Preparation for Child Psych PRITE and Boards
Revision as of 19:29, 30 October 2012 by Eugene Grudnikoff MD (Talk | contribs) (→Genetic and non-genetic factors=)
Introduction
Epidemiology
OCD in children and adolescents often goes unrecognized and undiagnosed due to its idiosyncratic, not always obvious nature.
- Point prevalence of pediatric OCD is 0.25% (British study 5-15 y.o., Heyman I, IntRevPsych 2003);
- Overall pediatric prevalence rate is 1-2% (USA studies, Apter A, JAACAP 1996)
- Incidence of OCD peaks during two developmental periods, pre-adolescents, and young adults (mean 20 y.o.). (Geller D, March J, Practice Parameter, JAACAP 2012)
Genetic and non-genetic factors
- OCD has a significant familial/genetic component with higher concordance rates in monozygotic twins vs. dizygotic twins.
- Environmental triggers and immunological cross-reactions, particularly to Strep infection had been implicated. Specifically, in PANDAS - Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus, is attributed to immune response to Group A Strep, which can cause cross-reactivity and inflammation of basal ganglia. This can produce (the somewhat controversial) syntrome of PANDAS, which involves tics, OCD, and hyperactivity.