Obsessive compulsive disorder (OCD) is characterized by recurrent obsessions and compulsions that cause impairment in a child's day-to-day functioning. OCD falls under the category of anxiety disorders. According to the Diagnostic and Statistical Manual of Mental Disorders, OCD typically begins in adolescence or early adulthood but can begin in childhood. Males tend to exhibit the disorder at an earlier age than females. The symptoms in children are similar to those seen in adults except that children do not recognize their symptoms as being unusual or excessive.
Obsessions
Obsessions are thoughts, impulses or images that are persistent and cannot be controlled. According to the Children's Hospital of Philadelphia children may have an extreme preoccupation with dirt or germs, doubts such as whether or not a door is locked and excessive worry that something bad is going to happen. Other obsessions may be an extreme need for order, excessive attention to detail or a worry that something is lost or forgotten. These thoughts and images are more severe than just worrying about real life problems. The obsessions are usually not related to a situation that has occurred such as a recent robbery in the home. The problem is a product of the child's imagination.
Compulsions
Compulsions are the physical reaction to the obsessions. They are repetitive actions that take place to reduce the anxiety brought on by the obsessive thoughts. Compulsions can be physical rituals or mental acts. A child with a germ obsession may constantly avoid touching unclean objects or compulsively wash their hands even though they are clean. Someone with a fear of break-ins may check the door repeatedly even though it is locked and they have received reassurance that it is locked. Repeating sounds, words or phrases are another type of compulsion.
Impact On Functioning
The Diagnostic and Statistical Manual of Mental Disorders states that a diagnosis of OCD is reached if a child's obsessions and compulsions cause distress, are time consuming, or interfere with the child's daily functioning, social activities or relationships. Usually the problem is noticed by parents who subsequently bring a child in for treatment. Schoolwork tends to decline as the compulsions take up a large amount of time to carry out. Children tend to perform these rituals at home, out of the public eye and away from their peers. According to Healthy Place, OCD can turn into a life-long disorder if not treated. Children who cannot control their symptoms may become depressed. Older children may feel embarrassed by their problem and socially isolate themselves. Through the use of medication and psychotherapy many children can successfully recover from this disorder.
References
- The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, 2000.
- The Children's Hospital Of Philadelphia: Obsessive Compulsive Disorder
- Healthy Place: Obsessive-Compulsive Disorder in Children and Adolescents
