Pediatric obsessive-compulsive disorder: management priorities in primary care

Obsessive-compulsive disorder (OCD) is a severe neuropsychiatric condition with a substantial prevalence in childhood and adolescence. Our understanding of the etiopathogenesis of pediatric OCD continues to grow, along with diagnostic and treatment approaches. The present study attempts to provide a parsimonious review of important studies of pediatric OCD with particular emphasis on studies over the last year.

Consistent with many other pediatric conditions, OCD in childhood and adolescence has distinct yet overlapping features with the adult-onset type. It appears that OCD is a multidimensional disorder with substantial comorbidity with other neuropsychiatric disorders that may affect its course and treatment. Although its pathophysiology remains to be fully elucidated, evidence suggests that OCD likely results from a complex interaction between multiple genetic variants and nongenetic factors. Meanwhile, evidence supporting the efficacy of selective serotonin reuptake inhibitors, augmentation strategies affecting other neurotransmitter systems, and cognitive behavioral therapy for the treatment of pediatric OCD continues to emerge.

Results from the studies reviewed here reflect the heterogeneity of pediatric OCD. It is clear that clinicians need to consider specific symptoms, comorbid conditions, and the rapidly evolving clinical research when working with children and adolescents with OCD.