OBSESSIVE-COMPULSIVE DISORDER IN CHILDREN AND ADOLESCENTS

Children and adults with OCD have similar obsessions and compulsions, as well as a similar response to most psychotherapeutic and pharmacoth erapeutic interventions. A large proportion of adults with OCD, perhap s as high as 80%, have their onset during childhood or adolescence. Th c prevalence estimate of OCD in children is at least 2-4% and an even larger number may have subclinical OCD. Recent gains in OCD research h ave consisted in differentiating normal ritualistic behavior in childr en from OCD symptoms, realizing a more systematic assessment of OCD sy mptoms in children, refuting the impression that OCD in children is a rave condition and developing psychological and pharmacologic treatmen t strategies. Controlled studies of the phenomenology of OCD in childr en have been conducted. The vast majority of children with OCD have co ncurrent neuropsychiatric disorders including mood, tie, other anxiety and neurologic disorders, as well as pervasive developmental disorder s. Recent investigations show that risk to relatives for OCD or subthr eshold OCD is significantly higher in relatives than controls. Earlier age of onset also seems to be related to degree of familiality of OCD . The management of OCD in children entails an integrated approach of available behavioral, pharmacological, family therapy and supportive i nterventions. Illness education should be a major component of managem ent and individualized treatment is important. Further research in OCD should serve to improve the prognosis of this mostly chronic conditio n in children.