儿童和青少年强迫症：流行病学、诊断与管理
Obsessive-compulsive disorder in children and adolescents: epidemiology, diagnosis and management.
作者信息
Nazeer Ahsan, Latif Finza, Mondal Aisha, Azeem Muhammad Waqar, Greydanus Donald E
机构信息
Department of Psychiatry, Division of Child and Adolescent Psychiatry, Sidra Medicine, Doha, Qatar.
Division of Psychiatry and Behavioral Sciences, George Washington University, Children's National Medical Center, Washington, DC, USA.
出版信息
Transl Pediatr. 2020 Feb;9(Suppl 1):S76-S93. doi: 10.21037/tp.2019.10.02.
Abstract
Obsessive-compulsive disorder (OCD) can be found in about 4% of the general population and is characterized by various compulsions and obsessions that interfere with the person's quality of life from a mild to severe degree. The following discussion reflects on current concepts in this condition, including its epidemiology and etiologic underpinnings (behavioral, neurological, immunological, gastroenterological, as well as genetic). The interplay of PANS and PANDAS are included in this review. In addition, the core concepts of OCD diagnosis, differential diagnosis, and co-morbidities are considered. It is stressed that the quality of life for persons with pediatric OCD as well as for family members can be quite limited and challenged. Thus, principles of management are presented as a guide to improve the quality of life for these persons as much as possible.
摘要
强迫症（OCD）在普通人群中的发病率约为4%，其特征是各种强迫行为和强迫观念，会不同程度地干扰患者的生活质量，从轻度到重度不等。以下讨论反映了目前对这种疾病的认识，包括其流行病学和病因基础（行为学、神经学、免疫学、胃肠病学以及遗传学）。本次综述还涵盖了儿科自身免疫性神经精神障碍相关链球菌感染（PANS）和儿科自身免疫性神经精神障碍（PANDAS）之间的相互作用。此外，还探讨了强迫症诊断、鉴别诊断和共病的核心概念。需要强调的是，患有儿童强迫症的患者及其家庭成员的生活质量可能会受到很大限制并面临挑战。因此，本文提出了一些管理原则，以尽可能提高这些人的生活质量。
相似文献
1
Obsessive-compulsive disorder in children and adolescents: epidemiology, diagnosis and management.儿童和青少年强迫症：流行病学、诊断与管理
Transl Pediatr. 2020 Feb;9(Suppl 1):S76-S93. doi: 10.21037/tp.2019.10.02.
2
[Current and emerging features of obsessive-compulsive disorder--trends for the revision of DSM-5].[强迫症的当前及新出现特征——《精神疾病诊断与统计手册》第5版修订趋势]
Seishin Shinkeigaku Zasshi. 2012;114(9):1023-30.
3
Prevalence of Acute-Onset Subtypes in Pediatric Obsessive-Compulsive Disorder.儿童强迫症急性起病亚型的患病率
J Child Adolesc Psychopharmacol. 2017 May;27(4):332-341. doi: 10.1089/cap.2016.0031. Epub 2017 Jan 25.
4
Quality of life in obsessive-compulsive disorder: the different impact of obsessions and compulsions.强迫症患者的生活质量：强迫观念与强迫行为的不同影响。
Psychopathology. 2007;40(5):282-9. doi: 10.1159/000104744. Epub 2007 Jun 28.
5
Comorbid psychopathology and clinical symptomatology in children and adolescents with obsessive-compulsive disorder.患有强迫症的儿童和青少年的共病精神病理学与临床症状学
Psychiatriki. 2016 Jan-Mar;27(1):27-36.
6
Obsessive-Compulsive Disorder.强迫症
Continuum (Minneap Minn). 2018 Jun;24(3, BEHAVIORAL NEUROLOGY AND PSYCHIATRY):828-844. doi: 10.1212/CON.0000000000000603.
7
[Obsessive-compulsive disorder in children and adolescents].[儿童和青少年强迫症]
Harefuah. 2008 Apr;147(4):324-9, 374, 373.
8
Obsessions and Compulsions in Postpartum Women Without Obsessive Compulsive Disorder.无强迫症的产后女性的强迫观念与强迫行为
J Womens Health (Larchmt). 2015 Oct;24(10):825-30. doi: 10.1089/jwh.2014.5063. Epub 2015 Jun 29.
9
Obsessive-compulsive disorder.强迫症
Psychiatr Clin North Am. 2014 Sep;37(3):257-67. doi: 10.1016/j.psc.2014.06.004. Epub 2014 Jul 23.
10
Obsessive-compulsive disorder.强迫症
Continuum (Minneap Minn). 2015 Jun;21(3 Behavioral Neurology and Neuropsychiatry):783-8. doi: 10.1212/01.CON.0000466666.12779.07.
引用本文的文献
1
Hippocampal and amygdala subfield volumes in obsessive-compulsive disorder by medication status.强迫症患者海马体和杏仁核亚区体积与用药状态的关系
J Psychiatry Neurosci. 2025 May 21;50(3):E170-E180. doi: 10.1503/jpn.230119. Print 2025 May-Jun.
2
Natural history of SGCE-associated myoclonus dystonia in children and adolescents.儿童和青少年中与SGCE相关的肌阵挛性肌张力障碍的自然病史。
Dev Med Child Neurol. 2025 Jun;67(6):740-749. doi: 10.1111/dmcn.16214. Epub 2024 Dec 16.
3
Association between childhood maltreatment and obsessive-compulsive disorder comorbid with eating disorders: a cross-sectional study.儿童期虐待与共病饮食失调的强迫症之间的关联：一项横断面研究。
J Eat Disord. 2024 Sep 6;12(1):135. doi: 10.1186/s40337-024-01090-0.
4
A mobile app to challenge obsessional beliefs in adolescents: a protocol of a two-armed, parallel randomized controlled trial.一款用于挑战青少年强迫观念的手机应用：一项双臂、平行随机对照试验的方案。
BMC Psychiatry. 2024 Apr 9;24(1):265. doi: 10.1186/s12888-024-05735-x.
5
Treatment and Family Involvement for Young Children with Obsessive-Compulsive Disorder: An Experimental Study.患有强迫症的幼儿的治疗与家庭参与：一项实验研究。
Iran J Public Health. 2023 Dec;52(12):2699-2700. doi: 10.18502/ijph.v52i12.14331.
6
Comparison of accidental findings of brain magnetic resonance imaging of patients with obsessive-compulsive disorder and healthy controls.强迫症患者与健康对照者脑磁共振成像意外发现的比较。
BMC Psychiatry. 2023 Dec 1;23(1):899. doi: 10.1186/s12888-023-05393-5.
7
Comparative neurogenetics of dog behavior complements efforts towards human neuropsychiatric genetics.犬类行为的比较神经遗传学为人类神经精神遗传学的研究提供了补充。
Hum Genet. 2023 Aug;142(8):1231-1246. doi: 10.1007/s00439-023-02580-y. Epub 2023 Aug 14.
8
Psychometric Properties of Malay Obsessive-compulsive Inventory-child Version (OCI-CV) in Malaysian Perspectives.从马来西亚视角看马来语版儿童强迫症量表（OCI-CV）的心理测量特性
Scand J Child Adolesc Psychiatr Psychol. 2022 Nov 30;10(1):114-122. doi: 10.2478/sjcapp-2022-0012. eCollection 2022 Jan.
9
Fluoxetine for the treatment of onychotillomania associated with obsessive-compulsive disorder: a case report.氟西汀治疗与强迫症相关的拔甲癖：病例报告。
J Med Case Rep. 2022 Nov 20;16(1):431. doi: 10.1186/s13256-022-03652-9.
10
Are the symptom dimensions a predictor of short-term response to pharmacotherapy in pediatric obsessive-compulsive disorder? A retrospective cohort study.症状维度是儿童强迫症药物治疗短期反应的预测指标吗？一项回顾性队列研究。
Indian J Psychiatry. 2022 Jul-Aug;64(4):395-400. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_896_21. Epub 2022 Jul 13.
本文引用的文献
1
The gut microbiome in psychiatry: A primer for clinicians.精神病学中的肠道微生物群：临床医生指南。
Depress Anxiety. 2019 Nov;36(11):1004-1025. doi: 10.1002/da.22936. Epub 2019 Jul 29.
2
Abnormalities of hippocampal shape and subfield volumes in medication-free patients with obsessive-compulsive disorder.药物治疗的强迫症患者海马形状和亚区体积的异常。
Hum Brain Mapp. 2019 Oct 1;40(14):4105-4113. doi: 10.1002/hbm.24688. Epub 2019 Jun 12.
3
Adapted cognitive behavior therapy for obsessive-compulsive disorder with co-occurring autism spectrum disorder: A clinical effectiveness study.共病自闭症谱系障碍的强迫症的适应性认知行为治疗：一项临床有效性研究。
Autism. 2020 Jan;24(1):190-199. doi: 10.1177/1362361319856974. Epub 2019 Jun 12.
4
Serotonin system gene variants and regional brain volume differences in pediatric OCD.儿童强迫症中 5-羟色胺系统基因变异与脑区体积差异
Brain Imaging Behav. 2020 Oct;14(5):1612-1625. doi: 10.1007/s11682-019-00092-w.
5
Quality of life in children and adolescents with obsessive-compulsive disorder: The Pediatric Quality of Life Enjoyment and Satisfaction Questionnaire (PQ-LES-Q).患有强迫症的儿童和青少年的生活质量：儿童生活质量享受与满意度问卷（PQ-LES-Q）。
Bull Menninger Clin. 2019 Fall;83(4):377-397. doi: 10.1521/bumc_2019_83_03. Epub 2019 Jun 10.
6
Self-induced dermatoses: A great imitator.自身诱导性皮肤病：模仿大师。
Clin Dermatol. 2019 May-Jun;37(3):268-277. doi: 10.1016/j.clindermatol.2019.01.006. Epub 2019 Jan 11.
7
Mapping Cortical and Subcortical Asymmetry in Obsessive-Compulsive Disorder: Findings From the ENIGMA Consortium.强迫症中皮质和皮质下不对称性的映射：来自ENIGMA联盟的研究结果。
Biol Psychiatry. 2020 Jun 15;87(12):1022-1034. doi: 10.1016/j.biopsych.2019.04.022. Epub 2019 Apr 30.
8
Establishing a Pediatric Acute-Onset Neuropsychiatric Syndrome Clinic: Baseline Clinical Features of the Pediatric Acute-Onset Neuropsychiatric Syndrome Cohort at Karolinska Institutet.建立小儿急性起病神经精神综合征诊所：卡罗林斯卡学院小儿急性起病神经精神综合征队列的基线临床特征
J Child Adolesc Psychopharmacol. 2019 Oct;29(8):625-633. doi: 10.1089/cap.2018.0127. Epub 2019 Jun 5.
9
Clinical-Serological Characterization and Treatment Outcome of a Large Cohort of Italian Children with Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infection and Pediatric Acute Neuropsychiatric Syndrome.一大群患有与链球菌感染相关的儿童自身免疫性神经精神障碍和儿童急性神经精神综合征的意大利儿童的临床血清学特征及治疗结果
J Child Adolesc Psychopharmacol. 2019 Oct;29(8):608-614. doi: 10.1089/cap.2018.0151. Epub 2019 May 29.
10
Inflammation in Tic Disorders and Obsessive-Compulsive Disorder: Are PANS and PANDAS a Path Forward?抽动障碍和强迫症中的炎症：儿科自身免疫性神经精神障碍相关链球菌感染（PANS）和儿科急性发作性神经精神综合征（PANDAS）是前进的方向吗？
J Child Neurol. 2019 Sep;34(10):598-611. doi: 10.1177/0883073819848635. Epub 2019 May 21.
Zotero 插件