Department of Psychology, Lund University, Lund, Sweden.
Faculty of Medicine, Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund University, Sofiavägen 2D, Lund, SE-22241, Sweden.
BMC Psychiatry. 2023 Aug 24;23(1):622. doi: 10.1186/s12888-023-05111-1.
Obsessive-compulsive disorder (OCD) typically onsets during childhood or adolescence and difficulties with executive functioning (EF) may be involved in its onset and maintenance. Yet, few studies have examined everyday EF difficulties in youth with OCD and no study has compared EF in youth with OCD to EF in youth with anxiety disorders, leaving the diagnostic specificity of EF unclear.
In this study, parents of treatment-seeking children and adolescents with OCD (n = 96, M = 13.3, SD = 2.7, 59% girls) or anxiety disorders (n = 67, M = 14.0, SD = 2.6, 78% girls) reported on their children's everyday EF using the Behavior Rating Inventory of Executive Function (BRIEF) measure.
Compared to community youth, the two clinical groups showed moderately elevated EF deficits but did not differ significantly from each other. EF deficits were not associated with the major symptom dimensions of OCD, age of OCD symptom onset, duration of OCD symptoms, and OCD severity, and did not predict treatment outcome in OCD.
Compared to peers, youth with OCD show moderate difficulties with EF, but very similar difficulties are seen in youth with anxiety disorders, and it is unclear whether these difficulties are of clinical relevance. Among youth with OCD, EF difficulties were not differentially associated with the major symptom dimensions of OCD, which is inconsistent with findings from adults. Difficulties with EF did not predict treatment outcome, indicating that integrating EF modules into OCD treatment may be of limited value, although EF may be important for treatment planning in individual cases.
强迫症（OCD）通常在儿童或青少年时期发病，执行功能（EF）困难可能与其发病和维持有关。然而，很少有研究调查过 OCD 青少年的日常 EF 困难，也没有研究将 OCD 青少年的 EF 与焦虑障碍青少年的 EF 进行比较，这使得 EF 的诊断特异性不明确。
在这项研究中，接受治疗的 OCD（n=96，M=13.3，SD=2.7，59%为女孩）或焦虑障碍（n=67，M=14.0，SD=2.6，78%为女孩）青少年的父母使用行为评定量表的执行功能（BRIEF）评估报告了他们孩子的日常 EF。
与社区青少年相比，两个临床组表现出中等程度的 EF 缺陷，但彼此之间没有显著差异。EF 缺陷与 OCD 的主要症状维度、OCD 症状发病年龄、OCD 症状持续时间和 OCD 严重程度无关，也不能预测 OCD 的治疗结果。
与同龄人相比，OCD 青少年的 EF 存在中等程度的困难，但在焦虑障碍青少年中也存在非常相似的困难，并且这些困难是否具有临床意义尚不清楚。在 OCD 青少年中，EF 困难与 OCD 的主要症状维度没有差异相关，这与成人的研究结果不一致。EF 困难不能预测治疗结果，这表明将 EF 模块整合到 OCD 治疗中可能价值有限，尽管 EF 可能对个别病例的治疗计划很重要。
