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The cause of OCD is not known, but as is the case with many psychiatric conditions, thought to be multifactorial. 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. Certain environmental triggers during pregnancy and/or stressful life experiences have also been associated with OCD. Recent studies suggest that streptococcal infections may trigger the onset or increase the severity of OCD.
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. The ratio of males affected by OCD is twice that of females. The mean age of onset for pediatric OCD can be between 9-11 years old for boys and 11-13 years in girls. Twenty percent of children and adolescents with OCD also have another family member with OCD.
There are two hallmark symptoms of OCD, obsessions and compulsions. Individuals with the disorder may experience either symptom or both.
Obsessions are defined as recurrent and persistent thoughts, urges, or impulses that are experienced, at some time during the disturbance, as intrusive (bothersome), unwanted, and that most individuals find distressing. The child attempts to ignore or suppress such obsessions with some other thought or action (i.e. performing a compulsion).
The following are the most common obsessions
The following are common compulsive behaviors:
Note: 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.
Many children can have routines that they do in the context of normal development as discussed above. Concern should arise if you note that the thoughts and/or routines that your child engages in become excessive (i.e. taking up large portions of their time) and cause distress; or if the rituals/routines negatively impact your child’s social/interpersonal relationships, academic performance, daily mood, and/or sleep. If any of these signs are present, it is best to seek the advice of a mental health specialist and have your child evaluated.
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 their quality of life.
A substantial percentage of pediatric OCD cases will become “subclinical” over time, meaning that the symptoms will remit and/or reduce in severity so that there is no impact on daily functioning. For individuals who continue to have symptoms into adulthood, ongoing psychotherapy and medication treatment are recommended to help alleviate the impact that OCD symptoms have on daily life.
A calm, supportive family environment in which parents and/or caregivers actively support the child's coping strategies also should improve outcome.
A substantial portion of individuals with OCD will have a co-occurring psychiatric illness which can complicate the effectiveness of treatment in the child or adolescent.
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”