Diagnosis and Out-Patient Treatment of Early Childhood Obsessive Compulsive Disorder
Main Article Content
Abstract
Paediatric obsessive compulsive disorder [OCD] is a chronic condition often associated with severe disruptions of family functioning and key developmental milestones. Mean age of onset of juvenile OCD is between 10 and 11 years; however, studies on young children with OCD show that the disorder can manifest itself much earlier. OCD is characterized by a long duration of untreated illness, which, together with an earlier age of onset, has been associated with increased persistence. Although there are disease-specific treatments for OCD, there seems to be difficulty for health professionals to recognize and diagnose the disorder in young children appropriately. This may prolong the interval between help seeking and receiving an adequate diagnosis and treatment. The objective of this review is to give an overview of studies on the clinical presentation, diagnosis and treatment of OCD in very young children.
Keywords:
Obsessive compulsive disorder, early childhood, early intervention, cognitive behaviour therapy
Article Details
How to Cite
BREZINKA, Veronika.
Diagnosis and Out-Patient Treatment of Early Childhood Obsessive Compulsive Disorder.
Medical Research Archives, [S.l.], v. 9, n. 2, feb. 2021.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/2341>. Date accessed: 24 apr. 2024.
doi: https://doi.org/10.18103/mra.v9i2.2341.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1. Geller DA. Obsessive-compulsive and spectrum disorders in children and adolescents. Psychiatric Clinics of North America. 2006;29:353-370.
2. Zohar AH. The epidemiology of obsessive-compulsive disorder in children and adolescents. Child & Adolescent Psychiatric Clinics of North America. 1999;8:445-460.
3. Renshaw KD, Steketee GS, Chambless DL. Involving family members in the treatment of OCD. Cognitive Behaviour Therapy. 2005;34(3):164-175.
4. Barrett P, Farrell L, Dadds M, Boulter N. Cognitive-behavioral family treatment of childhood obsessive-compulsive disorder: long-term follow-up and predictors of outcome. Journal of the American Academy of Child and Adolescent Psychiatry. 2005;44(10):1005-1014.
5. Garcia A, Freeman J, Himle M, et al. Phenomenology of early childhood onset obsessive compulsive disorder. Journal of Psychopathology and Behavioral Assessment. 2009;31:104-111.
6. Coskun M, Zoroglu S, Ozturk M. Phenomenology, psychiatric comorbidity and family history in referred preschool children with obsessive-compulsive disorder. Child Adolesc Psychiatry Ment Health. 2012;6(1):36-36.
7. Micali N, Heyman I, Perez M, et al. Long-term outcomes of obsessive-compulsive disorder: Follow-up of 142 children and adolescents. British Journal of Psychiatry. 2010;197:128-134.
8. Walitza S, van Ameringen M, Geller D. Early detection and intervention for obsessive-compulsive disorder in childhood and adolescence. Lancet Child Adolesc Health. 2019.
9. Fineberg NA, Dell'Osso B, Albert U, et al. Early intervention for obsessive compulsive disorder: An expert consensus statement. European Neuropsychopharmacology. 2019.
10. Freeman J, Sapyta JJ, Garcia A, et al. Family-Based Treatment of Early Childhood Obsessive-Compulsive Disorder: The Pediatric Obsessive-Compulsive Disorder Treatment Study for Young Children (POTS Jr) - A Randomized Clinical Trial. JAMA Psychiatry. 2014;71(6):689-698.
11. Lewin AB, Park JM, Jones AM, et al. Family-based exposure and response prevention therapy for preschool-aged children with obsessive-compulsive disorder: A pilot randomized controlled trial. Behaviour Research and Therapy. 2014;56:30-38.
12. Geller DA, March J. Practice parameter for the assessment and treatment of children and adolescents with obsessive-compulsive disorder. Journal of the American Academy of Child & Adolescent Psychiatry. 2012;51:98-113.
13. Renner T, Walitza S. Schwere frühkindliche Zwangsstörung - Kasuistik eines 4-jährigen Mädchens. Zeitschrift fuer Kinder- und Jugendpsychiatrie und Psychotherapie. 2006;34:287-293.
14. Nakatani E, Krebs G, Micali N, Turner C, Heyman I, Mataix-Cols D. Children with very early onset obsessive-compulsive disorder: clinical features and treatment outcome. Journal of Child Psychology & Psychiatry. 2011;52(12):1261-1268.
15. Skriner LC, Freeman J, Garcia A, Benito K, Sapyta J, Franklin M. Characteristics of Young Children with Obsessive–Compulsive Disorder: Baseline Features from the POTS Jr. Sample. Child Psychiatry and Human Development. 2016;47:83-93.
16. Selles RR, Storch EA, Lewin AB. Variations in Symptom Prevalence and Clinical Correlates in Younger Versus Older Youth with Obsessive–Compulsive Disorder. Child Psychiatry and Human Development. 2014;45:666-674.
17. Glazier K, Calixte RM, Rothschild R, Pinto A. High rates of OCD symptom misidentification by mental health professionals. Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists. 2013;25(3):201-209.
18. Brezinka V, Mailaender V, Walitza S. Obsessive compulsive disorder in very young children – a case series from a specialized outpatient clinic. BMC Psychiatry. 2020;20:366-373.
19. Geller DA, Biederman J, Agranat A. Developmental aspects of obsessive compulsive disorder: findings in children, adolescents and adults Journal of Nervous and Mental Diseases. 2001;189:471-477.
20. Scahill L, Riddle MA, McSwiggin-Hardin M. Children's Yale-Brown Obsessive-Compulsive Scale: reliability and validity Journal of the American Academy of Child & Adolescent Psychiatry. 1997;36:844-852.
21. Freeman J, Flessner C, Garcia A. The Children's Yale-Brown Obsessive Compulsive Scale: reliability and validity for use among 5 to 8 year olds with obsessive-compulsive disorder. Journal of Abnormal Child Psychology. 2011;39:877-883.
22. Lewin AB, Piacentini J, De Nadai AS, et al. Defining clinical severity in pediatric obsessive-compulsive disorder. Psychological Assessment. 2014;26(2):679-684.
23. Johnco CJ, Lewin AB. Treatment of obsessive-compulsive disorder in very young children. In: Storch EA, Lewin AB, eds. Clinical Handbook of Obsessive-Compulsive and Related Disorders. New York: Springer; 2016:291-304.
24. Albert U, Baffa A, Maina G. Family accommodation in adult obsessive–compulsive disorder: Clinical perspectives. Psychology Research and Behavior Management. 2017;10.
25. Lebowitz ER. Parent-based treatment for childhood and adolescent OCD. Journal of Obsessive-Compulsive and Related Disorders. 2013;2(4):425-431.
26. Storch EA, Geffken GR, Merlo LJ, et al. Family Accommodation in Pediatric Obsessive-Compulsive Disorder. Journal of Clinical Child & Adolescent Psychology. 2007;36(2):207-216.
27. Lebowitz ER. Treatment of Extreme Family Accommodation in a Youth with Obsessive-Compulsive Disorder. In: Storch EA, Lewin AB, eds. Clinical Handbook of Obsessive-Compulsive and Related Disorders. New York: Springer; 2016:321-335.
28. Stewart E, Cancilliere MK, Freeman J, et al. Elevated Autism Spectrum Disorder Traits in Young Children with OCD. Child Psychiatry Hum Dev. 2016;47(6):993-1001.
29. Storch EA, Lewin AB, Geffken GR, Morgan JR, Murphy TK. The role of comorbid disruptive behavior in the clinical expression of pediatric obsessive-compulsive disorder Behaviour Research and Therapy. 2010;48:1204-1210.
30. Wewetzer C, Walitza S. Obsessive-Compulsive Disorders. In: Gerlach M, Warnke A, Greenhill L, eds. Psychiatric Drugs in Children and Adolescents. Basic Pharmacology and Practical Applications. Vienna: Springer; 2014:469-474.
31. Bloch MH, Storch EA. Assessment and management of treatment-refractory obsessive-compulsive disorder in children. J Am Acad Child Adolesc Psychiatry. 2015;54(4):251-262.
32. Lewin AB, McGuire JF, Murphy TK, Storch EA. Editorial Perspective: The importance of considering parent's preferences when planning treatment for their children – the case of childhood obsessive-compulsive disorder. Journal of Child Psychology and Psychiatry. 2014;55(12):1314-1316.
33. Pediatric OCD Treatment Study PT. Cognitive-behavior therapy, sertraline, and their combination for children and adolescents with obsessive-compulsive disorder. The Pediatric OCD Treatment Study (POTS) randomized controlled trial. JAMA. 2004;292(16):1969-1976.
34. Freeman J, Choate-Summers ML, Moore PS, et al. Cognitive Behavioral Treatment for Young Children With Obsessive-Compulsive Disorder. Biological Psychiatry. 2007;61(3):337-343.
35. Freeman J, Garcia A, Coyne L, et al. Early Childhood OCD: Preliminary findings from a family-based cognitive-behavioral approach. Journal of the American Academy of Child & Adolescent Psychiatry. 2008, 47(5):593-602.
36. Rosa-Alcázar AI, Iniesta-Sepúlveda M, Storch EA, Rosa-Alcázar Á, Parada-Navas JL, Olivares Rodríguez J. A preliminary study of cognitive-behavioral family-based treatment versus parent training for young children with obsessive-compulsive disorder. J Affect Disord. 2017;208:265-271.
2. Zohar AH. The epidemiology of obsessive-compulsive disorder in children and adolescents. Child & Adolescent Psychiatric Clinics of North America. 1999;8:445-460.
3. Renshaw KD, Steketee GS, Chambless DL. Involving family members in the treatment of OCD. Cognitive Behaviour Therapy. 2005;34(3):164-175.
4. Barrett P, Farrell L, Dadds M, Boulter N. Cognitive-behavioral family treatment of childhood obsessive-compulsive disorder: long-term follow-up and predictors of outcome. Journal of the American Academy of Child and Adolescent Psychiatry. 2005;44(10):1005-1014.
5. Garcia A, Freeman J, Himle M, et al. Phenomenology of early childhood onset obsessive compulsive disorder. Journal of Psychopathology and Behavioral Assessment. 2009;31:104-111.
6. Coskun M, Zoroglu S, Ozturk M. Phenomenology, psychiatric comorbidity and family history in referred preschool children with obsessive-compulsive disorder. Child Adolesc Psychiatry Ment Health. 2012;6(1):36-36.
7. Micali N, Heyman I, Perez M, et al. Long-term outcomes of obsessive-compulsive disorder: Follow-up of 142 children and adolescents. British Journal of Psychiatry. 2010;197:128-134.
8. Walitza S, van Ameringen M, Geller D. Early detection and intervention for obsessive-compulsive disorder in childhood and adolescence. Lancet Child Adolesc Health. 2019.
9. Fineberg NA, Dell'Osso B, Albert U, et al. Early intervention for obsessive compulsive disorder: An expert consensus statement. European Neuropsychopharmacology. 2019.
10. Freeman J, Sapyta JJ, Garcia A, et al. Family-Based Treatment of Early Childhood Obsessive-Compulsive Disorder: The Pediatric Obsessive-Compulsive Disorder Treatment Study for Young Children (POTS Jr) - A Randomized Clinical Trial. JAMA Psychiatry. 2014;71(6):689-698.
11. Lewin AB, Park JM, Jones AM, et al. Family-based exposure and response prevention therapy for preschool-aged children with obsessive-compulsive disorder: A pilot randomized controlled trial. Behaviour Research and Therapy. 2014;56:30-38.
12. Geller DA, March J. Practice parameter for the assessment and treatment of children and adolescents with obsessive-compulsive disorder. Journal of the American Academy of Child & Adolescent Psychiatry. 2012;51:98-113.
13. Renner T, Walitza S. Schwere frühkindliche Zwangsstörung - Kasuistik eines 4-jährigen Mädchens. Zeitschrift fuer Kinder- und Jugendpsychiatrie und Psychotherapie. 2006;34:287-293.
14. Nakatani E, Krebs G, Micali N, Turner C, Heyman I, Mataix-Cols D. Children with very early onset obsessive-compulsive disorder: clinical features and treatment outcome. Journal of Child Psychology & Psychiatry. 2011;52(12):1261-1268.
15. Skriner LC, Freeman J, Garcia A, Benito K, Sapyta J, Franklin M. Characteristics of Young Children with Obsessive–Compulsive Disorder: Baseline Features from the POTS Jr. Sample. Child Psychiatry and Human Development. 2016;47:83-93.
16. Selles RR, Storch EA, Lewin AB. Variations in Symptom Prevalence and Clinical Correlates in Younger Versus Older Youth with Obsessive–Compulsive Disorder. Child Psychiatry and Human Development. 2014;45:666-674.
17. Glazier K, Calixte RM, Rothschild R, Pinto A. High rates of OCD symptom misidentification by mental health professionals. Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists. 2013;25(3):201-209.
18. Brezinka V, Mailaender V, Walitza S. Obsessive compulsive disorder in very young children – a case series from a specialized outpatient clinic. BMC Psychiatry. 2020;20:366-373.
19. Geller DA, Biederman J, Agranat A. Developmental aspects of obsessive compulsive disorder: findings in children, adolescents and adults Journal of Nervous and Mental Diseases. 2001;189:471-477.
20. Scahill L, Riddle MA, McSwiggin-Hardin M. Children's Yale-Brown Obsessive-Compulsive Scale: reliability and validity Journal of the American Academy of Child & Adolescent Psychiatry. 1997;36:844-852.
21. Freeman J, Flessner C, Garcia A. The Children's Yale-Brown Obsessive Compulsive Scale: reliability and validity for use among 5 to 8 year olds with obsessive-compulsive disorder. Journal of Abnormal Child Psychology. 2011;39:877-883.
22. Lewin AB, Piacentini J, De Nadai AS, et al. Defining clinical severity in pediatric obsessive-compulsive disorder. Psychological Assessment. 2014;26(2):679-684.
23. Johnco CJ, Lewin AB. Treatment of obsessive-compulsive disorder in very young children. In: Storch EA, Lewin AB, eds. Clinical Handbook of Obsessive-Compulsive and Related Disorders. New York: Springer; 2016:291-304.
24. Albert U, Baffa A, Maina G. Family accommodation in adult obsessive–compulsive disorder: Clinical perspectives. Psychology Research and Behavior Management. 2017;10.
25. Lebowitz ER. Parent-based treatment for childhood and adolescent OCD. Journal of Obsessive-Compulsive and Related Disorders. 2013;2(4):425-431.
26. Storch EA, Geffken GR, Merlo LJ, et al. Family Accommodation in Pediatric Obsessive-Compulsive Disorder. Journal of Clinical Child & Adolescent Psychology. 2007;36(2):207-216.
27. Lebowitz ER. Treatment of Extreme Family Accommodation in a Youth with Obsessive-Compulsive Disorder. In: Storch EA, Lewin AB, eds. Clinical Handbook of Obsessive-Compulsive and Related Disorders. New York: Springer; 2016:321-335.
28. Stewart E, Cancilliere MK, Freeman J, et al. Elevated Autism Spectrum Disorder Traits in Young Children with OCD. Child Psychiatry Hum Dev. 2016;47(6):993-1001.
29. Storch EA, Lewin AB, Geffken GR, Morgan JR, Murphy TK. The role of comorbid disruptive behavior in the clinical expression of pediatric obsessive-compulsive disorder Behaviour Research and Therapy. 2010;48:1204-1210.
30. Wewetzer C, Walitza S. Obsessive-Compulsive Disorders. In: Gerlach M, Warnke A, Greenhill L, eds. Psychiatric Drugs in Children and Adolescents. Basic Pharmacology and Practical Applications. Vienna: Springer; 2014:469-474.
31. Bloch MH, Storch EA. Assessment and management of treatment-refractory obsessive-compulsive disorder in children. J Am Acad Child Adolesc Psychiatry. 2015;54(4):251-262.
32. Lewin AB, McGuire JF, Murphy TK, Storch EA. Editorial Perspective: The importance of considering parent's preferences when planning treatment for their children – the case of childhood obsessive-compulsive disorder. Journal of Child Psychology and Psychiatry. 2014;55(12):1314-1316.
33. Pediatric OCD Treatment Study PT. Cognitive-behavior therapy, sertraline, and their combination for children and adolescents with obsessive-compulsive disorder. The Pediatric OCD Treatment Study (POTS) randomized controlled trial. JAMA. 2004;292(16):1969-1976.
34. Freeman J, Choate-Summers ML, Moore PS, et al. Cognitive Behavioral Treatment for Young Children With Obsessive-Compulsive Disorder. Biological Psychiatry. 2007;61(3):337-343.
35. Freeman J, Garcia A, Coyne L, et al. Early Childhood OCD: Preliminary findings from a family-based cognitive-behavioral approach. Journal of the American Academy of Child & Adolescent Psychiatry. 2008, 47(5):593-602.
36. Rosa-Alcázar AI, Iniesta-Sepúlveda M, Storch EA, Rosa-Alcázar Á, Parada-Navas JL, Olivares Rodríguez J. A preliminary study of cognitive-behavioral family-based treatment versus parent training for young children with obsessive-compulsive disorder. J Affect Disord. 2017;208:265-271.