In this review, we will examine the differences between the early- or pediatric-onset form of OCD (these terms are used interchangeably) and the adult-onset form, including epidemiology, symptom presentations, clinical correlates, comorbid disorders, familial and genetic factors, environmental and epigenetic factors, salient neurocircuitry, treatment response, course and outcome. Despite this, the latest incarnation of the Diagnostic and Statistical Manual of the American Psychiatric Association, the DSM5 ( 1) does not specify a developmental subtype, but rather includes two different “specifiers” that apply particularly to children and adolescents. Evidence for such a developmental subtype draws from multiple lines of observation and investigation at the clinical, translational and basic science levels. The importance of cognitive, academic and social development tasks of childhood and adolescence, illness-specific and familial factors, and immune-mediated inflammatory factors are discussed, with their implications for management.įor decades, clinical research has posited a developmental subtype of Obsessive Compulsive Disorder (OCD) that affects youth, and which may be distinct in important ways from the adult-onset form. In this paper we review the clinical, familial and translational biomarker correlates seen in early onset OCD that support the notion of a developmental subtype and discuss implications for research and treatment aimed at this cohort. Ascertainment and early intervention in affected youth is critical to abbreviate the functional impairments associated with untreated illness. The notion that early onset OCD represents a unique developmental subtype of the disorder has been considered by many researchers based on several specific age-related factors. As new cases are added, the cumulative prevalence of OCD increases, but the great majority of cases have an onset in youth. There appear to be two peaks of incidence of Obsessive Compulsive Disorder (OCD), one with a pre-adolescent onset and another in early adulthood. 3Psychiatry and Neuroimmunology Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.2Harvard Medical School, Boston, MA, United States.1Pediatric OCD and Tic Disorder Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.Geller 1,2 * Saffron Homayoun 2,3 Gabrielle Johnson 1 Our familiar routines are more important than we may think.Daniel A. A person who has experienced a serious trauma must have as much control (in a healthy way) as they can. There is much that is out of our control in the world and there is much that is within our control. As human beings, our routines - the gym, church, lunch with friends - create a consistent and reliable sense of control in life.
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