recently conducted and ongoing in adolescent obsessive-compulsive disorder indicates that the clinical signs and symptoms are indistinguishable from those seen in adults. Comorbidity appears to follow the same trends in adolescents and adults, with anxiety and affective symptomatology predominating. Contrary to expectation, Gilles de la Tourette disorder does not appear either as a concurrent syndrome, or as an eventual outcome in obsessive-compulsive adolescents. Males are greatly over-represented among adolescents with an early childhood onset. The neurological and neuropsychological findings are the only ones that appear to distinguish the adolescent and adult obsessive-compulsive patients. The findings point to frequent neurological abnormalities in adolescents with obsessive-compulsive disorder. The natural history over the short-term seems to be negatively affected by severity. The clinical efficacy of clomipramine and the failure of another tricyclic antidepressant parallels the therapeutic experience reported in adult patients. The presence of depression is unrelated to the efficacy of clomipramine. The neuropsychological and neurological abnormalities, together with the data from the longitudinal and treatment studies, strongly suggest that obsessive-compulsive disorder in adolescents is not a variant of the overall group of anxiety disorders.
最近针对青少年强迫症开展的及正在进行的研究表明,其临床体征和症状与成年人的难以区分。共病情况在青少年和成年人中似乎遵循相同趋势,以焦虑和情感症状为主。与预期相反,抽动秽语障碍在患有强迫症的青少年中既未表现为并发综合征,也未成为最终结果。在幼儿期起病的青少年中,男性占比极高。神经学和神经心理学研究结果似乎是区分青少年和成年强迫症患者的唯一因素。研究结果表明,患有强迫症的青少年经常出现神经学异常。短期内的自然病程似乎受到严重程度的负面影响。氯米帕明的临床疗效以及另一种三环类抗抑郁药的无效情况与成年患者报告的治疗经验相似。抑郁症的存在与氯米帕明的疗效无关。神经心理学和神经学异常,以及纵向研究和治疗研究的数据,有力地表明青少年强迫症并非焦虑症总体组别的一个变体。