Obsessive-compulsive Disorder in Children and Teens

Reviewed Nov 10, 2017

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Summary

  • OCD is not the result of bad parenting.
  • OCD can lead to excessive hand washing, questioning, and double checking.
  • PANDAS is an intense onset of OCD caused by strep infections.

Obsessive-compulsive disorder (OCD) is one of the most common childhood mental illnesses. It can start as early as the toddler years but may not be noticed right away. Often a teacher or school counselor may be the first one to spot it. Students with OCD may take an extra-long time with schoolwork. This is due to a constant checking and rechecking of answers.

Along with doubt, kids with OCD also become obsessed with fear. This could be the fear of illness, being impure, or being in some other danger. This fear and doubt compels the child to repeat rituals. Some of these are too much hand washing, and endless questioning and double checking. The child can also become obsessed with certain numbers or with having things done a certain way. This can lead to urges to count, repeat, touch, organize, and rearrange things. Children who display OCD-type symptoms should be referred to a child and adolescent psychiatrist for proper diagnosis.

Development

The peer pressure of trying to fit in is only made stronger by OCD. While younger children may not realize anything is wrong, older kids with OCD may feel ashamed. They may try to hide their compulsions at school or when out with friends. Some may even try to hide them from their own family. Other kids try to involve family members in their OCD rituals. This can put a great need on parents and siblings. A number of children with OCD will also tend to have tic disorders. This is very true of boys.

Causes

OCD may be passed down through families, but it is not the result of bad parenting. It is not clear why some children will get OCD while others will not. It is thought to be caused by a chemical imbalance in the brain. While most symptoms of OCD come slowly, in some cases they seem to appear overnight. Research shows that these sudden cases are often due to untreated strep infections.

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS)

PANDAS is a sudden, intense onset of OCD symptoms in children that is due to strep infections. This is often a strep throat or scarlet fever infection that was untreated. It may have occurred months before but went unnoticed. In some cases it was noticed but only partly treated.

The OCD symptoms come on very quickly and can become full blown within one to two days. The child may also display tics or signs of other mental illness. These can involve major separation anxiety and other panic-type behaviors. The child may have trouble focusing or become hyper, irritable, or depressed. Some kids will show signs of regression. This could be using baby talk, throwing temper tantrums, or bed-wetting.
 
Treatment of PANDAS and OCD

The sudden and severe nature of PANDAS can be very scary to parents. They may feel like their child has become a different person overnight. Kids who display symptoms of PANDAS need to be tested right away for active strep infection. If the results are positive, antibiotics should be given. This will take care of the infection and also lessen most of the symptoms. The child should also be checked for tic disorder or Tourette syndrome.

Children with OCD can be treated with cognitive-behavioral therapy, antidepressants (SSRIs), or both. This is true whether the symptoms are PANDAS-related or not. SSRIs should be started at very low doses to cut down on side effects. This is even more vital for children with PANDAS who can be overly sensitive to drugs. WRAP® for Kids can also be effective.

Resources

Swidey, Neil (2012) “The PANDAS puzzle: Can a common infection cause OCD in kids?” Boston Globe Magazine, The Medical Issue: Mysteries Within
www.bostonglobe.com/magazine/2012/10/27/the-pandas-puzzle-can-common-infection-cause-ocd-kids/z87df6Vympu7bvPtapETLJ/story.html

Ten Turtles on Tuesday: A Story for Children About Obsessive–Compulsive Disorder by Ellen Flanagan Burns, Magination Press/American Psychological Association, 2014.

By Kevin Rizzo
Source: National Alliance on Mental Illness; National Institute of Mental Health, www.nimh.nih.gov/labs-at-nimh/research-areas/clinics-and-labs/pdnb/web.shtml
Reviewed by Paulo Correa, MD, Medical Director, Beacon Health Options

Summary

  • OCD is not the result of bad parenting.
  • OCD can lead to excessive hand washing, questioning, and double checking.
  • PANDAS is an intense onset of OCD caused by strep infections.

Obsessive-compulsive disorder (OCD) is one of the most common childhood mental illnesses. It can start as early as the toddler years but may not be noticed right away. Often a teacher or school counselor may be the first one to spot it. Students with OCD may take an extra-long time with schoolwork. This is due to a constant checking and rechecking of answers.

Along with doubt, kids with OCD also become obsessed with fear. This could be the fear of illness, being impure, or being in some other danger. This fear and doubt compels the child to repeat rituals. Some of these are too much hand washing, and endless questioning and double checking. The child can also become obsessed with certain numbers or with having things done a certain way. This can lead to urges to count, repeat, touch, organize, and rearrange things. Children who display OCD-type symptoms should be referred to a child and adolescent psychiatrist for proper diagnosis.

Development

The peer pressure of trying to fit in is only made stronger by OCD. While younger children may not realize anything is wrong, older kids with OCD may feel ashamed. They may try to hide their compulsions at school or when out with friends. Some may even try to hide them from their own family. Other kids try to involve family members in their OCD rituals. This can put a great need on parents and siblings. A number of children with OCD will also tend to have tic disorders. This is very true of boys.

Causes

OCD may be passed down through families, but it is not the result of bad parenting. It is not clear why some children will get OCD while others will not. It is thought to be caused by a chemical imbalance in the brain. While most symptoms of OCD come slowly, in some cases they seem to appear overnight. Research shows that these sudden cases are often due to untreated strep infections.

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS)

PANDAS is a sudden, intense onset of OCD symptoms in children that is due to strep infections. This is often a strep throat or scarlet fever infection that was untreated. It may have occurred months before but went unnoticed. In some cases it was noticed but only partly treated.

The OCD symptoms come on very quickly and can become full blown within one to two days. The child may also display tics or signs of other mental illness. These can involve major separation anxiety and other panic-type behaviors. The child may have trouble focusing or become hyper, irritable, or depressed. Some kids will show signs of regression. This could be using baby talk, throwing temper tantrums, or bed-wetting.
 
Treatment of PANDAS and OCD

The sudden and severe nature of PANDAS can be very scary to parents. They may feel like their child has become a different person overnight. Kids who display symptoms of PANDAS need to be tested right away for active strep infection. If the results are positive, antibiotics should be given. This will take care of the infection and also lessen most of the symptoms. The child should also be checked for tic disorder or Tourette syndrome.

Children with OCD can be treated with cognitive-behavioral therapy, antidepressants (SSRIs), or both. This is true whether the symptoms are PANDAS-related or not. SSRIs should be started at very low doses to cut down on side effects. This is even more vital for children with PANDAS who can be overly sensitive to drugs. WRAP® for Kids can also be effective.

Resources

Swidey, Neil (2012) “The PANDAS puzzle: Can a common infection cause OCD in kids?” Boston Globe Magazine, The Medical Issue: Mysteries Within
www.bostonglobe.com/magazine/2012/10/27/the-pandas-puzzle-can-common-infection-cause-ocd-kids/z87df6Vympu7bvPtapETLJ/story.html

Ten Turtles on Tuesday: A Story for Children About Obsessive–Compulsive Disorder by Ellen Flanagan Burns, Magination Press/American Psychological Association, 2014.

By Kevin Rizzo
Source: National Alliance on Mental Illness; National Institute of Mental Health, www.nimh.nih.gov/labs-at-nimh/research-areas/clinics-and-labs/pdnb/web.shtml
Reviewed by Paulo Correa, MD, Medical Director, Beacon Health Options

Summary

  • OCD is not the result of bad parenting.
  • OCD can lead to excessive hand washing, questioning, and double checking.
  • PANDAS is an intense onset of OCD caused by strep infections.

Obsessive-compulsive disorder (OCD) is one of the most common childhood mental illnesses. It can start as early as the toddler years but may not be noticed right away. Often a teacher or school counselor may be the first one to spot it. Students with OCD may take an extra-long time with schoolwork. This is due to a constant checking and rechecking of answers.

Along with doubt, kids with OCD also become obsessed with fear. This could be the fear of illness, being impure, or being in some other danger. This fear and doubt compels the child to repeat rituals. Some of these are too much hand washing, and endless questioning and double checking. The child can also become obsessed with certain numbers or with having things done a certain way. This can lead to urges to count, repeat, touch, organize, and rearrange things. Children who display OCD-type symptoms should be referred to a child and adolescent psychiatrist for proper diagnosis.

Development

The peer pressure of trying to fit in is only made stronger by OCD. While younger children may not realize anything is wrong, older kids with OCD may feel ashamed. They may try to hide their compulsions at school or when out with friends. Some may even try to hide them from their own family. Other kids try to involve family members in their OCD rituals. This can put a great need on parents and siblings. A number of children with OCD will also tend to have tic disorders. This is very true of boys.

Causes

OCD may be passed down through families, but it is not the result of bad parenting. It is not clear why some children will get OCD while others will not. It is thought to be caused by a chemical imbalance in the brain. While most symptoms of OCD come slowly, in some cases they seem to appear overnight. Research shows that these sudden cases are often due to untreated strep infections.

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS)

PANDAS is a sudden, intense onset of OCD symptoms in children that is due to strep infections. This is often a strep throat or scarlet fever infection that was untreated. It may have occurred months before but went unnoticed. In some cases it was noticed but only partly treated.

The OCD symptoms come on very quickly and can become full blown within one to two days. The child may also display tics or signs of other mental illness. These can involve major separation anxiety and other panic-type behaviors. The child may have trouble focusing or become hyper, irritable, or depressed. Some kids will show signs of regression. This could be using baby talk, throwing temper tantrums, or bed-wetting.
 
Treatment of PANDAS and OCD

The sudden and severe nature of PANDAS can be very scary to parents. They may feel like their child has become a different person overnight. Kids who display symptoms of PANDAS need to be tested right away for active strep infection. If the results are positive, antibiotics should be given. This will take care of the infection and also lessen most of the symptoms. The child should also be checked for tic disorder or Tourette syndrome.

Children with OCD can be treated with cognitive-behavioral therapy, antidepressants (SSRIs), or both. This is true whether the symptoms are PANDAS-related or not. SSRIs should be started at very low doses to cut down on side effects. This is even more vital for children with PANDAS who can be overly sensitive to drugs. WRAP® for Kids can also be effective.

Resources

Swidey, Neil (2012) “The PANDAS puzzle: Can a common infection cause OCD in kids?” Boston Globe Magazine, The Medical Issue: Mysteries Within
www.bostonglobe.com/magazine/2012/10/27/the-pandas-puzzle-can-common-infection-cause-ocd-kids/z87df6Vympu7bvPtapETLJ/story.html

Ten Turtles on Tuesday: A Story for Children About Obsessive–Compulsive Disorder by Ellen Flanagan Burns, Magination Press/American Psychological Association, 2014.

By Kevin Rizzo
Source: National Alliance on Mental Illness; National Institute of Mental Health, www.nimh.nih.gov/labs-at-nimh/research-areas/clinics-and-labs/pdnb/web.shtml
Reviewed by Paulo Correa, MD, Medical Director, Beacon Health Options

The information provided on the Achieve Solutions site, including, but not limited to, articles, quizzes, and other general information, is for informational purposes only and should not be treated as medical, health care, psychiatric, psychological or behavioral health care advice. Nothing contained on the Achieve Solutions site is intended to be used for medical diagnosis or treatment or as a substitute for consultation with a qualified health care professional. Please direct questions regarding the operation of the Achieve Solutions site to Web Feedback. If you have concerns about your health, please contact your health care provider.  ©2017 Beacon Health Options, Inc.

 

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