Preparation for Child Psych PRITE and Boards
(→Diagnosis) |
|||
Line 17: | Line 17: | ||
* Most common obsessions in children and adolescents involve '''aggressive''' and '''catastrophic''' worries (e.g death of parent); these become less common in adults. (Geller DA, J Nerv Men D/o 2001) | * Most common obsessions in children and adolescents involve '''aggressive''' and '''catastrophic''' worries (e.g death of parent); these become less common in adults. (Geller DA, J Nerv Men D/o 2001) | ||
* '''Contamination''' worries are common throughout the developmental spectrum. | * '''Contamination''' worries are common throughout the developmental spectrum. | ||
− | * Sexual and religious obsessions are common in adolescents. | + | * '''Sexual''' and '''religious''' obsessions are common in adolescents. |
− | * Most common compulsions | + | * Most common compulsions across the developmental spectrum involve checking, cleaning, and ordering rituals. |
− | + | * '''Hoarding''' compulsions are more common in children in adolescents and become less common in adults. (Geller DA, J Nerv Men D/o 2001) | |
+ | |||
==Treatment== | ==Treatment== | ||
{{stub}} | {{stub}} |
Revision as of 19:52, 30 October 2012
Contents
Introduction
Epidemiology
OCD in children and adolescents often goes unrecognized and undiagnosed due to its idiosyncratic, not always obvious nature.
- Point prevalence of pediatric OCD is 0.25% (British study 5-15 y.o., Heyman I, IntRevPsych 2003);
- Overall pediatric prevalence rate is 1-2% (USA studies, Apter A, JAACAP 1996)
- Incidence of OCD peaks during two developmental periods, pre-adolescents, and young adults (mean 20 y.o.). (Geller D, March J, Practice Parameter, JAACAP 2012)
Genetic and non-genetic factors
- OCD has a significant familial/genetic component with higher concordance rates in monozygotic twins vs. dizygotic twins.
- Environmental triggers and immunological cross-reactions, particularly to Strep infection had been implicated. Specifically, in PANDAS - Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus, is attributed to immune response to Group A Strep, which can cause cross-reactivity and inflammation of basal ganglia. This can produce (the somewhat controversial) syntrome of PANDAS, which involves tics, OCD, and hyperactivity.
Diagnosis
Presentation
- Children may have compulsions without obsessions.
- Most common obsessions in children and adolescents involve aggressive and catastrophic worries (e.g death of parent); these become less common in adults. (Geller DA, J Nerv Men D/o 2001)
- Contamination worries are common throughout the developmental spectrum.
- Sexual and religious obsessions are common in adolescents.
- Most common compulsions across the developmental spectrum involve checking, cleaning, and ordering rituals.
- Hoarding compulsions are more common in children in adolescents and become less common in adults. (Geller DA, J Nerv Men D/o 2001)