Obsessive-Compulsive Disorder (OCD) is reported to be 0.3-0.9% in children and adolescents, but it is thought to be more common. ‘Stop. However, cases starting at a much younger age (up to 2 years of age) are encountered in the literature and clinical practice. Although many psychological theories have been put forward regarding its emergence, it is now accepted that OCD is a neuropsychiatric disease with biological foundations.
The disease typically presents with obsessions and compulsions.
The medical term for the condition called ‘obsession’ or ‘delusion’ is ‘obsession’. Obsessions are repetitive thoughts, impulses, or fantasies that are unwanted, inappropriate, and cause marked distress. The person tries to ignore these thoughts, impulses, or phantasies, suppress them, or neutralize them with another thought or action. The person is aware that these thoughts, impulses and fantasies are a product of his own brain. However, children may not be able to express this fully.
The repetitive behavior or mental actions of the person in response to obsessions are also called ‘compulsions’ in the medical language.
For example, thinking that one’s hands are dirty despite knowing that they are clean is an ‘obsession’, and unnecessarily washing their hands to get rid of this thought is a ‘compulsion’.
Obsessions and compulsions can be seen in everyone to a small extent, but if they impair the person’s quality of life and functionality and cause serious loss of time, they are considered a disease and need treatment.
In studies, the most common obsessions in children; ‘
Pollution,
The thought of getting sick,
The thought that something bad will happen,
Fear that someone will die or get sick,
Symmetry ,
Sexual thoughts,
Forbidden or violent thoughts,
The need to tell, ask and get approval is striking.
Common compulsions are;
Wash,
Check,
Edit,
Sort,
Count,
Touch,
Repetition,
Accumulation,
Thinking over and over.
Neurochemical studies, neuroimaging studies and neuropsychological evaluations show that the disease is caused by some dysfunctions in the basal ganglia and frontal regions of the brain, and the levels of neurotransmitters such as serotonin and dopamine are also related to the emergence of the disease. There is also strong evidence for genetic transmission of the disease. Studies have also shown that some cases of OCD may be associated with tic disorder and Tourette’s syndrome, suggesting that these cases may result from a similar genetic origin.
It is known that OCD is much more common in children than is thought, but children tend to hide their distress due to thoughts that they will often be blamed and misunderstood. If parents or teachers can be reassuring in their approach to children and can make children be comfortable and open with them, children will also be comfortable in expressing their problems.
So how do children express their obsessions? They often seem troubled when talking about the subject. They say that an inner voice (sometimes they say it is their own opinion, some may describe it as someone else’s voice) causes certain behaviors and thoughts, even though they do not want to think or act in this way. For example: cursing something, disturbing sexually explicit images come to mind, something bad will happen if he doesn’t do something twice, or he thinks that even though he has locked the door, he thinks that he hasn’t locked it and has to check again and again.
Sometimes, only repetitive behaviors (compulsions) may occur without accompanying thoughts and these can be easily observed from the outside.
Treatment: The most successful treatment in OCD is medication + behavioral cognitive therapy. It is a disease that usually responds well to treatment. Depression can often be added to the picture in untreated cases. It impairs the child’s functionality more and more, making school and home life unbearable. It also begins to create serious difficulties for its environment.
Sometimes childhood psychoses may begin as OCD. Therefore, it is very important that the child is treated by a physician.
