Obsessive-compulsive disorder (OCD) is an anxiety disorder that causes obsessions and/or compulsions. Obsessions are repeated, uncontrollable, and intrusive thoughts, impulses, or images that cause anxiety or distress. Compulsions are repetitive behaviors that relieve the distress caused by obsessions.
UPMC experts provide comprehensive care for OCD using the latest evidence-based therapies. We will develop a personalized treatment plan to help your child manage symptoms and improve their ability to function.
On this page:
What Is Obsessive-Compulsive Disorder (OCD)?
Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by obsessions and/or compulsions. Obsessions consist of repetitive, uncontrollable, and intrusive thoughts, impulses, or images that cause anxiety or distress. Compulsions are repetitive behaviors that relieve distress caused by obsessions.
What is the difference between OCD and ADHD?
OCD is an anxiety disorder that has specific symptoms of obsessions and compulsions. Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that causes difficulty with self-regulation of behavior, including problems with inattention, impulsivity, and hyperactivity.
Although OCD and ADHD may co-occur in children and adolescents, they are different conditions that require separate treatment.
How common is OCD?
OCD is a common mental health disorder. Researchers estimate that it affects between 1% and 4% of children and adolescents.
What causes OCD?
Researchers aren’t sure what causes OCD. However, they believe it may be linked to genetics and environmental factors.
OCD risk factors
Although the exact cause of OCD is unclear, researchers are exploring whether OCD may be linked to:
- Brain structure, chemistry, and biology.
- Family history and genetics.
- Trauma in childhood, such as child abuse or neglect.
Complications of OCD
Complications of OCD can affect various aspects of life and may cause difficulties with:
- Ability to perform everyday activities.
- Mental health and self-esteem.
- Performance in school or work.
- Physical health problems.
- Social relationships.
What Are the Signs and Symptoms of OCD?
Symptoms of OCD include obsessions, compulsions, or a combination of both.
At what age does OCD start?
OCD symptoms in children typically begin between the ages of 7 and 12. Symptoms may also develop during the teenage years or in early adulthood.
How early can a child show signs of OCD?
Children can show signs of OCD as early as age 3. However, diagnosis is not typically possible before age 5.
What are the symptoms of OCD in children?
Symptoms of OCD in children may include:
Symptoms of obsessions
A child or adolescent with obsessions may have symptoms including:
- Excessively complaining about clothing or shoes not fitting or matching "just right."
- Fear of germs, dirt, or contamination.
- Fear of losing things.
- Needing things to be arranged or organized in a particular way.
- Thoughts or pictures in their head that they can't get rid of.
- Worries about something bad happening to themselves or a loved one.
Symptoms of compulsions
A child or adolescent with compulsions may have symptoms including:
- Arranging or organizing things in a particular way.
- Compulsive counting.
- Demanding that you prepare food or fold laundry in a certain way.
- Excessive cleaning or handwashing.
- Frequent “checking” to make sure lights are off, the door is locked, etc.
- Having problems following routines, such as getting ready for school or bed.
- Repeatedly asking the same questions.
- Saying, "I just have to," when asked why they are behaving in certain ways.
Other symptoms of OCD
People with OCD may also have a condition called Tourette syndrome or another type of tic disorder that causes sudden, repeated, and uncontrollable movements or sounds.
Children and adolescents with OCD may also be diagnosed with other conditions, including anxiety disorders, attention deficit hyperactivity disorder (ADHD), eating disorders, mood disorders, and autism spectrum disorder (ASD).
OCD symptoms following a strep infection
Some children develop OCD symptoms and tics after a strep infection, such as strep throat. This is known as pediatric autoimmune neuropsychiatric disorder associated with streptococcal infection (PANDAS).
Symptoms can look very similar to typical OCD symptoms. However, they start soon after a strep infection.
Researchers are trying to find the best way to diagnose and treat PANDAS. Infectious disease experts recommend treating strep infections with antibiotics and treating OCD symptoms and tics with standard treatment for OCD and tics.
Repeated streptococcal infections need to be treated appropriately to reduce the risk of developing PANDAS. If your child has a fever and sore throat, ask your pediatrician to take a throat culture to check for strep.
When should I see a doctor about my child’s OCD symptoms?
If your child has symptoms of OCD that are affecting school, work, social relationships, or other aspects of everyday life, you should schedule an appointment with your pediatrician.
How Do You Diagnose OCD?
Your child’s doctor will ask about your symptoms and look for patterns that are common in OCD.
What to expect during your child’s visit
If your doctor suspects OCD, they will:
- Ask about your child’s symptoms.
- Perform a physical exam.
- Perform an OCD evaluation.
- Review your health history and medications.
Tests to diagnose OCD
No single test can diagnose OCD. Your doctor will look for patterns of OCD symptoms during an OCD evaluation.
OCD prognosis
For some people, OCD is a condition that requires lifelong treatment and management. In about half of children and adolescents with OCD, symptoms disappear or lessen by adulthood.
If left untreated, it can lead to problems that affect self-esteem, mental health, school and work performance, and overall functioning. However, with treatment, people with OCD can live healthy and productive lives.
How Do You Treat OCD?
The goals of OCD treatment are to improve your child’s ability to function at school, work, in social situations, and at home. Specific treatment goals will be tailored to individual symptoms, challenges, and needs.
OCD care often includes a combination of treatments, such as:
Medication for OCD
Your doctor may prescribe one or more medications to help manage OCD symptoms. The most common medications are antidepressants, which help to reduce symptoms of anxiety.
Behavioral therapy to treat OCD
Cognitive behavioral therapy (CBT) teaches children and their parents strategies for managing OCD symptoms. Depending on your needs, your doctor may recommend individual, family, or group therapy.
Exposure and response prevention (ERP) therapy is a type of CBT that gradually exposes you to your fears or obsessions. Over time, ERP teaches you to cope with your fear or obsession, which leads to reduced anxiety and improved symptoms.
Why Choose UPMC for OCD Care?
When you choose UPMC for OCD care, you will receive:
- Access to anxiety disorder expertise — Our anxiety disorder experts treat the full spectrum of conditions using the latest, evidence-based guidelines and strategies.
- A full range of treatment options — We offer cognitive behavioral therapy and medication, often in combination, to effectively treat OCD and improve your level of functioning.
- Multidisciplinary care — We partner with mental health professionals, pediatricians, primary care providers, and other medical experts to provide complete care that optimizes your quality of life.
