Obsessive-compulsive and related disorders in transitional-age youth

Abstract

Obsessive-compulsive and related disorders (OCRDs) occur in transitional age youth (TAY) and refer to obsessive-compulsive disorder and the related disorders of body dysmorphic disorder, hoarding disorder, trichotillomania (hair-pulling disorder), and excoriation (skin-picking) disorder. The OCRDs are relatively common psychiatric disorders, generally emerge early in life, and most tend to run a chronic, impairing course. Common developmental stressors occur in transitional age youth (TAY) at the same age when most psychiatric problems first occur. Just as with all psychiatric disorders, the assessment and diagnosis of OCD and related disorders in TAY are approached in a multimodal fashion, including clinical and diagnostic interviews with the patient and relevant informants, a review of any collateral information, and the use of objective measures. Establishing the goals for treatment should include decreasing symptom frequency and severity, improving the patient's functioning, and helping the patient to improve his or her quality of life. Cognitive behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs) are recommended as safe, evidence-based, and effective first-line treatments for OCD. Similar treatments are also effective for the other OCD-related disorders. Whether to utilize CBT, an SSRI (or other similar medications), or combined treatment for these disorders also depends on various individual factors. Psychoeducation and the utilization of resources for TAY with OCD and related disorders can help to prevent many common pitfalls in the management of these disorders in TAY.