What is Obsessive Compulsive Disorder (OCD)?

by S. Evelyn Stewart,M.D.

OCD: The Big Picture

• OCD is a common illness that often begins in childhood
• OCD is under-recognized and many individuals wait years before being diagnosed
• OCD is a real illness that affects the brain and tends to run in families
• OCD is not a result of something that the child, parent or others did wrong
• There is no known cure for OCD, but
• OCD is very treatable with cognitive-behavioral therapy (CBT) and medications
• Many professionals, artists, actors and athletes have OCD- your child’s future success does not have to be limited by OCD!

OCD: The Close Up

• OFFICIAL DEFINITION: OCD is described in the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV)3 as being characterized by repetitive thoughts, images, impulses, or actions that are distressing, time-consuming, or that affect function.
• OCD is a very common disorder that affects individuals throughout the lifespan.
• Symptoms experienced by OCD-sufferers are diverse.
• Obsessions can focus on aggressive and/or sexually intrusive thoughts, religious thoughts, concerns about symmetry, a part of the body, hoarding, pathological doubt, or thoughts of contamination. Sexual obsessions are not uncommon in children.
• Compulsions are also varied; they include washing, counting, checking, repeating, hoarding, ordering, arranging and the conduct of mental rituals.
• More often than not, patients with OCD experience more than one type of symptom at any given time, while the symptoms change over the long-term course of the illness.
• Approximately 2%-3% of the world’s population suffers from OCD at some point in their lives3.
• Although OCD often has a waxing and waning course, it may increase in severity when left untreated, which causes unnecessary pain to those afflicted and to their families.
• OCD is often kept a secret, even from family members, due to the shame associated with its peculiar symptoms.

Childhood OCD as a potential OCD subtype

(ref Stewart SE,et al. Obsessive-Compulsive Disorder and OCD-Related Disorders. In: Stern TA, et al, editors. MGH: Comprehensive Clinical Psychiatry. Mosby/Elsevier Publ.; 2008.)

Many researchers have argued that early-onset or childhood OCD may be a distinct type of OCD. Between one fifth and one half of adults with OCD developed the disorder in childhood. Childhood-onset OCD has been associated with greater severity and higher rates of compulsions without obsessions. When OCD begins in childhood, other disorders such as tic disorders, attention-deficit hyperactivity disorder (ADHD), and anxiety disorders are more likely to be present. Also, genetic factors appear to play a larger role in the causes of OCD that onsets in youth.