精神医学63巻6号

2021年06月発行

特集 強迫についてあらためて考える

強迫とこころの発達

著者： 金生由紀子¹

所属機関： ¹東京大学医学部附属病院こころの発達診療部

ページ範囲：P.969 - P.975

抄録　強迫とこころの発達について，一般の子ども・若者における知見を中心に先行研究を検討した。反復的，儀式的行動は，強迫様行動とも言うことができ，2〜4歳の一般の幼児の大多数に認められ，その時期における定型発達の一部と思われる。5〜6歳になると実行機能の発達が進み，自己制御が高まるとともに不安が軽減されて強迫様行動が減少すると思われる。一方，強迫症状は，一般の子ども・若者で，10歳からいったん減少した後に20歳に近づくと増加に転じる可能性が高く，強迫症(OCD)の発症年齢が10歳前後と20歳前後という2つのピークを有することに対応すると思われる。強迫性と神経ネットワーク結合との関連が示唆されており，発達の経過中で相互に影響する可能性があるが，さらなる検討を要すると思われる。強迫様行動と強迫症状の関連が示されているが，それについても検討を進めることが望まれる。

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