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Obsessive-Compulsive Disorders in Children

A small number of children are preoccupied with repetitive thoughts, or actions that, to the outsider, seem foolish and illogical. These recurring ideas (obsessions) and repeated actions (com­pulsions) are uncontrollable, and can upset their lives and ultimately disrupt the nor­mal functioning of their families. In about one-third to one-half of all affected individ­uals, obsessive-compulsive disorder be­gins in childhood and adolescence.

Children with obsessive-compulsive be­havior may excessively wash their hands or brush their teeth. They may be driven to check things repeatedly, making sure they have packed their homework assignments or their lunch in the morning. They may repeat certain rituals, perhaps entering and exiting a room a particular number of times. They may arrange and rearrange a table setting meticulously, or become concerned with germs, dirt, crime, violence, disease, or death in an overly dramatic manner.

One doctor treated an obsessive-compul­sive child who was preoccupied with thoughts of a devastating tornado. From the age of six, this youngster would check radar weather maps on television and con­tinuously ask his mother about whether she had heard of any tornado warnings.

An eight-year-old boy's obsessive-com­pulsive behavior began with frequent hand-washing and soon escalated to constant anxiety about fires and accidents. He would spend six to eight hours a day mon­itoring the electrical outlets and the light switches in his house, as well as scrubbing his hands and indulging in other compul­sive behavior.

Even at their young ages, these children often recognize that their behavior is bizarre. However, if they attempt to control it, they are usually overcome with anxiety and revert to their peculiar rituals for re­lief. Knowing that their behavior is not nor­mal, they often try to hide it from family and friends. Many children have these unusual behaviors for many months before they are discovered.

Why do these youngsters go through such rituals? Most children say they simply do not know. Researchers investigating the causes of obsessive-compulsive disorder describe it as a neurobiological distur­bance that seems to run in families.

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