Preschool-onset obsessive-compulsive disorder with complete remission

Dai Miyawaki,1 Ayako Goto,1 Yoshihiro Iwakura,1,2 Kaoru Hirai,1 Yusuke Miki,1 Naomi Asada,1,2 Hiroki Terakawa,1 Koki Inoue1 1Department of Neuropsychiatry, Osaka City University Graduate School of Medicine, Osaka, Japan; 2Department of Child and Adolescent Psychiatry, Osaka City General Hospital, O...

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Autores principales:	Miyawaki D, Goto A, Iwakura Y, Hirai K, Miki Y, Asada N, Terakawa H, Inoue K
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	very early-onset OCD differential diagnosis family-based cognitive behavioral therapy inpatient treatment Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/e49ddb07d8fd480ba1c24e5688132dff
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spelling	oai:doaj.org-article:e49ddb07d8fd480ba1c24e5688132dff2021-12-02T08:11:53ZPreschool-onset obsessive-compulsive disorder with complete remission1178-2021https://doaj.org/article/e49ddb07d8fd480ba1c24e5688132dff2018-07-01T00:00:00Zhttps://www.dovepress.com/preschool-onset-obsessive-compulsive-disorder-with-complete-remission-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Dai Miyawaki,1 Ayako Goto,1 Yoshihiro Iwakura,1,2 Kaoru Hirai,1 Yusuke Miki,1 Naomi Asada,1,2 Hiroki Terakawa,1 Koki Inoue1 1Department of Neuropsychiatry, Osaka City University Graduate School of Medicine, Osaka, Japan; 2Department of Child and Adolescent Psychiatry, Osaka City General Hospital, Osaka, Japan Abstract: Early-onset obsessive-compulsive disorder (OCD) is more severe than later-onset OCD. There are no reports of any early-onset OCD patients being cured, especially with respect to preschoolers. In this case report, we describe the successful treatment and cure of a 6-year-old preschool girl with severe OCD since the age of 3. At the age of 3, the patient began to fear contamination and danger to herself and her family, leading to excessive hand-washing, and several months later, ritualized checking. The OCD symptoms waxed and waned for about 3 years and thereafter worsened gradually over a few weeks, culminating in a refusal to eat and dress. At the age of 6, after a week of inpatient pediatric treatment with no improvement, the patient was transferred to Osaka City University Hospital to seek psychiatric treatment. The patient fully recovered from OCD following family-based cognitive-behavioral therapy (CBT) and short-term use of low-dose fluvoxamine in an inpatient setting. After treatment, the OCD symptoms disappeared with complete remission for over 3 years. Now, aged 9, the patient has good global functioning and is well adjusted in her daily life with no need for any treatment. To the best of our knowledge, this is the first report of preschool-onset OCD with long-term complete remission with inpatient treatment in a preschooler with severe OCD. Some preschoolers with very early-onset OCD may have good prognosis without continuous pharmacotherapy, although the symptoms with the onset are severe enough to require hospitalization. Preschool-onset OCD is likely to be misdiagnosed as separation anxiety disorder. Our findings suggest that family-based CBT, which is the treatment of choice for preschool-onset OCD, can be applicable to inpatient treatment. Early detection and intensive intervention of OCD in preschoolers may improve the chance of remission. Keywords: very early-onset OCD, differential diagnosis, family-based cognitive-behavioral therapy, inpatient treatmentMiyawaki DGoto AIwakura YHirai KMiki YAsada NTerakawa HInoue KDove Medical Pressarticlevery early-onset OCDdifferential diagnosisfamily-based cognitive behavioral therapyinpatient treatmentNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 14, Pp 1747-1753 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	very early-onset OCD differential diagnosis family-based cognitive behavioral therapy inpatient treatment Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	very early-onset OCD differential diagnosis family-based cognitive behavioral therapy inpatient treatment Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Miyawaki D Goto A Iwakura Y Hirai K Miki Y Asada N Terakawa H Inoue K Preschool-onset obsessive-compulsive disorder with complete remission
description	Dai Miyawaki,1 Ayako Goto,1 Yoshihiro Iwakura,1,2 Kaoru Hirai,1 Yusuke Miki,1 Naomi Asada,1,2 Hiroki Terakawa,1 Koki Inoue1 1Department of Neuropsychiatry, Osaka City University Graduate School of Medicine, Osaka, Japan; 2Department of Child and Adolescent Psychiatry, Osaka City General Hospital, Osaka, Japan Abstract: Early-onset obsessive-compulsive disorder (OCD) is more severe than later-onset OCD. There are no reports of any early-onset OCD patients being cured, especially with respect to preschoolers. In this case report, we describe the successful treatment and cure of a 6-year-old preschool girl with severe OCD since the age of 3. At the age of 3, the patient began to fear contamination and danger to herself and her family, leading to excessive hand-washing, and several months later, ritualized checking. The OCD symptoms waxed and waned for about 3 years and thereafter worsened gradually over a few weeks, culminating in a refusal to eat and dress. At the age of 6, after a week of inpatient pediatric treatment with no improvement, the patient was transferred to Osaka City University Hospital to seek psychiatric treatment. The patient fully recovered from OCD following family-based cognitive-behavioral therapy (CBT) and short-term use of low-dose fluvoxamine in an inpatient setting. After treatment, the OCD symptoms disappeared with complete remission for over 3 years. Now, aged 9, the patient has good global functioning and is well adjusted in her daily life with no need for any treatment. To the best of our knowledge, this is the first report of preschool-onset OCD with long-term complete remission with inpatient treatment in a preschooler with severe OCD. Some preschoolers with very early-onset OCD may have good prognosis without continuous pharmacotherapy, although the symptoms with the onset are severe enough to require hospitalization. Preschool-onset OCD is likely to be misdiagnosed as separation anxiety disorder. Our findings suggest that family-based CBT, which is the treatment of choice for preschool-onset OCD, can be applicable to inpatient treatment. Early detection and intensive intervention of OCD in preschoolers may improve the chance of remission. Keywords: very early-onset OCD, differential diagnosis, family-based cognitive-behavioral therapy, inpatient treatment
format	article
author	Miyawaki D Goto A Iwakura Y Hirai K Miki Y Asada N Terakawa H Inoue K
author_facet	Miyawaki D Goto A Iwakura Y Hirai K Miki Y Asada N Terakawa H Inoue K
author_sort	Miyawaki D
title	Preschool-onset obsessive-compulsive disorder with complete remission
title_short	Preschool-onset obsessive-compulsive disorder with complete remission
title_full	Preschool-onset obsessive-compulsive disorder with complete remission
title_fullStr	Preschool-onset obsessive-compulsive disorder with complete remission
title_full_unstemmed	Preschool-onset obsessive-compulsive disorder with complete remission
title_sort	preschool-onset obsessive-compulsive disorder with complete remission
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/e49ddb07d8fd480ba1c24e5688132dff
work_keys_str_mv	AT miyawakid preschoolonsetobsessivecompulsivedisorderwithcompleteremission AT gotoa preschoolonsetobsessivecompulsivedisorderwithcompleteremission AT iwakuray preschoolonsetobsessivecompulsivedisorderwithcompleteremission AT hiraik preschoolonsetobsessivecompulsivedisorderwithcompleteremission AT mikiy preschoolonsetobsessivecompulsivedisorderwithcompleteremission AT asadan preschoolonsetobsessivecompulsivedisorderwithcompleteremission AT terakawah preschoolonsetobsessivecompulsivedisorderwithcompleteremission AT inouek preschoolonsetobsessivecompulsivedisorderwithcompleteremission
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Preschool-onset obsessive-compulsive disorder with complete remission

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