The aim was to examine the clinical features of Obsessive-Compulsive Disorder (OCD) in preschool and the effectiveness of aripiprazole with a standardized Cognitive-Behavioral Family Therapy (CBFT) in the treatment of preschoolers with OCD. Twelve preschool children, 36–72 months of age were diagnosed with OCD according to the Diagnostic and Statistical Manual of Mental Disorders, the Fifth Edition criteria by a fellowship-trained child and adolescent psychiatrist. They were evaluated with Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime version and Childhood Yale-Brown Obsessive Compulsive Scale (CY-BOCS) at baseline, at the end of the 12th and 24th weeks of treatment. The baseline mean of total CY-BOCS score decreased from 33.67 to 13.83 at the 12th week and 5.58 at the end of the 24th week of treatment. Also, 66.7% of them had at least one psychiatric comorbidity. Overall, this study revealed the effect of aripiprazole with CBFT in preschool-aged children with OCD. Also, the presence of comorbidity that is seen frequently in preschoolers with OCD may complicate the treatment. Therefore, there is a need to increase awareness of OCD and its comorbidities in preschoolers to supply treatment at an early age.
AdelsonS. L.American Academy of Child and Adolescent Psychiatry (AACAP) Committee on Quality Issues (CQI). (2012). Practice parameters on gay, lesbian, or bisexual sexual orientation, gender nonconformity, and gender discordance in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 51(9), 957–974. https://doi.org/10.1016/j.jaac.2012.07.004
2.
Akyol ArdicU.ErcanE. S.KutluA.YuceD.IpciM.InciS. B. (2017). Successful treatment response with aripiprazole augmentation of SSRIs in refractory obsessive-compulsive disorder in childhood. Child Psychiatry and Human Development, 48(5), 699–704. https://doi.org/10.1007/s10578-016-0694-8
3.
BusnerJ.TargumS. D. (2007). The clinical global impressions scale: Applying a research tool in clinical practice. Psychiatry, 4(7), 28–37. 20526405.
4.
CancilliereM. K.FreemanJ.GarciaA.BenitoK.SapytaJ.FranklinM. (2018). Assessing acute secondary treatment outcomes in early-onset obsessive-compulsive disorder. Child Psychiatry and Human Development, 49(5), 718–729. https://doi.org/10.1007/s10578-018-0786-8
5.
CavanaghK. (2014). Geographic inequity in the availability of cognitive-behavioral therapy in England and Wales: A 10-year update. Behavioral and Cognitive Psychotherapy, 42(4), 497–501. https://doi.org/10.1017/s1352465813000568
6.
ChabaneN.DelormeR.MilletB.MourenM. C.LeboyerM.PaulsD. (2005). Early-onset obsessive-compulsive disorder: A subgroup with a specific clinical and familial pattern?Journal Of Child Psychology and Psychiatry, And Allied Disciplines, 46(8), 881–887. https://doi.org/10.1111/j.1469-7610.2004.00382.x
7.
ChaconP.BernardesE.FaggianL.BatistuzzoM.MoriyamaT.MiguelE. C.PolanczykG. V. (2018). Obsessive-compulsive symptoms in children with first-degree relatives diagnosed with obsessive-compulsive disorder. Revista Brasileira de Psiquiatria, 40(4), 388–393. https://doi.org/10.1590/1516-4446-2017-2321
8.
ChouinardG.MargoleseH. C. (2005). Manual for the extrapyramidal symptom rating scale (ESRS). Schizophrenia Research, 76(2–3), 247–265. https://doi.org/10.1016/j.schres.2005.02.013
9.
CorrellC. U.ManuP.OlshanskiyV.NapolitanoB.KaneJ. M.MalhotraA. K. (2009). Cardiometabolic risk of second-generation antipsychotic medications during first-time use in children and adolescents. JAMA, 302(16), 1765–1773. https://doi.org/10.1001/jama.2009.1549
10.
CoskunM. (2017). Aripiprazole monotherapy was effective in treating obsessive-compulsive disorder in a preschool boy. Journal Of Clinical Psychopharmacology, 37(5), 636–637. https://doi.org/10.1097/jcp.0000000000000748
11.
CoskunM.ZorogluS. (2009). Efficacy and safety of fluoxetine in preschool children with obsessive-compulsive disorder. Journal Of Child And Adolescent Psychopharmacology, 19(3), 297–300. https://doi.org/10.1089/cap.2008.055
12.
CoskunM.ZorogluS.OzturkM. (2012). Phenomenology, psychiatric comorbidity, and family history in referred preschool children with obsessive-compulsive disorder. Child And Adolescent Psychiatry and Mental Health, 6(1), 36. https://doi.org/10.1186/1753-2000-6-36
13.
CoustalsN.MénardM. L.CohenD. (2021). Aripiprazole in children and adolescents. Journal of Child and Adolescent Psychopharmacology, 31(1), 4–32. https://doi.org/10.1089/cap.2020.0014
14.
DemirokD.ÜnalF.PehlivantürkB. (2001). Çocuk ve ergenlerde obsesif kompulsif bozukluk: Sosyodemografik ve klinik özellikler. Çocuk ve Ergen Ruh Sağlığı Dergisi, 8(1), 11–18.
15.
ErcanE. S.ArdicU. A.ErcanE.YuceD.DurakS. (2015). A promising preliminary study of aripiprazole for treatment-resistant childhood obsessive-compulsive disorder. Journal Of Child and Adolescent Psychopharmacology, 25(7), 580–584. https://doi.org/10.1089/cap.2014.0128
16.
ErcanE. S.KanduluR.Akyol ArdicU. (2012). Preschool children with obsessive-compulsive disorder and fluoxetine treatment. European Child and Adolescent Psychiatry, 21(3), 169–172. https://doi.org/10.1007/s00787-012-0244-2
17.
FarrellL. J.SluisR.WatersA. M. (2016). Intensive treatment of pediatric OCD: The case of Sarah. Journal Of Clinical Psychology, 72(11), 1174–1190. https://doi.org/10.1002/jclp.22397
18.
FindlingR. L.YoungstromE. A.McNamaraN. K.StansbreyR. J.WynbrandtJ. L.AdegbiteC.RowlesB. M.DemeterC. A.FrazierT. W.CalabreseJ. R. (2012). Double-blind, randomized, placebo-controlled long-term maintenance study of aripiprazole in children with bipolar disorder. The Journal of Clinical Psychiatry, 73(1).57–63. https://doi.org/10.4088/jcp.11m07104
19.
FreemanJ.FlessnerC. A.GarciaA. (2011). The children’s yale-brown obsessive-compulsive scale: Reliability and validity for use among 5- to 8-year-olds with obsessive-compulsive disorder. Journal of Abnormal Child Psychology, 39(6), 877–883. https://doi.org/10.1007/s10802-011-9494-6
20.
GarciaA. M.FreemanJ. B.HimleM. B.BermanN. C.OgataA. K.NgJ.Choate-SummersM. L.LeonardH. (2009). Phenomenology of early childhood onset obsessive-compulsive disorder. Journal of Psychopathology and Behavioral Assessment, 31(2), 104–111. https://doi.org/10.1007/s10862-008-9094-0
21.
GellerDaniel A (2006). Obsessive-compulsive and spectrum disorders in children and adolescents. Psychiatr Clin North Am, 0193-953X29(2), 353–70. DOI:10.1016/j.psc.2006.02.012. 16650713.
22.
GellerD. A.BiedermanJ.FaraoneS. V.BellordreC. A.KimG. S.HagermoserL.CradockK.FrazierJ.CoffeyB. J. (2001). Disentangling chronological age from age of onset in children and adolescents with obsessive-compulsive disorder. The International Journal of Neuropsychopharmacology, 4(2), 169–178. https://doi.org/10.1017/s1461145701002395
23.
HannaG. L.HimleJ. A.CurtisG. C.GillespieB. W. (2005). A family study of obsessive-compulsive disorder with pediatric probands. American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics: The Official Publication of The International Society of Psychiatric Genetics, 134B(1), 13–19. https://doi.org/10.1002/ajmg.b.30138
24.
IervolinoA. C.RijsdijkF. V.CherkasL.FullanaM. A.Mataix-ColsD. (2011). A multivariate twin study of obsessive-compulsive symptom dimensions. Archives of General Psychiatry, 68(6), 637–644. https://doi.org/10.1001/archgenpsychiatry.2011.54
25.
KirinoE. (2012). Efficacy and safety of aripiprazole in children and adolescent patients. European Child and Adolescent Psychiatry, 21(7), 361–368. https://doi.org/10.1007/s00787-012-0270-0
26.
KoranL. (1999). Obsessive-compulsive and related disorders in adults: A comprehensive clinical guide. Cambridge University Press.
27.
LanJ.SherT. G. (2019). Cognitive-behavioral family therapy. InLebowJ. L.ChambersA. I.BreunlinD. (Eds.), Encyclopedia of couple and family therapy. Springer Publishing Company.
28.
LeonardH. L.GoldbergerE. L.RapoportJ. L.CheslowD. L.SwedoS. E. (1990). Childhood rituals: Normal development or obsessive-compulsive symptoms?Journal of the American Academy of Child and Adolescent Psychiatry, 29(1), 17–23. https://doi.org/10.1097/00004583-199001000-00004
29.
LiZ.JiW.LiD.LiX.FengW. (2014). Microstructural abnormality in left nucleus accumbens predicts dysfunctional beliefs in treatment-resistant obsessive-compulsive disorder. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 20, 2275–2282. https://doi.org/10.12659/msm.891102
30.
ManceboM. C.GreenbergB.GrantJ. E.PintoA.EisenJ. L.DyckI.RasmussenS. A. (2008). Correlates of occupational disability in a clinical sample of obsessive-compulsive disorder. Comprehensive Psychiatry, 49(1), 43–50. https://doi.org/10.1016/j.comppsych.2007.05.016
31.
MarcusR. N.OwenR.KamenL.ManosG.McQuadeR. D.CarsonW. H.AmanM. G. (2009). A placebo-controlled, fixed-dose study of aripiprazole in children and adolescents with irritability associated with autistic disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 48(11), 1110–1119. https://doi.org/10.1097/chi.0b013e3181b76658
32.
MasiG.CosenzaA.MillepiediS.MuratoriF.PariC.SalvadoriF. (2009). Aripiprazole monotherapy in children and young adolescents with pervasive developmental disorders: A retrospective study. CNS Drugs, 23(6), 511–521. https://doi.org/10.2165/00023210-200923060-00005
33.
MasiG.MillepiediS.MucciM.BertiniN.MilantoniL.ArcangeliF. (2005). A naturalistic study of referred children and adolescents with obsessive-compulsive disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 44(7), 673–681. https://doi.org/10.1097/01.chi.0000161648.82775.ee
34.
MerloL. J.LehmkuhlH. D.GeffkenG. R.StorchE. A. (2009). Decreased family accommodation associated with improved therapy outcome in pediatric obsessive-compulsive disorder. Journal of Consulting and Clinical Psychology, 77(2), 355–360. https://doi.org/10.1037/a0012652
35.
MiyawakiD.GotoA.IwakuraY.HiraiK.MikiY.AsadaN.TerakawaH.InoueK. (2018). Preschool-onset obsessive-compulsive disorder with complete remission. Neuropsychiatric Disease and Treatment, 14, 1747–1753. https://doi.org/10.2147/ndt.s169797
36.
MuscatelloM. R.BrunoA.PandolfoG.MicòU.ScimecaG.RomeoV. M.SantoroV.SettineriS.SpinaE.ZoccaliR. A. (2011). Effect of aripiprazole augmentation of serotonin reuptake inhibitors or clomipramine in treatment-resistant obsessive-compulsive disorder: A double-blind, placebo-controlled study. Journal of Clinical Psychopharmacology, 31(2), 174–179. https://doi.org/10.1097/jcp.0b013e31820e3db6
37.
O’ConnorK. P.AardemaF.BouthillierD.FournierS.GuayS.RobillardS.PélissierM. C.LandryP.TodorovC.TremblayM.PitreD. (2005). Evaluation of an inference-based approach to treating obsessive-compulsive disorder. Cognitive Behavior Therapy, 34(3), 148–163. https://doi.org/10.1080/16506070510041211
38.
PerisT. S.SugarC. A.BergmanR. L.ChangS.LangleyA.PiacentiniJ. (2012). Family factors predict treatment outcomes for pediatric obsessive-compulsive disorder. Journal of Consulting and Clinical Psychology, 80(2), 255–263. https://doi.org/10.1037/a0027084
39.
RapoportJ. L.Inoff-GermainG.WeissmanM. M.GreenwaldS.NarrowW. E.JensenP. S.LaheyB. B.CaninoG. (2000). Childhood obsessive-compulsive disorder in the NIMH MECA study: Parent versus child identification of cases methods for the epidemiology of child and adolescent mental disorders. Journal of Anxiety Disorders, 14(6), 535–548. https://doi.org/10.1016/s0887-6185(00)00048-7
40.
RapoportJ. L.SwedoS. (2003). Obsessive-compulsive disorder. In RutterM.TaylorE. (Eds.), Rutter’s child and adolescent psychiatry (6th ed., pp. 571–592). Blackwell Publishing.
41.
ReynoldsS.WilsonC.AustinJ.HooperL. (2012). Effects of psychotherapy for anxiety in children and adolescents: A meta-analytic review. Clinical Psychology Review, 32(4), 251–262. https://doi.org/10.1016/j.cpr.2012.01.005
42.
ScahillL.KanoY.KingR. A.CarlsonA.PellerA.LeBrunU.Do Rosario-CamposM. C.LeckmanJ. F. (2003). Influence of age and tic disorders on obsessive-compulsive disorder in a pediatric sample. Journal of Child and Adolescent Psychopharmacology, 13(Suppl 1), S7–S17. https://doi.org/10.1089/104454603322126304
43.
StorchE. A.GeffkenG. R.MerloL. J.JacobM. L.MurphyT. K.GoodmanW. K.LarsonM. J.FernandezM.GrabillK. (2007). Family accommodation in pediatric obsessive-compulsive disorder. Journal of Clinical Child and Adolescent Psychology, 36(2), 207–216. https://doi.org/10.1080/15374410701277929
44.
TramontinaS.ZeniC. P.KetzerC. R.PheulaG. F.NarvaezJ.RohdeL. A. (2009). Aripiprazole in children and adolescents with bipolar disorder comorbid with attention-deficit/hyperactivity disorder: A pilot randomized clinical trial. The Journal of Clinical Psychiatry, 70(5), 756–764. https://doi.org/10.4088/jcp.08m04726
45.
TurnerC. M. (2006). Cognitive-behavioral theory and therapy for obsessive-compulsive disorder in children and adolescents: Current status and future directions. Clinical Psychology Review, 26(7), 912–938. https://doi.org/10.1016/j.cpr.2005.10.004
46.
ÜnalFatihÖktemFerhundeÇetin ÇuhadaroğluFüsunÇengel KültürS EbruAkdemirDevrimFoto ÖzdemirDilşadÇakHalime TunaÜnalDilekTıraşKevserAslanCihanKalaycıBilge MerveAydosBüşra SultanKütükFundaTaşyürekEmineKaraokurRemziKarabucakBaşakKarakökBurakKaraerYusufArtıkAbdülbaki (2019). [Reliability and Validity of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version, DSM-5 November 2016-Turkish Adaptation (K-SADS-PL-DSM-5-T)]. Turk Psikiyatri Derg, 30(1), 42–50. 31170306.
47.
Van der BruggenC. O.StamsG. J. J. M.BoegelsS. M. (2008). Research review: The relation between child and parent anxiety and parental control: A meta-analytic review. Journal of Child Psychology and Psychiatry, 49(12), 1257–1269. https://doi.org/10.1111/j.1469-7610.2008.01898.x
48.
WatsonH. J.ReesC. S. (2008). Meta-analysis of randomized, controlled treatment trials for pediatric obsessive-compulsive disorder. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 49(5), 489–498. https://doi.org/10.1111/j.1469-7610.2007.01875.x
49.
WilcoxH. C.GradosM.SamuelsJ.RiddleM. A.BienvenuO. J.3rdPintoA.CullenB.WangY.ShugartY. Y.LiangK. Y.NestadtG. (2008). The association between parental bonding and obsessive-compulsive disorder in offspring at high familial risk. Journal of Affective Disorders, 111(1), 31–39. https://doi.org/10.1016/j.jad.2008.01.025
50.
YucelenA. G.Rodopman-ArmanA.TopcuogluV.YazganM. Y.FisekG. (2006). Interrater reliability and clinical efficacy of children's yale-brown obsessive-compulsive scale in an outpatient setting. Comprehensive Psychiatry, 47(1), 48–53. https://doi.org/10.1016/j.comppsych.2005.04.005
51.
ZoharA. H.FelzL. (2001). Ritualistic behavior in young children. Journal of Abnormal Child Psychology, 29(2), 121–128. https://doi.org/10.1023/a:1005231912747
