Obsessive-compulsive disorder (OCD) is characterized by unwanted, intrusive thoughts (obsessions), which often compel sufferers to repeatedly perform ritualistic behaviors or routines (compulsions) in order to ease their anxiety. These compulsions are excessive and often illogical. Common obsessions include, but are not limited to, fears of contamination by dirt or germs, excessive concern regarding order, fear that one will cause harm to a loved one, excessive doubting, preoccupation with throwing things away that are of little value, and bothersome religious or sexual thoughts. Common compulsions include, but are not limited to, excessive handwashing, repeated checking, hoarding, repetition of words, phrases or activities, touching or arranging, and mental rituals (e.g., excessive praying or use of special words or “good” thoughts to neutralize “bad” thoughts).

Youth with OCD spend a significant amount of their time (at least one hour per day) engaging in rituals. This significantly interferes with everyday activities and can cause problems with schoolwork, school attendance, family relationships, and peer relations. Rituals, such as excessive handwashing, can pose health risks, such washing hands until they are raw or bleed. Most adults with OCD typically recognize that their rituals are irrational, but feel unable to control or stop them. Most children do not realize that their behavior is irrational or excessive.

OCD affects approximately 2-3% of children and adolescents. Typical onset occurs between 9-12 years old. There appear to two peaks, one in early childhood and one in early adolescence. Evidence suggests that those with early onset OCD tend to have a family history of OCD. Boys tend to develop OCD before puberty, whereas girls are more likely to develop it during adolescence.

References

• Albano, A. M., Chorpita, B. F., & Barlow, D. H. (1996). Childhood anxiety disorders. In E.J. Marsh & R. A. Barkley (Eds.), Child psychopathology (pp. 196-241). New York: Guilford Press.

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• Hanna, G. (1995). Demographic and clinical features of obsessive-compulsive disorder in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 19-27.

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• Piacentini, J., & Graae, F. (1997). Childhood OCD. In E. Hollander & D. Stein (Eds.), Obsessive-compulsive disorders: Diagnosis, etiology, treatment (pp. 23-46). New York: Marcel Dekker.

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• Swedo, S. E., Rapoport, J. L., Leonard, H., Lenane, M., & Cheslow, D. (1989). Obsessive-compulsive disorder in children and adolescents: Clinical phenomenology of 70 consecutive cases. Archives of General Psychiatry, 46, 335-341.