儿童和青少年中的强迫症和社交焦虑障碍课件.ppt

儿童和青少年中的强迫症和社交焦虑障碍 OCD And Social Anxiety Disorder 　In Children And Adolescents ? 　　　　John T. Walkup, MD Financial Disclosure Statement John T.Walkup,MD Consultant Janssen Pharmaceutica Inc,Solvay Pharmaceuticals Grants/Research Support GlaxoSmithKline,Lilly Research Laboratories,Pfizer Inc,Solvay Pharmaceuticals,Wyeth-Ayerst Laboratories Introduction Review -OCD -social anxiety disorder Review recently published RUPP anxiety treatment study for -separation anxiety disorder -social anxiety disorder -generalized anxiety disorder Obsessive-Compulsive Disorder Controlled Trials Clomipramine-DeVeaugh-Geiss et al,1992 Fluoxetine-Riddle et al,1992 Sertraline-March et al,1998 Fluvoxamine-Riddle et al,2001 Paroxetine-data analysis Fluoxetine-data analysis Paroxetine ii-study under way Foa and March-study under way Sertraline In Childhood OCD Double-blind,placebo-controlled,12-week,multisite trial N=187;age=6-7 year;sertraline≤200mg/d Sertralineplacebo Mild side effects Similar profile of response as clomipramine March et al.JAMA,1998;280:1752. Fluvoxamine In Childhood OCD Double-blind,placebo-controlled,multisite trial N=120;age=8-17 years;fluvoxamine 50-200mg/d Fluvoxamineplacebo Mild side effects Riddle et al.J Am Acad Child Adolesc Psychiatry.2001;40:222. Paroxetine In Childhood OCD Double-blind,placebo-controlled,multisite trial 16 weeks open-label treatment and 16 weeks double-blind treatment N=375;mean age=12 years;paroxetine 10-60mg/d Mild side effects Emsile et al.presented at the American Psychiatric Association Meeting.Chicago.IL.2000. Long-Term Treatment Of OCD In Children And Adolescents Leonard et al,1991 DeVeaugh-Geiss et al,1992 Walkup et al,1999 Wagner et al,1999 Desipramine Substitution During Long-Term Treatment With Clomipramine Double-blind desipramine substitution(8 months) N=26 on long-term clomipramine for OCD Results Leonard et al.Arch Gen Psychiatry.1991;48:922. Fluvoxamine In Childhood CD:long-Term Treatment Mul