Obsessive-compulsive disorder (OCD)

What causes obsessive-compulsive disorder?    

The cause of OCD is not known. Research indicates that OCD is a neurological brain disorder. Evidence suggests that people with OCD have a deficiency of a chemical in the brain called serotonin. OCD tends to run in families, suggesting a genetic component. However, OCD may also develop without a family history of OCD. Recent studies suggest that streptococcal infections may trigger the onset or increase the severity of OCD. 

Who is affected by obsessive-compulsive disorder?    

While symptoms of OCD do occur in children, it is recognized as a relatively common mental health disorder in adolescents, with up to 2 percent to 3 percent of children and adolescents having OCD. Unlike other anxiety disorders, twice as many males have OCD as females. Twenty percent of children and adolescents with OCD also have another family member with OCD. 

What are the symptoms of obsessive-compulsive disorder? 

The following are the most common symptoms of obsessive-compulsive disorder. However, each child may experience symptoms differently. Symptoms may include:   

• an extreme preoccupation with dirt, germs, or contamination
• repeated doubts (for example, whether or not the door is locked)
• obtrusive thoughts about violence, hurting, killing someone, or harming self
• spending long periods of time touching things, counting, thinking about numbers and sequences
• preoccupation with order, symmetry, or exactness
• persistent thoughts of performing repugnant sexual acts or forbidden, taboo behaviors
• troubled by thoughts that are against personal religious beliefs
• an extreme need to know or remember things that may be very trivial
• excessive attention to detail
• excessive worrying about something terrible happening

Compulsive behaviors (the repetitive rituals used to reduce anxiety caused by the obsessions) can become excessive, disruptive, and time-consuming, and may interfere with daily activities and relationships. Examples of compulsive behaviors may include:   

• repeated handwashing (often 100 or more times a day)
• checking and rechecking repeatedly (i.e., to ensure that a door is locked)
• following rigid rules of order (i.e., putting on clothes in the very same sequence every day, keeping belongings in the room in a very particular way and becoming upset if the order becomes disrupted)
• hoarding objects
• counting and recounting excessively
• grouping or sequencing objects
• repeating words spoken by self (palilalia) or others (echolalia); repeatedly asking the same questions
• coprolalia (repeatedly speaking obscenities) or copropraxia (repeatedly making obscene gestures)
• repeating sounds, words, numbers, and/or music to oneself

The symptoms of OCD may resemble other medical conditions or psychiatric problems, including Tourette's disorder. Always consult your child's physician for a diagnosis. 

Prevention of obsessive-compulsive disorder:    

Preventive measures to reduce the incidence of OCD in children are not known at this time. However, early detection and intervention can reduce the severity of symptoms, enhance the child's normal growth and development, and improve the quality of life experienced by children or adolescents with anxiety disorders.