Study examines OCD among children

Wednesday, October 8, 2008

Obsessive Compulsive Disorder is often thought of as a disorder that affects adults. But a new study by Brown researchers shows that it can actually develop in children as young as four years old.

The study, which began in 2001 and was published Sept. 18 in the Journal of Psychopathology and Behavioral Assessment, involved clinical psychological assessments of 58 children from ages 4 to 8 with moderate to moderately severe OCD.

The study was co-authored by Abbe Garcia, assistant professor of psychiatry; Jennifer Freeman, assistant professor of psychiatry and human behavior; and the late Henrietta Leonard, a professor of psychiatry, in conjunction with researchers from the universities of North Dakota and Oregon.

About one in five of the children were on medication, while one in four had undergone therapy. The study showed that even though children with OCD may have similar symptoms to older children and even adults with OCD, there are key differences, such as a later onset of depression. The patients’ young ages can also help in early intervention.

“We were very pleased with our findings because we believe they shine a light on an under-researched population,” said Abbe Garcia.

“Early diagnosis and intervention are critical to reducing the severity of symptoms and improving quality of life,” Garcia said in a press release.

According to the National Institute of Mental Health, OCD is found in about 2.2 million adults. It is characterized by “persistent upsetting thoughts (obsessions),” and many people affected by the disorder performs “rituals,” such as washing their hands repetitively, in order to temporarily relieve the obsession, according to NIMH’s Web site.

Garcia said that while symptoms tend to be consistent across ages, young children with OCD do show some differences.

“Young children who have washing rituals, for example, may exhibit the ritual in a different manner than an adult or an older child,” she said. This may be spitting in their hands, she said, or in some cases, young children may need someone else to carry out their ritual because they themselves are unable to do it at that age.

For instance, Garcia said, if a child needs to see his clothes washed in a washing machine, he would need his parents to take part in that activity. Then the parent may carry out the ritual for him. But if a parent does not take part in it, then it may curtail that symptom, she said. However, because the child becomes very distressed, the parent may eventually give in.

One of the treatments that these children can go through is cognitive intervention, which is a type of “exposure with response prevention,” Garcia said. Basically, the child is forced to face what he or she is anxious about and is prevented from using the ritual that he would use to temporarily relieve it, she said.

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