It can be difficult to diagnose a child with obsessive-compulsive disorder (OCD), says Jeffrey Kent, MD, a child and adolescent psychiatrist in private practice. “Often, it will first show up as irritability, anger, or school problems,” Dr. Kent explains. “Lots of kids hide their true symptoms because they don’t know that there is anything anyone can do about them.” According to the American Academy of Child and Adolescent Psychiatry (AACAP), when a child has OCD, they may have obsessive, uncontrollable thoughts about almost anything, such as being exposed to dangerous germs or a specific violent image. In order to diminish the anxiety, children with OCD often compulsively repeat behaviors that may relate to the content of the obsessions, like excessive hand-washing or repeatedly checking door locks.
As of yet, there has no single definitive cause of OCD determined; however, there is clearly a link to problems with pathways and chemicals in the brain. For that reason, antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), are often effective. In recent years, evidence has linked the onset of OCD in some children with strep infections, says Kent. Research suggests that an antibody against the streptococcus bacteria, which is a part of the body’s natural immune function to fight infection, acts on a brain enzyme and triggers an acute disorder in children that mimics the effects of OCD.
According to the International OCD Foundation, there are four drugs, all SSRIs that have been specifically approved for treating OCD in children. None of these drugs modify OCD symptoms overnight, or even in a week. It can take several weeks or months to see significant improvement. If the first medication does not seem to be working, the does can be modified or other medications can be tried until the right match for the child is found. Another possible treatment for OCD in children is psychotherapy, especially cognitive or behavioral therapy. It is also very important for parents, siblings and other close family members to become educated about OCD and provide emotional support to the child.