Top PDF Obsessive-compulsive disorder in children and adolescents.

Obsessive-compulsive disorder in children and adolescents.

Obsessive-compulsive disorder in children and adolescents.

OCD commonly starts in childhood, and in addition to causing signi ficant distress and impairment in children, it can persist into adult life where the WHO ranks it as one of the most impairing illnesses. 57 National guidelines exist for the assess- ment and treatment of OCD, and children should be offered interventions according to guidelines incorporating these evidence-based treatments. A substantial proportion of children and adolescents will respond with full or partial remission to CBT, which may be combined with an SRI/SSRI. Unfortunately, inadequate provision of CBT means limitations in access to treatments, and current research aims to establish more access- ible and economic formats of CBT. Ongoing research into the genetic and biological basis of OCD and its relationship with infections/autoimmunity may also in time increase understand- ing of mechanisms and offer new treatment possibilities.
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Theory of Mind Skills in Adolescents with Obsessive-Compulsive Disorder

Theory of Mind Skills in Adolescents with Obsessive-Compulsive Disorder

Methods: The study included 30 adolescents between 12 to 16 years old who were diagnosed with OCD according to the Diagnostic and Statistical Manual of Mental Disorders Fifth edition (DSM-5) and 30 adolescents without any psychiatric diagnoses. Sociodemographic characteristics of the participants were collected with a form; in addition, neuropsychological tests were administered to examine development of ıntelligence and ToM skills. Turkish version of Schedule for Affective Disorders and Schizophrenia for School-Age-Children Present and lifetime version, Children's Yale-Brown Obsessive Compulsive Scale, Children’s Depression Inventory, and Childhood Anxiety Screening Scale were administered. Intelligence level of patients were assessed with Wechsler Intelligence Scale for Children-Revised; while ToM skills were evaluated with Hinting Task Reading the Mind in the Eyes Task and false belief tasks such as Sally-Anne, Smarties, Chocolate Bar cand Ice-Cream Truck tests.
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Children with obsessive compulsive disorder: are they just “little adults”?

Children with obsessive compulsive disorder: are they just “little adults”?

Childhood-onset obsessive-compulsive disorder (OCD) affects 1%–2% of children and adolescents. It is charac- terized by recurrent obsessions and compulsions that create distress and interfere with daily life. The symptoms reported by children are similar to those seen among individuals who develop OCD in adulthood, and the two groups of patients are treated with similar symptom-relieving behavior therapies and medications. However, there are differences in sex ratios, patterns of comorbidity, and the results of neuroimaging studies that might be impor- tant. Here we review the diagnosis and treatment of childhood-onset OCD in light of pediatric and adult studies. We also discuss current knowledge of the pathophysiology of the disorder. Despite advances in this area, further research is needed to understand better the etiopathogenesis of the disorder and to develop new, more effective therapeutic options.
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Quality of life in children and adolescents with obsessive–compulsive disorder: a systematic review and meta-analysis

Quality of life in children and adolescents with obsessive–compulsive disorder: a systematic review and meta-analysis

Abstract: Obsessivecompulsive disorder (OCD) is a seriously impairing psychiatric condition that affects 1%–3% of youth. Investigating the quality of life (QOL) is an important issue for treatment planning of this disorder, as targeting symptoms without taking it into account may bias assessment and prognosis when the patient presents with reduced symptoms that do not correspond to improved QOL. However, QOL in young individuals with OCD has been under- studied. This meta-analysis summarized current evidence that assessed differences in global, social and school QOL dimensions, between children/adolescents with OCD and screened controls. Age, sex and OCD severity were examined as moderators. Case–control studies were included if children/adolescents with primary OCD were compared with screened controls on validated self-reported QOL outcomes. Online databases (January 1966–January 2016) were searched. Five case–control studies were included (n=543, 17 effect sizes overall). On global QOL, a large effect size emerged (d=−1.16, P,0.001), suggesting that individuals with OCD had lower global QOL than controls. Moderate effect sizes emerged for school (d=−0.61, P,0.01) and social QOL (d=−0.54, P,0.01), respectively, indicating worse QOL on these domains for individuals with OCD. For samples with higher OCD severity, global QOL of individuals with OCD was lower than that for controls (β=−0.02, P,0.05). For samples with lower percentages of females, global QOL of individuals with OCD was more impaired (β=0.02, P,0.001). Age was not correlated with effect sizes. Assessment and treatment should target QOL for young males suffering from more severe OCD. The small number of included studies highlighted that QOL is under-recognized. Future research should focus on additional QOL domains and compare which ones are impaired among individuals with OCD compared with other psychiatric conditions. Overall, the results pointed out the importance of addressing QOL in both practice and research on assessment and treatment of children/adolescents with this condition. Keywords: obsessivecompulsive disorder, youth, functioning, social quality of life, severity, case–control study
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Sociodemographic and Clinical Features of Obsessive Compulsive Disorder in a Large Sample of Children and Adolescents from Turkey

Sociodemographic and Clinical Features of Obsessive Compulsive Disorder in a Large Sample of Children and Adolescents from Turkey

This retrospective chart review study of a large clinical sample of Turkish children and adolescents with OCD revealed that males and females had similar ages at clinical application and that their duration of symptoms was also similar. Parental characteristics did not differ between genders apart from greater maternal self- reported psychopathology among female children with OCD. Males with OCD had later word onset and toilet training while females had significantly less breastfeeding histories. The most common obsession in this sample was contamination while the most common compulsion was ordering/ checking. Cleaning and checking compulsions were more common among males while contamination and exactness obsessions were more common among females. Female children in our sample also report a greater number of obsessions and compulsions. Males had greater ADHD and tic disorder comorbidity while females had greater MDD comorbidity. It is known that the comorbidity of ADHD and OCD is associated with earlier onset, dominance of male sex, more severe psycho-social impact, and OCD related dysfunction and increases the probabality of other psychiatirc disorders(bipolar disorder, tic disorders, anxiety disorders etc) being addded to the clinical Picture (30, 31). In the present study also, ADHD and tic disorders were more common in males diagnosed with OCD, which is compatible with the literature. Additionally, having comorbid Major depressive disorder increaes the tendency to chronic OCD and leads the treatment response to decrease and the prognosis to become more unfavorable (32). In the present sudy, it was found to cause common occurrence of MDD in girls, clincial picture being more complicated and occurrence of higher number of obsessions and compulsions. In conclusion,further retrospective and prospective studies evaluating the ages of onset and etiology of comorbid disorders can be useful in understanding how these disorders are related
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Poor performance on the Iowa gambling task in children with obsessive-compulsive disorder

Poor performance on the Iowa gambling task in children with obsessive-compulsive disorder

the Wisconsin Card Sorting Test (WCST), which mea- sures executive function or abstract reasoning abilities, is thought to be associated with functioning of the dorsolateral prefrontal cortex (DLPFC) [6], a region not included in the orbitofrontal-striatal-thalamic circui- try model of OCD [7]. Previous studies have revealed impaired IGT performance in adult OCD patients [8-11], which may reflect OFC dysfunction in these individuals. However, to our knowledge, no study has investigated IGT performance in children with OCD. Recent findings suggest that gray matter and white matter changes in children and adolescents with OCD are broadly consis- tent with those identified in adult OCD patients [12,13]. Therefore, we presumed that children with OCD might show impaired performance on the IGT, reflecting OFC dysfunction. Conversely, children with OCD may per- form normally on the WCST if DLPFC function is not specifically associated with OCD in children.
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Evaluation of the frontal lobe functions in children with obsessive compulsive disorder

Evaluation of the frontal lobe functions in children with obsessive compulsive disorder

Obsessivecompulsive disorder (OCD) is a mental disorder where people feel the need to check things repeatedly, have certain thoughts repeatedly, or feel they need to perform certain routines repeatedly. People with this disorder are unable to control either the thoughts or the activities. Common activities include hand washing, counting of things, and checking to see if a door is locked. Often they take up more than an hour a day. The condition could be associated with tics, anxiety disorder, and an increased risk of suicide. In general, such behavior can disturb the normal functioning of the child. It is estimated that OCD affects 1–3% of the general population. The National Comorbidity Survey Replication found a edi an age of onset in OCD of 19 years, with 21% of cases having onset by age 10 (Kessler et al.2005). The cause of this disorder is unknown. However, it appears to be some genetic components with identical twins more often affected than non-identical twins. Risk factors include a history of child abuse or other stress inducing event. Some cases have been documented to occur following infections. Males and females are affected about equally. Recent volumetric magnetic resonance imaging(MRI) and genotyping of seven polymorphisms in two genes conducted in pediatric OCD patient showed that GRIN2B and SLC1A1 may be associated with regional volumetric alterations in orbit frontal cortex, anterior cingulatecortex and thalamus in children with OCD (Arnold et al. 2009).
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Microribonucleic acid dysregulations in children and adolescents with obsessive–compulsive disorder

Microribonucleic acid dysregulations in children and adolescents with obsessive–compulsive disorder

have been shown to be particularly abundant in the brain, their role in the development and activity of the nervous system remains largely unknown. In the present study, we evaluated miR18a-5p, miR22-3p, miR24-3p, miR106b-5p, miR107, miR125b-5p, and miR155a-5p levels in children and adolescents with OCD. In selecting miRNAs for the current study, previous literature pointing out the potential underlying neurobiology (enzyme, carrier molecule, recep- tor, etc) of the disease was reviewed, and potential most disease related miRNAs from the miRNA database (http:// mirbase.org/) were chosen. Table 1 shows the features of the studied miRNAs.
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Children with obsessive-compulsive disorder: are they just little adults?

Children with obsessive-compulsive disorder: are they just little adults?

( A ) One possibility is that this then decreases the inhibitory output via GABA from the GPi and SNr to the thalamus, resulting in thalamic excitatory glutamatergic output to the fro[r]

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Assessment and Treatment of Obsessive Compulsive Disorder Children and Adolescents

Assessment and Treatment of Obsessive Compulsive Disorder Children and Adolescents

compulsive rituals before they go to bed. Some kids and teens even stay up late because of their OCD, and are often exhausted the following day. Problems at School: OCD can affect homework, attention in class, and school attendance. If this happens, you need to be an advocate for your child. It is your right under the Disabilities

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International OCD Foundation. Obsessive Compulsive Disorder

International OCD Foundation. Obsessive Compulsive Disorder

At first, ERP may sound scary to many children and teenagers, and they may not be ready to try it. It is important to find a CBT therapist who is experienced in working with children with OCD, and who can carefully get them ready for ERP by making it child-friendly. When youngsters understand how exposure and habituation work, they may be more willing to tolerate the initial anxiety experienced during ERP, because they know it will increase and then subside. Parents need to be involved in their child’s treatment as well, under the therapist’s guidance.

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 OBSESSIVE COMPULSIVE DISORDER: A REVIEW

 OBSESSIVE COMPULSIVE DISORDER: A REVIEW

OCD often seems to "run in the family." In fact, almost half of all cases show a familiar pattern. Research studies report that parents, siblings and children of a person with OCD have a greater chance of developing OCD than does someone with no family history of the disorder. One might ask if OCD is "taught" by one family member to another. 8 Researchers looking for genes that might be linked to OCD have not been able to find them. It is believed there may be genes, though, that are involved in regulating serotonin and passed on through the generations. One study involving identical twins showed that if one twin -develops OCD, the other is likely to follow, which suggests that the tendency to develop obsessions and compulsions may be genetic. Other studies have shown a relationship -between OCD and Tourette's syndrome (TS). Families of individuals with TS also seem to have high rates of OCD, suggesting a genetic relationship between these two conditions. 8 TREATMENTS AND DRUGS 13
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Metacognitions, responsibility, and. perfectionism in obsessive-compulsive disorder

Metacognitions, responsibility, and. perfectionism in obsessive-compulsive disorder

4 Many different factors have been proposed regarding the etiology of the disorder; e.g. genetic, neurophysiological, and psychological factors. OCD is believed to have a genetic component, but Norrholm and Ressler (2009) pointed out that the identification of allelic variants and the development of gene×environment models have been slow to develop. Van Grootheest, Cath, Beekman, and Boomsma`s (2005) review of twin studies of anxiety disorders revealed “genetic liabilities” in OCD of 45–65% in children and 27–47% in adults. At a neurochemical level, serotonin and dopamine are the primary neurotransmitters thought to be involved, while the corticostriatal-thalamocortical neural circuit is considered important at a neurophysiological level (Bartz & Hollander, 2006). Functional imaging studies have demonstrated that the orbitofrontal cortex, caudate nucleus, thalamus, and anterior cingulate gyrus are involved (Saxena, Bota, & Brody, 2001). At a psychological level, behavioral, cognitive, and metacognitive theories have been the dominating theoretical perspectives.
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Obsessive compulsive disorder

Obsessive compulsive disorder

Indeed, the algorithm (see Fig. 1 below) can readily be adapted for children, bearing in mind considerations such as differences in dosing and differences in risk-benefit determination (e.g. clinicians are less likely to use untested augmentation strategies in children). Consultation with a child psychiatrist may well be indicated in such cases.

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Predictors of treatment response in obsessive-compulsive disorder

Predictors of treatment response in obsessive-compulsive disorder

Several treatment outcome studies suggest that certain factors may predict poorer or better treatment response and efficacy. The identification of such factors may allow the identification of patients at risk of a poorer prognosis, and an individualized treatment approach, resulting in better outcomes. Several potential predictors have already been identified, but there is limited consensus on which factors really predict a different outcome, limiting their appliance in clinical practice. Keeley et al. (2008) reviewed predictors of treatment response in open and controlled trials of cognitive- behavioral therapy for obsessive-compulsive disorder in adults and children, reporting several variables consistently associated with outcome, including: strength of the therapeutic relationship, patients’ family environment, OCD severity, symptom subtypes, comorbid severe depression and comorbid personality disorder (Mary L Keeley, Storch, Merlo, & Geffken, 2008). Knopp et al. (2013) systematically reviewed the predictors of treatment response to psychological therapies for adults with OCD, finding associations between worse treatment outcome and hoarding pathology, increased anxiety, OCD severity, symptom subtypes, unemployment and being single/not married (Knopp, Knowles, Bee, Lovell, & Bower, 2013). Both reviews acknowledge the lack of consensus of their findings, as well as a significant variation in the measurement tools and methods across included trials. Given these limitations, the present review serves to strengthen currently existing evidence on predictors of treatment response to psychological and pharmacological therapies for OCD.
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Obsessive-Compulsive Disorder: Diagnosis and Management

Obsessive-Compulsive Disorder: Diagnosis and Management

Although OCD in childhood can occur in isolation, there is a high rate of comorbidity with mood disor- ders, tic disorders, attention-deficit/hyperactivity dis- order, and developmental abnormalities. Children with abrupt onset of obsessive-compulsive symptoms or tics should be evaluated for group A Streptococcus infection, with possible PANDAS. Children with OCD should be referred to a subspecialist. CBT with exposure and response prevention is the preferred initial treatment modality. SSRI treatment may be indicated in patients with severe symptoms, or when there is lack of improve- ment with CBT alone. 21
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A REVIEW ON OBSESSIVE COMPULSIVE DISORDER

A REVIEW ON OBSESSIVE COMPULSIVE DISORDER

caused significant distress or social impairment) in monozygotic twins; the concordance of dizygotic twins was only half as large. On the other hand, none of eight monozygotic twin pairs in another study were concordant for OCD, according to Andrews et al. in 1990. A recent review notes that in Pauls' study in 1992, 10% of the parents of children and adolescents with OCD themselves had the disorder, and in another study, OCD was present in 25% of fathers and 9% of mothers. The symptoms of parents and children usually differed, arguing against social or cultural transmission. The recent finding, by Murphy et al. in 1997 and Swedo et al. in 1997, that an antigen which is a genetic marker for rheumatic fever susceptibility is also a marker for susceptibility to an autoimmune form of childhood onset OCD will undoubtedly spur progress in unravelling genetic contributions to the pathogenesis of OCD.
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Prevalence of childhood obsessive-compulsive personality traits in adults with obsessive compulsive disorder versus obsessive compulsive personality disorder

Prevalence of childhood obsessive-compulsive personality traits in adults with obsessive compulsive disorder versus obsessive compulsive personality disorder

Identifying risk factors of psychopathology has been an important research challenge. Prior studies examining the impact of childhood temperament on adult disorder have largely focused on undercontrolled and inhibited presentations, with little study of overcontrolled traits such as obsessive-compulsive personality traits (OCPTs). We compared rates of childhood OCPTs in adults with OCD (without OCPD) (n = 28) to adults with OCPD (without OCD) (n = 27), adults with both OCD and OCPD (n = 28), and healthy controls (HC) (n= 28), using the Childhood Retrospective Perfectionism Questionnaire, a validated measure of perfectionism, inflexibility, and drive for order. Adults with OCPD (both with and without comorbid OCD) reported higher rates of all three childhood OCPTs relative to HC. Individuals with OCD (without OCPD) reported higher rates of inflexibility and drive for order relative to HC, suggesting that these traits may presage the development of OCD, independent of OCPD. Childhood OCPTs were associated with particular OCD symptom dimensions in adulthood (contamination/cleaning, doubt/checking, and symmetry/ordering), independent of OCD onset age and OCPD diagnosis. Longitudinal prospective studies evaluating OCPTs in children are needed to better understand the progression of these traits from childhood to adulthood and their ability to predict future psychopathology.
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Nicotine treatment of obsessive compulsive disorder

Nicotine treatment of obsessive compulsive disorder

other people, especially children, was the predominant symptom. For instance, while out taking walks, he was afraid of accidentally pushing a child into the roadway, and when driving a car, he was afraid he might run over someone without noticing. His obsessions compelled him to scan the papers and phone all hospitals in the city by the end of the day to make sure he had not hurt anyone. In parallel, he also developed contamination fears and he engaged in extensive moral ruminations.

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Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder

Paroxetine is pregnancy category D as exposure in the first trimester may increase the risk of cardiac malformations. Citalopram, escitalopram, fluoxetine, and sertraline are all pregnancy category C and should be used with caution. Treatment in children and adolescents should begin with CBT. Sertraline, fluvoxamine, fluoxetine, and clomipramine are FDA approved for OCD in children, but should be used with caution due to the possibility of an increase in suicidal thoughts or behaviors. While no specific studies of treating OCD in the elderly have been published, experience with pharmacotherapy in the elderly points towards a “start low, go slow” mentality. Older patients may also be more suscep- tible to adverse drug effects.
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