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The Treatment of Obsessive-Compulsive Disorder in Adolescence

A Report of Fifteen Cases

Published online by Cambridge University Press:  29 January 2018

Derek Bolton
Affiliation:
Institute of Psychiatry; Adolescent Unit, Bethlem Royal and Maudsley Hospitals, Monks Orchard Road, Beckenham, Kent BR3 3BX
Suzanne Collins
Affiliation:
Wandsworth Health District, London
Derek Steinberg
Affiliation:
Adolescent Unit, Bethlem Royal and Maudsley Hospitals

Summary

The treatment of 15 adolescents with obsessive-compulsive disorder is described. Treatment was in most cases primarily behavioural (response-prevention), with the family involved in the therapy. Other components of treatment which were used in some cases are also described: medication, psychotherapy, and ‘milieu’ therapy. Outcome after treatment was generally good, with symptoms in most cases being relieved entirely or reduced to a mildly incapacitating level. Treatment gains in most cases were maintained at follow-up. Obstacles to treatment are noted, and recommendations are made as to the management of the disorder in adolescence.

Type
Research Article
Copyright
Copyright © 1983 The Royal College of Psychiatrists 

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References

Adams, P. L. (1973) Obsessive Children. New York: Brunner Mazel.Google Scholar
Black, A. (1974) The natural history of obsessional neurosis. in Obsessional States (ed. Beech, H. R.). London: Methuen.Google Scholar
Bolton, D. & Turner, T. (In press) Obsessive-compulsive neurosis with conduct disorder in adolescence: a report of two cases. Journal of Child Psychology and Psychiatry. Google Scholar
Carr, A. T. (1974) Compulsive neurosis: a review of the literature. Psychological Bulletin, 81, 311–18.CrossRefGoogle ScholarPubMed
Clark, D., Sugrim, I. & Bolton, D. (1982) Primary obsessional slowness: a nursing treatment programme with a 13 year old male adolescent. Behaviour Research and Therapy, 20, 289–92.CrossRefGoogle ScholarPubMed
Clark, D. & Bolton, D. (in preparation) (a) A psychometric study of obsessional phenomena in obsessive-compulsive adolescents.Google Scholar
Clark, D. & Bolton, D. & Bolton, D. (in preparation) (b) Obsessive-compulsive adolescents and their families: a psychometric study.Google Scholar
Fenichel, O. (1946) The Psychoanalytic Theory of Neurosis. New York: Norton.Google Scholar
Fine, S. (1973) Family therapy and a behavioural approach to childhood obsessive-compulsive neurosis. Archives of General Psychiatry, 28, 695–7.CrossRefGoogle Scholar
Freud, S. (1950) Totem and Taboo. London: Routledge and Kegan Paul.Google Scholar
Friedmann, C. T. & Silvers, F. M. (1977) A multimodality approach to inpatient treatment of obsessive-compulsive disorder. American Journal of Psychotherapy, 31, 456–65.CrossRefGoogle ScholarPubMed
Green, D. (1980) A behavioural approach to the treatment of obsessional rituals: an adolescent case study. Journal of Adolescence, 3, 297306.CrossRefGoogle Scholar
Hallam, R. S. (1974) Extinction of ruminations: a case study. Behaviour Therapy, 5, 565–8.CrossRefGoogle Scholar
Hollingsworth, C. E., Tanguay, P. E., Grossman, L. & Pabst, P. (1980) Long-term outcome of obsessive-compulsive disorder in childhood. Journal of the American Academy of Child Psychiatry, 19, 134–44.CrossRefGoogle ScholarPubMed
Horne, D. J. de L., McTiernan, G. & Strauss, N. H. M. (1981) A case of severe obsessive-compulsive behaviour treated by nurse therapists in an inpatient unit. Behavioural Psychotherapy, 9, 4654.CrossRefGoogle Scholar
Ingram, I. M. (1961) Obsessional illness in mental hospital patients. Journal of Mental Science, 107, 382402.CrossRefGoogle ScholarPubMed
Judd, L. L. (1965) Obsessive compulsive neurosis in children. Archives of General Psychiatry, 12, 136–43.CrossRefGoogle ScholarPubMed
Kringlen, E. (1965) Obsessional neurotics: a long-term follow up. British Journal of Psychiatry, 111, 709–22.CrossRefGoogle ScholarPubMed
Lewis, A. J. (1936) Problems of obsessional illness. Proceedings of the Royal Society of Medicine, 29, 325–36.Google ScholarPubMed
Marks, I. M., Hodgson, R. & Rachman, S. (1975) Treatment of chronic obsessive-compulsive neurosis by in vivo exposure. British Journal of Psychiatry, 127, 349–64.CrossRefGoogle ScholarPubMed
Mayer-Gross, W., Slater, E. & Roth, M. (1969) Clinical Psychiatry, 3rd Edition. London: Baillière, Tindall and Cassell.Google Scholar
Pollit, J. D. (1957) The natural history of obsessional states: a study of 150 cases. British Medical Journal, i, 194–8.Google Scholar
Rachman, S. (1974) Primary obsessional slowness. Behaviour Research and Therapy, 12, 918.CrossRefGoogle ScholarPubMed
Rachman, S., Cobb, J., Grey, S., McDonald, B., Mawson, D., Sartory, G. & Stern, R. (1979) The behavioural treatment of obsessive-compulsive disorders, with and without clomipramine. Behaviour Research and Therapy, 17, 467–78.CrossRefGoogle ScholarPubMed
Rachman, S. & Hodgson, R. (1980) Obsessions and Compulsions. Englewood Cliffs, N.J.: Prentice-Hall.Google Scholar
Rapoport, J., Elkins, R. & Mikkelsen, E. (1980) Clinical controlled trial of Chlorimipramine in adolescents with obsessive-compulsive disorder. Psychopharmacology Bulletin, 16, 61–3.Google ScholarPubMed
Schneider, K. (1925) Zwangszustände in Schizophrenic. Archiv für Psychiatrie und Nervenkrankheiten, 74, 93107.CrossRefGoogle Scholar
Stanley, L. (1980) Treatment of ritualistic behaviour in an 8 year old girl by response-prevention: a case report. Journal of Child Psychology and Psychiatry, 21, 8590.CrossRefGoogle Scholar
Stern, R. S. (1978) Obsessive thoughts: the problem of therapy. British Journal of Psychiatry, 132, 200–5.Google Scholar
Stern, R. S. & Cobb, J. (1978) Phenomenology of obsessive-compulsive neurosis. British Journal of Psychiatry, 132, 233–9.CrossRefGoogle Scholar
Warren, W. (1960) Some relationships between the psychiatry of children and of adults. Journal of Mental Science, 106, 815–26.CrossRefGoogle ScholarPubMed
Warren, W. (1965) A study of adolescent psychiatric inpatients and the outcome six or more years later. I. Clinical histories and hospital findings, II. The follow-up study. Journal of Child Psychology and Psychiatry, 6, 117, and, 141–60.CrossRefGoogle ScholarPubMed
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