OCD in Children and Adolescents

What is Obsessive-Compulsive Disorder (OCD)?

Obsessive-Compulsive Disorder (OCD) usually begins in adolescence or young adulthood. It is characterized by recurring and intense obsessions and/or compulsions that cause extreme discomfort and interfere with daily functioning. Obsessions are recurring and persistent thoughts, impulses or undesired images which cause anxiety or stress. Usually, these are unrealistic or irrational. They are not just excessive worries about problems or preoccupations. Compulsions are repetitive or rituals, like hand washing, hoarding, organizing, checking something over and over. They can also be mental acts, like counting, repeating words silently or avoiding situations or places. 

What are signs of OCD in children/teens?

The obsessions or compulsions cause so much anxiety or stress that they interfere with the child's normal routine, functioning, social activities or relationships. The obsessive thoughts vary with age and may change over time. A young child with OCD may have thoughts that harm will occur to himself or a family member, such as an intruder in the house. The child may compulsively check all locks of the home after his parents are asleep in order to relieve anxiety. Then the child may fear that he may have accidentally unlocked the door while checking and must compulsively check over and over again. 

An older child or a teenager with OCD may fear that he will become ill with germs, disease or contaminated food. To cope with feelings, they may develop rituals, such as a behavior or activity that gets repeated. Sometimes the obsession and compulsion are linked: "If I stop checking or doing this, something bad will happen." 

OCD is a brain disorder and is usually hereditary. However, the child may not develop symptoms if his/her parent has the disorder. Recent studies have also shown that OCD may occur or worsen after a streptococcal bacterial infection. A child may also develop OCD with no family history. 

What are the effects of OCD in children/teens?

Children and adolescents feel shame and embarrassment about their OCD. Many fear it means they're crazy and will not talk about their thoughts and behaviors. Good communication between parents and children can help with understanding of the problem and the parents can appropriately help their child. 

How is OCD in children/teens treated?

Most children with OCD can be treated with a combination of psychotherapy (cognitive and behavioral) and certain medications, such as selective serotonin reuptake inhibitors (SSRI's). Family support and education are important to the success of treatment. 

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