Even young children can have OCD
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The symptoms of obsessive-compulsive disorder are familiar to most -- hand washing, checking, tapping, counting. But many may not be aware that these behaviors can be evident in children as young as 4.
A recent study found that very young children can exhibit full-blown OCD symptoms on a par with older children. ‘What’s been studied before has been older kids and adolescents, but not younger kids in this 8-and-under range,’ says Abbe Garcia, the study’s lead author and a staff psychologist at the Bradley Hasbro Children’s Research Center in Providence, R.I. She adds that many adults and adolescents with OCD report having had symptoms as children.
She quickly makes the distinction between OCD and what she calls ‘normal development rituals’ that young children can display -- asking a parent to read the same bedtime story three times, for instance. OCD behavior must meet specific criteria that includes obsessive and compulsive actions such as repetitive and anxiety-provoking thoughts and ritualized behaviors such as hand washing, cleaning and checking something over and over. The rituals offer only temporary relief, however, and not doing them can result in even more anxiety.
In the study, published online this month in the Journal of Psychopathology and Behavioral Assessment, 58 children between 4 and 8 with OCD were given clinical psychological evaluations. Researchers found that, on average, onset occurred at about age 5. Almost 50% experienced a gradual onset; and 29% had a chronic course, while 28% had a waxing and waning course. Many of the children had co-morbidities that included general anxiety disorder and separation anxiety.
The additional disorders were a surprise to Garcia: ‘We thought we’d just find OCD,’ she says, ‘and that the cascade of correlates might not be found at this age.’ Treatment for children with OCD typically consists of psychotherapy and/or medication such as selective serotonin reuptake inhibitors.
As for how the disorder could affect these children as they age, Garcia says the jury is still out. ‘We don’t really know even for older kids and adolescents what the prognosis is,’ she says, adding that some research suggests symptoms might decrease with age, while other studies show they might worsen.
‘If parents are concerned about their child,’ she says, ‘if their behavior is causing problems in the daily routine, then they should take their child to their pediatrician -- someone who knows the child well. If the level of concern is beyond that, take them to a child psychiatrist for evaluation. . . . Early intervention is important. The sooner they take their children in, the sooner they can get information and start a course of treatment.’
-- Jeannine Stein