Obsessive-compulsive disorder in children: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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Obsessive-compulsive disorder is characterized by obsessions, compulsions, or both. Obsessions and compulsions cause marked distress and affect achievement and social functioning. Diagnosis is based on anamnestic data. Treatment includes behavioral therapy and SSRI.
In most cases, obsessive-compulsive disorder (OCD) does not have an explicit etiologic factor. Nevertheless, some cases seem to be related infections caused by group A beta-hemolytic streptococcus. This syndrome is called a pediatric autoimmune neuropsychiatric disorder associated with streptococcus (PANDAS). PANDAS should be suspected in all children with sudden onset of severe symptoms similar to obsessive-compulsive disorder in children, since early antibiotic therapy can prevent or reduce long-term effects. To date, in this area are actively conducted research, and if you suspect a PANDAS highly recommended specialist advice.
[Symptoms of obsessive-compulsive disorder in children
In typical cases, obsessive-compulsive disorder in children has a gradual, inconspicuous beginning. Most of the children at the beginning hide the symptoms, and on examination it turns out that they were present a few years before the diagnosis.
Obsessions, as a rule, are experiences or fears of some unfavorable event, for example, infecting with a deadly disease, sinning and going to hell, as well as some forms of traumatizing oneself or others. Compulsions are deliberate deliberate actions, usually performed to neutralize or oppose obsessive fears, such as constant checks and recheckings; excessive washing, recounting, putting in order, leveling and much more. The conjunction of obsession and compulsion can have an element of logic, for example washing hands in order not to become infected. In other cases, communication can be illogical, for example, count to 50 to prevent the development of a heart attack in the grandfather.
Most children experience some anxiety that their obsessions and compulsions are abnormal. Many children are shy and secretive. Abrasions and cracks in the hands may be signs that the child is compulsively washing them. Another common symptom is the extremely long stay of the child in the bathroom. Homework can be done very slowly (because of a discussion about errors) or may be abounded with corrections. Parents can notice that the child performs repetitive or bizarre actions, for example, checks the door lock, chews food a certain number of times, avoids touching some things.
Such children often and tediously ask to calm them, are reinsured, sometimes tens or even hundreds of times a day. Some examples of the desire to make sure and calm down include such questions as "Do you think I have a temperature? Can there be a tornado here? Do you think the car will start? What if we're late? What if the milk is sour? What if a burglar comes to us? "
Prognosis and treatment of obsessive-compulsive disorder in children
Approximately in 5% of cases the disorder weakens in some years and therapy can be stopped. In other cases a tendency to chronic course is noted, however, normal functioning can be maintained while continuing treatment. Approximately 5% of children are resistant to treatment, and their lifestyle remains severely impaired.
In the vast majority of cases not associated with streptococcal infection, treatment usually involves a combination of behavioral therapy and SSRI. If appropriate centers are available and the child is highly motivated, behavioral therapy can be used in isolation.