2012 AACAP 美国评估与治疗儿童和青少年强迫性精神障碍的实践参考

These practice parameters describe the assessment and treatment of obsessive-compulsive disorder based on a detailed literature review and expert consultation. Obsessive compulsive disorder is a disorder of heterogeneous origin characterized by intrusive thoughts or compulsive urges or behaviors that are distressing, time-consuming, or functionally impairing. In children and adolescents, the disorder often is accompanied by a wide range of comorbidity, including mood, anxiety, attention, and learning difficulties, and/or tic disorder. These parameters describe the relevant areas of assessment, especially symptomatology, onset and course, other associated psychopathology, and developmental, family, and medical history (including post-infectious onset or exacerbations). Only two modalities have been systematically assessed and empirically shown to ameliorate core symptoms: cognitive behavioral therapy (primarily exposure/response prevention) and serotonin re-uptake inhibitor medication. Data regarding the indications, efficacy, and implementation of these modalities are reviewed. Because of the frequent co-occurrence of other psychopathology and adaptive difficulties, additional educational, individual and family psychotherapeutic, and pharmacological interventions often are necessary. Treatment planning guidelines are provided.