706 – 110 years after first report of obsessive compulsive disorder in childhood - where do we stand?

Abstract

Introduction First case report of paediatric obsessive compulsive disorder (OCD) was presented by Janet in 1903. Since then many more reports of OCD in children and adolescents have been published. OCD in adult patients has been studied in the last decades but studies for pediatric OCD only began in the last 20 years. Objectives To review the most recent knowledge on the characteristics, epidemiology, pathophysiology and treatment of pediatric OCD. Methods Review literature published on MEDLINE/Pubmed database in English language using “obsessive compulsive disorder in childhood”, “obsessive compulsive disorder in children and adolescents”, “OCD in childhood”, “OCD in children and adolescents” and “pediatric OCD” as key-words. Results OCD is common among children and adolescents, with prevalence of 1-3% that often becomes a chronic condition. OCD onset has a bimodal age distribution with one peak at age 11 and other peak in early adulthood. There is a male preponderance in affected children, high comorbidity with psychiatric disorders mainly with tic disorders and attention deficit hyperactivity disorder, higher familiality and higher rates of aggressive/harm obsessions and religious obsessions. The current etiologic model most commonly accepted points to a dysfunction of cortico-striato-thalamic loops. Cognitive behavioural therapy (CBT) and a combination of CBT with a selective serotonin reuptake inhibitor are the treatments of choice for pediatric OCD. Conclusions Pediatric OCD seems to be an OCD subtype with similarities but also with important differences from adultonset OCD. Further research is still needed to better elucidate the genetics and the exact pathophysiology of pediatric OCD.