March J S, Leonard H L
Department of Psychiatry, Duke University Medical Center, Durham, NC 27710, USA.
J Am Acad Child Adolesc Psychiatry. 1996 Oct;35(10):1265-73. doi: 10.1097/00004583-199610000-00012.
To review the literature on pediatric obsessive-compulsive disorder (OCD) from the perspective of information relevant to American Board of Psychiatry and Neurology recertification in child and adolescent psychiatry.
The clinical and research literatures were systematically searched or articles that address the diagnosis and treatment of pediatric OCD.
Drawing from the literature and their own clinical experience, the authors note that (1) OCD is a common neuropsychiatric disorder; (2) comorbidity is common, especially with tic, attention-deficit, anxiety, and affective disorders; (3) OCD following group A beta-hemolytic streptococcal infection may define an autoimmune sub-grouping calling for immunomodulatory treatments; and (4) OCD-specific cognitive-behavioral psychotherapy and pharmacotherapy with a serotonin reuptake inhibitor define the psychotherapeutic and pharmacotherapeutic treatments of choice, respectively.
Child psychiatrists should be familiar with the differential diagnosis and treatment of OCD.
从与美国精神病学和神经病学委员会儿童与青少年精神病学再认证相关的信息角度，回顾关于儿童强迫症（OCD）的文献。
系统检索临床和研究文献中有关儿童强迫症诊断与治疗的文章。
作者依据文献及自身临床经验指出：（1）强迫症是一种常见的神经精神疾病；（2）共病情况常见，尤其是与抽动症、注意力缺陷、焦虑症及情感障碍共病；（3）A组β溶血性链球菌感染后发生的强迫症可能界定了一个自身免疫亚组，需要进行免疫调节治疗；（4）针对强迫症的认知行为心理治疗和使用5-羟色胺再摄取抑制剂的药物治疗分别是心理治疗和药物治疗的首选方法。
儿童精神科医生应熟悉强迫症的鉴别诊断与治疗。
