Diagnóstico y manejo del trastorno obsesivo-compulsivo en niños y adolescentes
DOI:
https://doi.org/10.56183/iberojhr.v5i1.740Palavras-chave:
Trastorno obsesivo-compulsivo, Niños, Adolescentes, Diagnóstico, Terapia cognitivo-conductual, Farmacoterapia.Resumo
El trastorno obsesivo-compulsivo (TOC) en niños y adolescentes es una condición psiquiátrica caracterizada por la presencia de obsesiones y compulsiones que pueden interferir significativamente en el desarrollo y la calidad de vida de los afectados. Este artículo de revisión narrativa aborda los aspectos clave del diagnóstico y manejo del TOC en esta población. El diagnóstico temprano es crucial para minimizar el impacto del trastorno, y se basa en una evaluación clínica detallada que incluye entrevistas estructuradas con el paciente y sus familiares. Las herramientas diagnósticas estandarizadas también pueden ser útiles. En cuanto al manejo, se destaca la terapia cognitivo-conductual (TCC) como el tratamiento de primera línea, especialmente la técnica de exposición con prevención de respuesta (EPR). En casos moderados a severos, el uso de inhibidores selectivos de la recaptación de serotonina (ISRS) puede ser necesario. Además, se subraya la importancia de un enfoque multidisciplinario que involucre a profesionales de la salud mental, educadores y familias para optimizar los resultados terapéuticos. La identificación y tratamiento oportuno del TOC en niños y adolescentes es esencial para mejorar su pronóstico a largo plazo y facilitar un desarrollo más saludable.
Referências
Krebs G, Heyman I. Obsessive-compulsive disorder in children and adolescents. Arch Dis Child. 2015 May;100(5):495-9. doi: 10.1136/archdischild-2014-306934.
Stiede JT, Spencer SD, Onyeka O, Mangen KH, Church MJ, et al. Obsessive-Compulsive Disorder in Children and Adolescents. Annu Rev Clin Psychol. 2024 Jul;20(1):355-380. doi: 10.1146/annurev-clinpsy-080822-043910.
Walitza S, Melfsen S, Jans T, Zellmann H, Wewetzer C, Warnke A. Obsessive-compulsive disorder in children and adolescents. Dtsch Arztebl Int. 2011 Mar;108(11):173-9. doi: 10.3238/arztebl.2011.0173.
Boileau B. A review of obsessive-compulsive disorder in children and adolescents. Dialogues Clin Neurosci. 2011;13(4):401-11. doi: 10.31887/DCNS.2011.13.4/bboileau.
Zalpuri I, Matzke M, Shashank V, Joshi M. Obsessive-Compulsive Disorder in Children and Adolescents: Early Detection in Primary Care Settings. Pediatrics (2025) 155 (3): e2024069121. https://doi.org/10.1542/peds.2024-069121
Endres, D., Pollak, T.A., Bechter, K. et al. Immunological causes of obsessive-compulsive disorder: is it time for the concept of an “autoimmune OCD” subtype?. Transl Psychiatry 12, 5 (2022). https://doi.org/10.1038/s41398-021-01700-4
Steele DW, Caputo EL, Kanaan G, Zahradnik ML, Brannon E, et al. Diagnosis and Management of Obsessive Compulsive Disorders in Children [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2024 Dec. Report No.: AHRQ 25-EHC001
Nazeer A, Latif F, Mondal A, Azeem MW, Greydanus DE. Obsessive-compulsive disorder in children and adolescents: epidemiology, diagnosis and management. Transl Pediatr. 2020 Feb;9(Suppl 1):S76-S93. doi: 10.21037/tp.2019.10.02.
Schuyler M, Geller DA. Childhood Obsessive-Compulsive Disorder. Psychiatr Clin North Am. 2023 Mar;46(1):89-106. doi: 10.1016/j.psc.2022.10.002.
Jaspers F, Han S, Chan E, McKenney K, Simpson A, Boyle A, et al. Prevalence of Acute-Onset Subtypes in Pediatric Obsessive-Compulsive Disorder. J Child Adolesc Psychopharmacol. 2017 May;27(4):332-341. doi: 10.1089/cap.2016.0031.
Potter AS, Owens MM, Albaugh M, Garavan H, Sher KJ, et al. Obsessive-Compulsive Disorder in the Adolescent Brain Cognitive Development Study: Impact of Changes From DSM-IV to DSM-5. J Am Acad Child Adolesc Psychiatry. 2021 Apr;60(4):421-424. doi: 10.1016/j.jaac.2020.07.904.
Rajith RK, Krishnakumar P. Clinical profile of obsessive-compulsive disorder in children. J Family Med Prim Care. 2022 Jan;11(1):251-255. doi: 10.4103/jfmpc.jfmpc_1328_21.
Anagnostopoulos DC, Korlou S, Sakellariou K, Kondyli V, Sarafidou J, Tsakanikos E, Giannakopoulos G, Liakopoulou M. Comorbid psychopathology and clinical symptomatology in children and adolescents with obsessive-compulsive disorder. Psychiatriki. 2016 Jan-Mar;27(1):27-36.
Spencer SD, Stiede JT, Wiese AD, Goodman WK, Guzick AG, Storch EA. Cognitive-Behavioral Therapy for Obsessive-Compulsive Disorder. Psychiatr Clin North Am. 2023 Mar;46(1):167-180. doi: 10.1016/j.psc.2022.10.004.
Elliott SJ, Marshall D, Morley K, Uphoff E, Kumar M, Meader N. Behavioural and cognitive behavioural therapy for obsessive compulsive disorder (OCD) in individuals with autism spectrum disorder (ASD). Cochrane Database Syst Rev. 2021 Sep 3;9(9):CD013173. doi: 10.1002/14651858.CD013173.pub2.
Freeman J, Garcia A, Benito K, Conelea C, Sapyta J, et al. The Pediatric Obsessive Compulsive Disorder Treatment Study for Young Children (POTS jr): Developmental Considerations in the Rationale, Design, and Methods. J Obsessive Compuls Relat Disord. 2012 Oct;1(4):294-300. doi: 10.1016/j.jocrd.2012.07.010.
Kakhi S, Soomro GM. Obsessive compulsive disorder in children and adolescents: duration of maintenance drug treatment. BMJ Clin Evid. 2015 Jun 3;2015:1019.
Cotton S, Kraemer KM, Sears RW, Strawn JR, Wasson RS, et al. Mindfulness-based cognitive therapy for children and adolescents with anxiety disorders at-risk for bipolar disorder: A psychoeducation waitlist controlled pilot trial. Early Interv Psychiatry. 2020 Apr;14(2):211-219. doi: 10.1111/eip.12848.
Peris TS, Rozenman MS, Sugar CA, McCracken JT, Piacentini J. Targeted Family Intervention for Complex Cases of Pediatric Obsessive-Compulsive Disorder: A Randomized Controlled Trial. J Am Acad Child Adolesc Psychiatry. 2017 Dec;56(12):1034-1042.e1. doi: 10.1016/j.jaac.2017.10.008.
Khomami Zadeh L, Corso G. Advances in Pediatric Obsessive-Compulsive Disorder (OCD) Treatment: A Comprehensive Narrative Review. Cureus. 2024 Aug 30;16(8):e68225. doi: 10.7759/cureus.68225.
Micali N, Heyman I, Perez M, Hilton K, Nakatani E, et al. Long-term outcomes of obsessive-compulsive disorder: follow-up of 142 children and adolescents. Br J Psychiatry. 2010 Aug;197(2):128-34. doi: 10.1192/bjp.bp.109.075317.
Nakatani E, Krebs G, Micali N, Turner C, Heyman I, et al. Children with very early onset obsessive-compulsive disorder: clinical features and treatment outcome. J Child Psychol Psychiatry. 2011 Dec;52(12):1261-8. doi: 10.1111/j.1469-7610.2011.02434.x.
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2025 Cristian Santiago Jácome Granda, Jemima Elizabeth Sinchiguano Ñacata, Daysi Fernanda Pazmiño Lascano, Vanessa Carolina Millán Rodríguez, Gabriela Estefanía Suárez Bracho, Eliana Stefania Vilema Miranda, Karen Dayana Pérez Silva, Sharon Aracely Duicela Simbaña
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
