[Obsessive-compulsive disorders in adolescents]

The research recently conducted and ongoing in adolescent obsessive-compulsive disorder indicates that the clinical signs and symptoms are indistinguishable from those seen in adults. Comorbidity appears to follow the same trends in adolescents and adults, with anxiety and affective symptomatology predominating. Contrary to expectation, Gilles de la Tourette disorder does not appear either as a concurrent syndrome, or as an eventual outcome in obsessive-compulsive adolescents. Males are greatly over-represented among adolescents with an early childhood onset. The neurological and neuropsychological findings are the only ones that appear to distinguish the adolescent and adult obsessive-compulsive patients. The findings point to frequent neurological abnormalities in adolescents with obsessive-compulsive disorder. The natural history over the short-term seems to be negatively affected by severity. The clinical efficacy of clomipramine and the failure of another tricyclic antidepressant parallels the therapeutic experience reported in adult patients. The presence of depression is unrelated to the efficacy of clomipramine. The neuropsychological and neurological abnormalities, together with the data from the longitudinal and treatment studies, strongly suggest that obsessive-compulsive disorder in adolescents is not a variant of the overall group of anxiety disorders.