Fodstad Jill C, Russell Rachel, Bullington Molly, Jones Lauren B, Iticovici Micah, Meudt Emily
Department of Psychiatry, Indiana University School of Medicine, 355 W. 16th St., Suite 4800, Indianapolis, IN, 46202, USA.
Indiana University Health Physicians, Bloomington, IN, USA.
J Autism Dev Disord. 2025 May;55(5):1745-1753. doi: 10.1007/s10803-024-06336-z. Epub 2024 Apr 12.
Adolescents and adults with Down syndrome are noted to display symptoms and behaviors consistent with a diagnosis of Obsessive Compulsive Disorder. While evidenced-based interventions, including psychopharmacology and therapeutic interventions including exposure and response prevention, exist and effectively treat obsessive-compulsive symptoms in neurotypical populations, less is known about effective treatments for similar presentations in persons with Down syndrome.
A scoping rapid review was conducted in April 2023 to determine what treatments are being used to target obsessive-compulsive symptoms and related behaviors in adolescents and adults with Down syndrome, the quality of those treatments, and their alignment with current evidenced-based interventions.
A total of eleven articles, all single case or case series, published between 1992 and 2017 were identified describing the treatment of 32 adolescents and adults with Down syndrome and obsessive-compulsive traits and behaviors including: hoarding, cleaning, gross motor compulsions, and food, hygiene, dressing, and checking rituals. Interventions used most often aligned with evidenced-based guidelines for treating obsessive compulsive disorder and included psychopharmacology, psychotherapy, and complementary and alternative medicine.
While the outcomes of most interventions yielded partial or significant reduction in symptoms, poor research quality and limited generalizability noted across all studies make it difficult to inform guidelines for caring for this high-needs population. In the future, we believe it is necessary to perform more rigorous research focused on treating obsessive compulsive symptoms in individuals with Down syndrome with sufficient follow-up to fully assess treatment effectiveness.
研究表明,患有唐氏综合征的青少年和成年人会表现出与强迫症诊断相符的症状和行为。虽然存在基于证据的干预措施,包括心理药理学以及暴露与反应阻止疗法等治疗性干预措施,这些措施能够有效治疗典型人群的强迫症状,但对于唐氏综合征患者类似症状的有效治疗方法却知之甚少。
2023年4月进行了一项范围快速综述,以确定针对患有唐氏综合征的青少年和成年人的强迫症状及相关行为采用了哪些治疗方法、这些治疗方法的质量如何,以及它们与当前基于证据的干预措施是否一致。
共识别出1992年至2017年间发表的11篇文章,均为单病例或病例系列研究,描述了对32名患有唐氏综合征且有强迫特征和行为的青少年和成年人的治疗情况,这些特征和行为包括:囤积、清洁、粗大运动强迫行为,以及饮食、卫生、穿衣和检查仪式。最常使用的干预措施与治疗强迫症的基于证据的指南一致,包括心理药理学、心理治疗以及补充和替代医学。
虽然大多数干预措施的结果使症状部分或显著减轻,但所有研究中均存在研究质量差和普遍性有限的问题,这使得为这一高需求人群制定护理指南变得困难。我们认为,未来有必要进行更严格的研究,重点关注对唐氏综合征患者强迫症状的治疗,并进行充分的随访以全面评估治疗效果。