What Are the Signs of OCD in Children?

OCD in children is genetically susceptible, and Lenane (1990) found that 20% of first-degree relatives of OCD patients can be diagnosed with OCD. There is a genetic correlation between multiple tics and OCD, and they are even considered to be different manifestations of the same gene. Pauls et al. Found that among children with OCD who are 5-9 years old, family members have a higher rate of tics.

Cui Yonghua

(Deputy Chief Physician)

Department of Pediatrics, Beijing Anding Hospital, Capital Medical University

Obsessive-compulsive disorder (OCD) is a kind of childhood emotional disorder with obsessive-compulsive disorder (OCD) as the main manifestation, accounting for 0.2% to 1.2% of children and adolescent psychiatric inpatients and outpatients. The prevalence rate of the juvenile population in the Flarment survey abroad was 0.8% and the lifetime prevalence rate was 1.9%. One third to one half of adults with obsessive-compulsive disorder come from childhood. The average age of childhood obsessive-compulsive disorder is 9 to 12 years, and 10% of the onsets are before the age of 7. Boys develop an average of 2 years earlier than girls. Early-onset cases are more common in boys, children with family history, and children with tics. The ratio of male to female in younger children was 3.2: 1, and the gender difference narrowed after puberty. Two-thirds of children continue to have this disorder 2-14 years after diagnosis.

Western Medicine Name: Childhood obsessive-compulsive disorder
English name: obsessive-compulsive disorder, OCD
The main symptoms: Obsession

Main cause: Genetic factors, brain damage, neurotransmitter abnormalities, psychological factors, etc.
Contagious: Non-contagious

Causes of childhood obsessive-compulsive disorder

Genetic factors of childhood obsessive-compulsive disorder

Children with obsessive-compulsive disorder brain damage

Brain damage is considered to be one of the causes of OCD. Various brain damage that cause basal ganglia damage can cause OCD. Patients with Parkinson's disease and Huntington's disease have increased rates of OCD after encephalitis. In recent years, it has been found that there is a correlation between OCD and minor chorea, and the incidence of OCD increases in children with minor chorea. Some people have found that the caudate nucleus of patients with childhood-onset OCD has shrunk, and positron emission tomography (PET) examination showed abnormal local glucose metabolism. Although the etiology of OCD is unknown, many clues suggest that it is related to dysfunction of the frontal, marginal, and basal ganglia.

Obsessive-compulsive neurotransmitter abnormalities in children

Serotonin recovery inhibitors can effectively treat OCD, so it is inferred that serotonin dysfunction exists in OCD. Neurotransmitters such as dopamine may also be involved in the pathogenesis of OCD.

Psychological factors of childhood obsessive-compulsive disorder

Psychoanalytic theory believes that children's obsessive-compulsive symptoms stem from the development of sexual psychological fixation in the anal period. This period is the period when children undergo toilet training. Parents require children to obey, while children's insistence on unconstrained contradictions causes conflicts in children's hearts, leading to Children develop hostile emotions, which fix or partially fix the development of sexual psychology. At this stage, compulsive symptoms are the external manifestations of heart conflict during this period.

Personality characteristics of children with obsessive-compulsive disorder parents

As early as 1962, Kanner realized that most children with obsessive-compulsive disorder live in families whose parents are too perfect. Parents have the characteristics of following the rules, step by step, perfection, and bad change.

Clinical manifestations of childhood obsessive-compulsive disorder

Obsessive-compulsive disorder in children is mainly manifested in two types of obsessions and obsessive-compulsive behaviors.

Obsessive-compulsive disorder

Including: (1) Forced doubt. Suspected that what had been done was not done well, was infected with a certain disease, spoke swear words, and was misunderstood because of bad words. (2) Forced recall. Repeatedly recalling events, music you have heard, words you have spoken, scenes you have watched, etc. If you are interrupted by external factors during the recall, you must start from the beginning, because you are afraid that people will disturb your own memories and become emotionally upset. (3) Compulsive exhaustion. The mind is entangled repeatedly on some issues that lack practical significance, such as indulging in the question of "why people are called rather than dogs." (4) Forced opposition. Think twice about two opposing concepts, such as "good" and "bad", "beauty" and "ugly".

Obsessive- compulsive behavior in children

Including: (1) Forced washing. Repeatedly wash your hands, clothes, face, socks, and teeth. (2) Force counting. Repeatedly count the roadside trees, windows on buildings, passing vehicles and pedestrians. (3) Compulsory ritual actions. Do a series of actions. These actions are often associated with "good", "bad", or "something of special significance". If you are interrupted before completing a series of actions, you must do it again. stop. (4) Forced inspection. Repeatedly check whether the school bag has the books to be learned, whether the money is still in the pocket, whether the doors and windows are pinned, and whether the bicycle is locked. Compulsive symptoms are often accompanied by emotional reactions such as anxiety and irritability. In severe cases, it will affect children's sleep, social interaction, learning efficiency, diet and other aspects.

Diagnosis of childhood obsessive-compulsive disorder

Diagnose according to the DSM-IV diagnostic criteria. The diagnostic basis includes compulsive thinking and / or compulsive behavior as the main clinical manifestations; the patient recognizes that these symptoms are excessive and unrealistic, and are distressed by being unable to get rid of them (in young Children may not have this characteristic); symptoms affect daily life, work, study, social activities or social functions; exclude other neuropsychiatric diseases or obsessive-compulsive symptoms, can not be explained by other mental disorders.

Treatment of childhood obsessive-compulsive disorder

Obsessive-compulsive medication for children

Drug therapy is one of the main methods for treating obsessive-compulsive disorder. A large number of studies on the treatment of obsessive-compulsive disorder have shown that chlorpromazine, fluoxetine, sertraline, fluvoxamine, venlafaxine and other drugs work well.

Obsessive-compulsive disorder psychotherapy

Behavioral therapy and cognitive behavioral therapy are the most commonly used psychotherapy methods to successfully treat childhood obsessive-compulsive disorder. According to the situation of the patient and the experience of the therapist, various specific treatment techniques are selected, such as response prevention and anxiety treatment training. For some severely repeated ritual actions similar to tics, habit reversal training can be used. reversal). Family therapy is also an important method for treating obsessive-compulsive disorder, especially for children with family discord, parental marriage problems, family members with special problems, and role confusion among family members, which is more suitable for family therapy. The goal of treatment is to integrate family members into the treatment system, so that all behavioral issues are publicly displayed, fully understand how each family member has an impact on compulsive sexual behavior, reorganize family relationships, reduce compulsive sexual behavior in children, and gradually form Various benign behaviors.

Family treatment of childhood obsessive-compulsive disorder

It mainly provides counseling and guidance to parents, eliminates parents' anxiety, corrects their improper parenting methods, encourages parents to establish exemplary behaviors to affect children, and cooperates with good doctors for psychological treatment. ^[1]