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Published on: January 9, 2015
[Severe early-childhood obsessive-compulsive disorder--case report on a 4-year-old girl]
Renner Tobias1, Susanne Walitza
1Klinik für Kinder- und Jugendpsychiatrie und Psychotherapie der Universität Würzburg. renner@kjp.uni-wuerzburg.de
Insights
Obsessive-compulsive disorder (OCD) can manifest in young children. Early diagnosis and behavior therapy, with parental involvement, effectively treat childhood OCD.
Area of Science:
- Child and Adolescent Psychiatry
- Developmental Psychology
- Behavioral Therapy
Background:
- Obsessive-compulsive disorder (OCD) is rarely diagnosed in children under six.
- Early-onset OCD presents unique diagnostic and therapeutic challenges.
Observation:
- A case study of a 4-year-old girl with severe OCD symptoms, including symmetry and order compulsions.
- The child experienced significant social impairment, affecting family and kindergarten activities.
Findings:
- Behavior therapy in an inpatient setting led to marked symptom improvement.
- The child's parents were intensively counseled and integrated into the treatment process.
- Adjuvant medication was not required for symptom remission.
Implications:
- OCD can occur as early as age four, requiring adapted diagnostic approaches.
- Standard diagnostic criteria (ICD-10, DSM-IV) are applicable for very early-onset OCD.
- Parental inclusion is crucial for successful behavioral intervention in early-onset OCD.
Objectives:
OCD is seldom diagnosed in children younger than six years of age. The present report deals with the diagnosis and therapy of OCD at a very early onset in childhood.
Methods:
Reported is the case of a 4-year-old girl who was affected by severe compulsive behaviour, with marked impairment of her familial and extra-domestic social activities, including an inability to attend kindergarten.
Results:
The girl was affected to an extreme extent by compulsive symptoms pertaining to symmetry and order, and suffered from severe psychological strain. Her symptoms improved markedly following behaviour therapy in an inpatient setting. Adjuvant medication was not necessary. Her parents were counselled intensively and included in the therapeutic process. She was able to return to her family, resuming activities appropriate for a child her age, and to attend kindergarten.
Conclusions:
OCD can develop in a child as early as at the age of four. For diagnostic procedure in cases of "very early onset", OCD criteria described by ICD-10 and DSM-IV can be applied. Behaviour therapy was effective even in this case of early manifestation of OCD. Particularly important is the inclusion of the parents in the therapeutic process.
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