Childhood obsessive compulsive disorder.
Childhood obsessive compulsive disorder.
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童年强迫症。
DOI：
10.1176/ajp.138.12.1545
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发表时间：
1992
期刊：
影响因子：
--
通讯作者：
H. Leonard
中科院分区：
文献类型：
--
作者：
J. Rapoport;S. Swedo;H. Leonard
儿童强迫症最近被认为比之前认为的更常见，这支持了成人流行病学研究发现的发病率远远高于临床研究的结果。临床上，表现通常与成人患者相似，但强迫症可能在没有强迫症的情况下发生，尽管强迫症和强迫症都很常见。症状通常会随着时间的推移而变化，但几乎所有受试者都会在某些时候经历过度洗涤，这是他们的症状之一。在患有强迫症的儿童的亲属中，强迫症和运动性抽搐的发生率增加。与多发性抽动症一样，症状的部分自愿控制是常见的。前瞻性随访研究显示，强迫症持续致残，情感障碍持续共病。强迫症症状选择性地与儿童时期出现的几种神经疾病有关，如抽动症和赛德纳姆舞蹈症，这两种疾病都被认为是基底节疾病。这种关联的含义是，在强迫症中，可能存在被基底节额叶皮质通路所包含的硬连接的复杂行为，这些行为被不适当地释放。
Childhood obsessive compulsive disorder has recently been recognized as being more common than previously believed, supporting epidemiologic studies in adults that found rates far higher than clinical studies have suggested. Clinically, presentation is generally similar to that for adult patients, but compulsions may occur in the absence of obsessions although both obsessions and compulsions are common. Symptoms typically change over time, but almost all subjects at some time experienced excess washing as one of their symptoms. There is an increased rate of obsessive compulsive disorder and of motor tics in the relatives of children with obsessive compulsive disorder. As with Tourette's disorder, partial voluntary control of symptoms is usual. Prospective follow-up studies show continued disability from obsessive compulsive disorder and continued comorbidity with affective disorders. Obsessive compulsive symptoms are selectively associated with several childhood onset neurologic disorders such as Tourette's disorder and Sydenham's chorea, both presumed to be basal ganglia disorders. The implication of this association is that there may be hard-wired complex behaviors subsumed by basal ganglia frontal cortical pathways that are inappropriately released in obsessive compulsive disorder.