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Questions & Answers About OCD In Children and Adolescents

By — Obsessive Compulsive Foundation
Updated on Feb 18, 2011

What is Obsessive Compulsive Disorder?

Obsessive Compulsive Disorder (OCD) is one of the most common psychiatric illnesses affecting young people.

OCD is an illness in which obsessions and/or compulsions are present. Obsessions are unwanted thoughts, images or impulses which cause distress. Compulsions are behaviors or actions performed to alleviate the distress caused by unwanted intrusive
thoughts. To be diagnosed with OCD, the obsessions or compulsions must last for more than one hour a day, or cause significant distress, or significantly impair daily functioning.

Avoidance of various stimuli — objects, persons, images, thoughts, etc. — that trigger obsessions and compulsions is common in OCD, which affects approximately 2%-3% of all children and adolescents in the United States. Although adults with OCD are usually aware that the obsessions or compulsions are unreasonable or excessive, this insight is not always present in children and adolescents.

What are some typical obsessions and compulsions?

Common obsessions include unrealistic fears of being contaminated, of causing harm to others, and of incompleteness. These obsessions can include blasphemous and/or strange sexual thoughts, a problem with the lack of symmetry or a need for certainty. Typical compulsions include repetitive behaviors such as rereading, rewriting, checking, cleaning, counting, ordering, and doing something over and over again until it feels “just right.” OCD-affected individuals compulsively seek reassurance by asking the same question repeatedly, despite having already received the answer.

What age groups are at risk for OCD?

OCD is an illness that affects children, adolescents and adults. In large population studies, it was discovered that one-half to two-thirds of adult OCD cases started in childhood.

Although OCD does occur at earlier ages, there are generally two peak ages for the onset of OCD. The first peak of onset occurs in preadolescence between 10-12 years of age. The second peak occurs in adulthood in the 20’s and early 30’s.

Is there a cure for OCD?

Unfortunately, at the present time there is no cure for OCD. However, there are treatment approaches that have been proven to control OCD symptoms in many cases. The “gold standard” of treatment for OCD includes both medications and cognitive-behavior therapy. Anti-OCD medications control symptoms, but do not “cure” the disorder. This means that the positive effects of an anti-OCD medication only occur as long as the drug is being taken. Even while taking antiobsessional
medications, some symptoms continue but are less severe.

Are treatments for children different from those for adults?

Management of OCD is very similar in all age groups. Behavior therapy approaches for young people are modified to be more “childfriendly” and accessible to a child’s understanding.

When are medications used in childhood and adolescent OCD?

Medication is considered when children are experiencing significant OCD-related impairment or distress, and when cognitive-behavioral therapy is unavailable or only partially effective. The benefits must be judged to out- weigh the risks when medications are used.

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