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Childhood obsessive compulsive disorder.

J L Rapoport¹, S E Swedo, H L Leonard

¹Child Psychiatry Branch, NIMH, Bethesda, MD 20895.

The Journal of Clinical Psychiatry

|April 1, 1992

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Childhood obsessive compulsive disorder (OCD) is more common than previously thought. OCD symptoms in children often include excess washing and can be linked to other neurological disorders, impacting long-term well-being.

Area of Science:

Child and Adolescent Psychiatry
Neuroscience
Behavioral Science

Background:

Childhood obsessive compulsive disorder (OCD) is increasingly recognized as more prevalent than previously estimated.
Epidemiological data in adults suggest higher OCD rates than clinical observations alone indicate.
Clinical presentation in children often mirrors adult cases, though compulsions can occur without obsessions.

Purpose of the Study:

To summarize current understanding of childhood obsessive compulsive disorder (OCD).
To highlight the clinical presentation, symptom variability, and associated conditions in pediatric OCD.
To explore the neurobiological underpinnings suggested by associations with other disorders.

Main Methods:

Review of epidemiological and clinical studies on childhood OCD.

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Analysis of symptom presentation, including obsessions, compulsions, and symptom evolution.

Examination of comorbidity and familial patterns, including associations with tic disorders and other neurologic conditions.

Main Results:

Childhood OCD is more common than previously believed, with symptoms similar to adults but variable presentation.
Excessive washing is a common symptom, and symptoms can change over time.
Increased rates of OCD and motor tics are observed in relatives; OCD is associated with childhood-onset neurologic disorders like Tourette's disorder.

Conclusions:

Childhood OCD is a significant public health concern with lasting disability and comorbidity.
The association with basal ganglia disorders suggests a neurobiological basis involving basal ganglia-frontal cortical pathways.
Further research into these pathways may elucidate the mechanisms of OCD and related disorders.