Information on obsessive - compulsive disorder in children and adolescents including diagnosis, treatment and self-help materials.
People with obsessive-compulsive disorder (OCD) suffer intensely from recurrent, unwanted thoughts (obsessions) or rituals (compulsions), which they feel they cannot control. Rituals such as hand-washing, counting, checking, or cleaning are often performed with the hope of preventing obsessive thoughts or making them go away. Performing these rituals, however, provides only temporary relief, and not performing them markedly increases anxiety. Left untreated, obsessions and the need to perform rituals can take over a person's life. OCD is often a chronic, relapsing illness. Fortunately, through research supported by the National Institute of Mental Health (NIMH) and by industry, effective treatments have been developed to help people with OCD.
There is growing evidence that OCD represents abnormal functioning of brain circuitry, probably involving a part of the brain called the striatum. OCD is not caused by family problems or attitudes learned in childhood, such as an inordinate emphasis on cleanliness, or a belief that certain thoughts are dangerous or unacceptable. Brain imaging studies using a technique called positron emission tomography (PET) have compared people with and without OCD. Those with OCD have patterns of brain activity that differ from people with other mental illnesses or people with no mental illness at all. In addition, PET scans show that in patients with OCD, both behavioral therapy and medication produce changes in the striatum. This is graphic evidence that both psychotherapy and medication affect the brain.
Treatments for OCD have been developed through
research supported by the NIMH and other research
institutions. These treatments, which combine
medications and behavioral therapy (a specific type of
psychotherapy), are often effective. Several medications
have been proven effective in helping people with OCD:
clomipramine, fluoxetine, fluvoxamine, sertraline, and
paroxetine. If one drug is not effective, others should
be tried. A number of other medications are currently
being studied. A type of behavioral therapy known as
"exposure and response prevention" is very useful for
treating OCD. In this approach, a person is deliberately
and voluntarily exposed to whatever triggers the
obsessive thoughts, and then is taught techniques to
avoid performing the compulsive rituals and to deal with
the anxiety.
For a complete discussion on the treatment of OCD in
kids and teens, please go to Summary of the Practice
Parameters for the Assessment and Treatment of Children
and Adolescents with Obsessive-Compulsive Disorder by
the American Academy of Child and Adolescent Psychiatry.
OCD is sometimes accompanied by depression, eating
disorders, substance abuse, attention deficit
hyperactivity disorder, or other anxiety disorders. When
a person also has other disorders, OCD is often more
difficult to diagnose and treat. Symptoms of OCD can
also coexist and may even be part of a spectrum of other
brain disorders, such as Tourette's syndrome.
Appropriate diagnosis and treatment of other disorders
are important to successful treatment of OCD. Compulsive
hair pulling is known as trichotillomania.
Publication No. OM-99 4154 (Revised)
Printed September 1999
Childhood OCD can be a truly debilitating disability,
not just a minor problem or personality quirk. Children
with OCD experience extreme anxiety, embarrassment,
sometimes even harassment, because of this disorder.
Their OCD symptoms often prevent them from building good
relationships, from achieving their best in school, and
from having a normal childhood. The effects of this
disruption can be painful and lifelong.
The good news is that OCD is very treatable. With
prompt, consistent intervention, most young people with
OCD can wrest back control of their lives.
Obsessive-Compulsive Disorder helps parents: