[Epidemiology of obsessive-compulsive disorder in children and adolescents]

Although obsessive-compulsive disorders are rarely found in young subjects seen in infantile psychiatry, anamnestic studies have shown that more than one third of obsessive patients seen at adult age agree that the onset of their disorder dates back to when they were under 15 years of age. The first direct epidemiological study on the prevalence of obsessive-compulsive disorder during adolescence was recently conducted in a New Jersey county, USA. Over 5,500 high school teenagers were asked to fill in a questionnaire dealing with different aspects of mental pathology and 356 of them were selected, on the basis of their answers, to be included in further clinical examinations. Thus, the current prevalence rate of obsessive-compulsive disorder was found to be 1 (+/- 0.5)% of the general adolescent population, and the lifetime prevalence rate, 1.9 (+/- 0.7)%. These results are close to the rates of prevalence observed in the U.S. general adult population during the same period. The obsessive-compulsive cases detected in this investigation showed the same characteristics as the clinical cases usually described, except for the absence of male predominance generally observed in consulting patients; 75% of obsessive patients also presented other associated psychopathological disorders, most often major depression, overanxious disorder and/or bulimia, but only 20% of them had already consulted mental health professionals. This study shows that obsessive-compulsive disorder during adolescence is more frequent than expected, but often remains undiagnosed and untreated.