Frequently Asked Questions
It is unclear exactly what causes OCD, but several factors are thought to play a role in increasing the risk for OCD including genetics, family history, enabling behaviors by family members, certain conditions and complications of pregnancy, tic disorders, and autoimmune diseases like strep.
OCD is seen in as many as 1-3% of children and adolescents.
OCD does run in families and can be passed down through genes from parent to child.
OCD is treated with therapy, psychoeducation and/or medication. The type of therapy thought to be most effective is called Cognitive Behavioral Therapy (CBT) with Exposure Response Prevention (ERP). CBT helps people understand that there is a connection between their thoughts, moods and actions, and if they change their thoughts to be less anxious and more realistic, their moods and actions can improve, too. ERP involves exposing the child to something that makes them anxious (like a public door handle) and then encouraging them to resist the urge to do the ritual (like washing their hands over and over). By resisting the urge, they get used to the anxious feeling and they learn it slowly gets better with time, and without needing to perform the ritual. Then the need to do the ritual slowly gets better.
Not all kids with OCD will need medication. If medication is recommended, medications from the SSRI (Selective Serotonin Reuptake Inhibitor) class are most commonly prescribed. These medications include sertraline, fluoxetine, fluvoxamine, citalopram, escitalopram, and others. An older medication called clomipramine from the tricyclic antidepressant (TCA) class is also prescribed for OCD. Sometimes medications from other classes are added to the these medications, as well, to help the initial medication have a bigger effect.
Children and teens with OCD can get better, especially if treated early.
Obsessive Compulsive Personality Disorder is different from OCD. It is not diagnosed until adulthood. It is a based on a pattern of behaviors and personality traits that get in the way of a balanced life and getting things done efficiently, like perfectionism, extreme orderliness, working way too hard, overthinking things, and being really controlling.
Pediatric AutoimmuneNeuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) is a diagnosis given when OCD symptoms come on suddenly or worsen suddenly after a strep infection. Sometimes involuntary repetitive movements or vocalizations called tics occur with the obsessions and/or compulsions. Mood symptoms and anxiety can appear, as well. PANDAS is thought to be triggered by an autoimmune reaction of the body trying to fight the strep virus but attacking its own cells, as well. No lab test can diagnose PANDAS, though blood tests can show a present, recent or past strep infection. A clinician makes the diagnosis after hearing the history and examining the child. The symptoms gradually get better, but can worsen if they catch strep again. The treatment for acute strep infection is antibiotics. The treatment for the OCD symptoms or tics in PANDAS is the same as for OCD or tics without strep infection.
Some of the most common other disorders that children and teens with OCD have include another anxiety disorder, Attention Deficit Hyperactivity Disorder, mood disorders, eating disorders, and tic disorders.