Obsessive Compulsive Disorder: Theory, Research, and Treatment

By Ross G. Menzies; Padmal De Silva | Go to book overview

Chapter 18
OBSESSIVE-COMPULSIVE
DISORDER IN CHILDREN AND
ADOLESCENTS

INTRODUCTION

Roz Shafran

Obsessive-compulsive disorder (OCD) is estimated to affect 0.5–2% of children and adolescents, and the phenomenology of OCD in children and adults is highly similar (Swedo et al., 1989b). Given the apparent continuum between the forms of OCD across the age range, it is not surprising that similar psychological and pharmacological interventions are used (Franklin et al., 1998). Nevertheless, significant differences exist in terms of the gender distribution of the disorder, co-morbidity, familial contribution, developmental issues and theories of maintenance. These differences have led to some proposals that childhood OCD is a distinct subtype of adult OCD (Geller et al., 1998) and it is argued that it can be viewed within the framework of paediatric auto-immune neuropsychiatric disorder associated with infection (Swedo et al., 1998). The chapter begins by describing the epidemiology and phenomenology of the disorder and assessment techniques. Psychological and neuropsychiatric theories of the disorder are discussed, and treatment outcome studies reviewed. The chapter concludes by calling for a closer integration between the science and practice of treating OCD in young people.


EPIDEMIOLOGY

Early prevalence estimates of OCD from child psychiatric clinics ranged from 0.2% to 1.2% (Berman, 1942; Hollingsworth et al., 1980; Judd, 1965) but more recent studies of adolescents in the community find prevalence rates ranging from 1–4% (Douglass et al., 1995; Flament et al., 1988;

Originally published as ‘Obsessive-compulsive disorder in children and adolescents’, in Child Psychology
and Psychiatry Review, vol. 6, no. 2. © 2001 Blackwell Publishing. Reproduced by permission of Blackwell
Publishing in Obsessive-Compulsive Disorder: Theory, Research and Treatment.

Edited by Ross G. Menzies and Padmal de Silva. © 2003 John Wiley & Sons, Ltd.

-311-

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