Krebs Georgina, Heyman Isobel
Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK OCD & Related Disorder Clinic for Young People, South London and Maudsley NHS Foundation Trust, London, UK.
Psychological Medicine Team, Great Ormond Street Hospital, London, UK Institute of Child Health, University College London, London, UK.
Arch Dis Child. 2015 May;100(5):495-9. doi: 10.1136/archdischild-2014-306934. Epub 2014 Nov 14.
Obsessive-compulsive disorder (OCD) in childhood and adolescence is an impairing condition, associated with a specific set of distressing symptoms incorporating repetitive, intrusive thoughts (obsessions) and distressing, time-consuming rituals (compulsions). This review considers current knowledge of causes and mechanisms underlying OCD, as well as assessment and treatment. Issues relating to differential diagnosis are summarised, including the challenges of distinguishing OCD from autism spectrum disorders and tic disorders in youth. The recommended treatments, namely cognitive behaviour therapy and serotonin reuptake inhibiting/selective serotonin reuptake inhibitor medications, are outlined along with the existing evidence-based and factors associated with treatment resistance. Finally, novel clinical developments that are emerging in the field and future directions for research are discussed.
儿童和青少年强迫症（OCD）是一种会造成损害的病症，与一组特定的令人痛苦的症状相关，这些症状包括反复出现的、侵入性的想法（强迫观念）以及令人痛苦的、耗时的仪式行为（强迫行为）。本综述探讨了强迫症潜在的病因和机制的现有知识，以及评估和治疗方法。总结了与鉴别诊断相关的问题，包括在青少年中区分强迫症与自闭症谱系障碍和抽动障碍的挑战。概述了推荐的治疗方法，即认知行为疗法和血清素再摄取抑制/选择性血清素再摄取抑制剂药物，以及现有的循证依据和与治疗抵抗相关的因素。最后，讨论了该领域正在出现的新临床进展和未来的研究方向。
