Obsessive-compulsive disorder (OCD) is characterized by unwanted and intrusive thoughts, images, or urges (obsessions), and/or repetitive, ritualized behaviors (compulsions). OCD affects 1-3% of children and adolescents.
Obsessions are intrusive & persistent thoughts or images that are distressing and difficult to control. They can be very time-consuming, and frequently cause problems in school, relationships, and daily living. Common obsessions in children and adolescents include:
- Contamination - excessive concern or worry about germs, dirt, or illnesses
- Forbidden thoughts - unwanted sexual, aggressive, or religious thoughts or images (e.g., fear of harming oneself or others, excessive concern about committing a sin, thoughts about offending God)
- Superstitious thoughts - lucky or unlucky numbers, colors, or words
Compulsions are behaviors or rituals that must be done repetitively or in a certain way, often as a means of decreasing anxiety associated with one's obsessions. Common compulsions in children and adolescents are:
- Washing/Cleaning - excessive or ritualized hand washing or showering, cleaning of personal objects, or anything done to prevent or remove contact with germs or contaminants
- Checking - checking that you did not make a mistake, that doors are locked or the oven is off
- Ordering/Repeating - rereading or rewriting, repeating routine activities (e.g., walking in and out of doorways, getting up and down from chairs, need for symmetry or evenness)
- Examples of motor tics are eye blinking, head jerking, shoulder shrugging, mouth/tongue movements, and hand movements.
- Examples of vocal tics are sniffing, throat clearing, grunting, coughing, and blurting out syllables.
- Tourette's Disorder is characterized by motor and vocal tics for at least a year.
- Chronic motor or vocal tic disorder involves either motor or vocal tics for at least a year.