Liu Xingyu, Fan Qing
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
School of Psychology and Cognitive Science, East China Normal University, Shanghai 200062, China.
Brain Sci. 2023 Feb 25;13(3):399. doi: 10.3390/brainsci13030399.
Obsessive-compulsive disorder (OCD) is a psychiatric disorder characterized by persistent thoughts with subsequent repetitive behaviors. Interventions that are effective for adult OCD cannot simply be generalized to pediatric OCD, since OCD in children and adolescents usually has a different clinical presentation, etiology and course from adult OCD. Delayed and inadequate treatment is associated with a worse prognosis, making the need for early identification and intervention in pediatric OCD very urgent. In this paper, we reflected on the current constraints that make early interventions for pediatric OCD unpromoted and reviewed the approaches with potential application for early identification and early intervention in pediatric OCD, categorized by three-level prevention stages corresponding to a clinical staging model. Since the etiology of pediatric OCD is still unclear, primary prevention is most lacking, and early interventions for pediatric OCD are currently focused on the secondary prevention stage, which aims to prevent the conversion of obsessive-compulsive symptoms into full-blown OCD; tertiary prevention mostly focuses on the alleviation of mild to moderate OCD, while interventions for co-morbidities are still in their infancy. We closed by considering the important research questions on this topic.
强迫症(OCD)是一种精神障碍,其特征为持续出现的想法以及随后的重复行为。对成人强迫症有效的干预措施不能简单地推广到儿童强迫症,因为儿童和青少年的强迫症通常在临床表现、病因和病程方面与成人强迫症有所不同。治疗延迟和不充分与较差的预后相关,这使得对儿童强迫症进行早期识别和干预的需求变得非常迫切。在本文中,我们反思了当前阻碍儿童强迫症早期干预推广的限制因素,并回顾了根据与临床分期模型相对应的三级预防阶段分类的、具有潜在应用价值的儿童强迫症早期识别和早期干预方法。由于儿童强迫症的病因仍不明确,一级预防最为缺乏,目前儿童强迫症的早期干预主要集中在二级预防阶段,其目的是防止强迫症状转变为全面发作的强迫症;三级预防主要侧重于缓解轻度至中度强迫症,而对共病的干预仍处于起步阶段。我们最后思考了关于这个主题的重要研究问题。