PRACTICE PARAMETERS FOR THE ASSESSMENT AND TREATMENT OF CHILDREN AND ADOLESCENTS WITH OBSESSIVE-COMPULSIVE DISORDER

These practice parameters describe the assessment and treatment of obs essive-compulsive disorder based on a detailed literature review and e xpert consultation. Obsessive-compulsive disorder is a disorder of het erogeneous origin characterized by intrusive thoughts or compulsive ur ges or behaviors that are distressing, time-consuming, or functionally impairing. In children and adolescents, the disorder often is accompa nied by a wide range of comorbidity, including mood, anxiety, attentio nal, and learning difficulties, and/or tic disorder. These parameters describe the relevant areas of assessment, especially symptomatology, onset, and course, other associated psychopathology, and developmental , family, and medical history (including postinfectious onset or exace rbations). Two modalities have been systematically assessed and empiri cally shown to ameliorate core symptoms: cognitive-behavioral therapy (primarily exposure/response prevention) and serotonin reuptake inhibi tor medication. Data regarding the indications, efficacy, and implemen tation of these modalities are reviewed. Because OCD frequently occurs in the context of other psychopathology and adaptive difficulties, ad ditional individual and family psychotherapeutic, pharmacological, and educational interventions often are necessary. Treatment planning gui delines are provided.