SEXUAL OBSESSIONS IN PEDIATRIC OBSESSIVE-COMPULSIVE DISORDER: CLINICAL CHARACTERISTICS AND TREATMENT OUTCOMES
SEXUAL OBSESSIONS IN PEDIATRIC OBSESSIVE-COMPULSIVE DISORDER: CLINICAL CHARACTERISTICS AND TREATMENT OUTCOMES
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DOI：
10.1002/da.22097
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发表时间：
2013-08-01
影响因子：
7.4
通讯作者：
Mataix-Cols, David
中科院分区：
文献类型：
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作者：
Fernandez de la Cruz, Lorena;Barrow, Faye;Mataix-Cols, David
背景：性强迫症在患有强迫症 (OCD) 的成年人中很常见，会造成极大的痛苦，有时会被误解为对他人构成风险。对于年轻人中此类症状的患病率、临床相关性和预后知之甚少。方法：383 名转诊至儿科强迫症专科诊所的患者在入院时接受了一系列措施，对于在诊所接受治疗的患者，在治疗后再次接受了一系列措施。对有和没有性强迫症的患者的社会人口统计学和临床特征进行了比较。混合模型方差分析比较了两组的治疗结果。结果：四分之一的患者在基线时有性强迫症（年龄范围 8-17 岁）；与没有性强迫症的人相比，他们的强迫症症状稍微严重一些，并且更加抑郁。有性强迫症的参与者更频繁地表现出攻击性和宗教强迫症、魔法思维、害怕说出某些事情、重复仪式、迷信游戏、精神仪式以及诉说、询问或坦白的需要。至关重要的是，两组之间的治疗结果没有差异。结论：性强迫症在儿童强迫症中很常见，甚至在很小的孩子中也是如此。尽管它们可能与特定的临床特征相关，但它们不会干扰治疗反应。应该认识到儿童性强迫症的发生，并将这些症状理解为普通的、无威胁性的强迫症症状，不会对其他人构成风险。他们对标准治疗策略做出反应，因此儿童和家庭应该收到关于康复机会的乐观信息。抑郁与焦虑 30:732-740, 2013。(C) 2013 Wiley periodicals, Inc.
Background: Sexual obsessions are common in adults with obsessive-compulsive disorder (OCD), cause great distress, and are sometimes misinterpreted as indicating risk to others. Little is known about the prevalence, clinical correlates, and prognosis of such symptoms in young people. Methods: Three hundred and eighty-three patients referred to a specialist pediatric OCD clinic were administered a series of measures at intake and, for those treated at the clinic, again after treatment. Patients with and without sexual obsessions were compared on socio-demographic and clinical characteristics. Mixed model analyses of variance compared treatment outcomes in both groups. Results: A quarter of patients had sexual obsessions at baseline (age range 8-17); they had slightly more severe OCD symptoms and were more depressed than those without sexual obsessions. Aggressive and religious obsessions, magical thinking, fear of saying certain things, repeating rituals, superstitious games, mental rituals, and the need to tell, ask, or confess were more frequent in participants with sexual obsessions. Crucially, no differences in treatment outcome were found between the groups. Conclusions: Sexual obsessions are common in pediatric OCD, even in very young children. Although they may be associated with particular clinical features, they do not interfere with treatment response. The occurrence of sexual obsessions in children should be recognized and these symptoms understood as ordinary, nonthreatening OCD symptoms, which pose no risk to others. They respond to the standard treatment strategies, so children and families should receive the usual message of optimism regarding the chances of recovery. Depression and Anxiety 30:732-740, 2013. (C) 2013 Wiley Periodicals, Inc.