title: Obsessive-compulsive disorder in children and adolescents.
abstract: BACKGROUND
  Early-onset obsessive-compulsive disorder (OCD) is one of the more common mental illnesses of children and adolescents, with prevalence of 1% to 3%. Its manifestations often lead to severe impairment and to conflict in the family. In this review, we summarize the manifestations, comorbidity, pathophysiology, and course of this disease as well as current modes of diagnosis and treatment.
  
  
  METHODS
  We selectively review the relevant literature and the German-language guidelines for the diagnosis and treatment of mental illnesses in children and adolescents.
  
  
  RESULTS
  Obsessive-compulsive manifestations are of many types and cause severe impairment. Comorbid mental disturbances are present in as many as 70% of patients. The disease takes a chronic course in more than 40% of patients. Cognitive behavioral therapy is the treatment of first choice, followed by combination pharmacotherapy including selective serotonin reuptake inhibitors (SSRI) and then by SSRI alone.
  
  
  CONCLUSIONS
  OCD often begins in childhood or adolescence. There are empirically based neurobiological and cognitive-behavioral models of its pathophysiology. Multiaxial diagnostic evaluation permits early diagnosis. Behavioral therapy and medications are highly effective treatments, but the disorder nonetheless takes a chronic course in a large percentage of patients.
authors.affiliation: Zentrum für Kinder- und Jugendpsychiatrie, Universität Zürich, Germany. susanne.walitza@kjpdzh.ch
authors.forename: Susanne
authors.initials: S
authors.lastname: Walitza
authors.forename: Siebke
authors.initials: S
authors.lastname: Melfsen
authors.forename: Thomas
authors.initials: T
authors.lastname: Jans
authors.forename: Henrike
authors.initials: H
authors.lastname: Zellmann
authors.forename: Christoph
authors.initials: C
authors.lastname: Wewetzer
authors.forename: Andreas
authors.initials: A
authors.lastname: Warnke
mesh_terms: D000293:Adolescent; D000295:Adolescent Medicine / Q000592:standards*; D002669:Child Welfare; D002675:Child, Preschool; D005260:Female; D005858:Germany; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis* / Q000628:therapy*; D010372:Pediatrics / Q000592:standards*; D017410:Practice Guidelines as Topic; D055815:Young Adult