Conclusions

Childhood OCD represents the disorder, in child psychiatry, whose clinical picture most closely resembles its adult counterpart. Despite a relative diversity, the symptom pool is remarkably finite and very similar to that seen in older individuals. Prevalence, comorbidity, and response to drug and behavioural treatment also appear similar across the lifespan. For tic disorders, there is continuity between child and adult presentations, but the disease is much more prone to resolve spontaneously or to be less disruptive in adulthood. Both disorders occur more often in males than in females and are likely to be linked to an array of neurobiological abnormalities, many of which remain to be understood.

Invaluable benefits can now be obtained from available pharmacological and behavioural treatments, but complete remission remains uncertain and long-term management may be required for childhood-onset OCD and tics. One of the main problems we are still facing is the difficulty in predicting outcome. More research is needed to gain better therapeutic response, and to disentangle the role of several neurotransmitter systems and other pathogenic factors in disorders that may prove to be neurobiologically heterogeneous.

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