OCD is a chronic disease characterized by obsessions (obsessions) and compulsions (compulsions) that causes significant deterioration in the social, occupational functionality and social activities of the individual. Obsessions are defined as thoughts, impulses, or fantasies that occur against the will of the person, cause uncontrollable distress, and manifest themselves in a repetitive manner.
Compulsions, on the other hand, are repetitive behaviors or mental acts performed to reduce anxiety caused by disturbing thoughts or to avoid or avoid the feared consequences. The person does not match these thoughts, impulses and actions with his normal life, and perceives it as a situation contrary to his logic, beliefs and moral understanding.
The prevalence of OCD varies between 0.2-4% in children and adolescents. The age of onset of OCD is 7 most frequently and 10 on average. However, there are cases of OCD that may require clinical treatment even in the first years of life. The earlier OCD begins, the worse the course. Scientific studies have shown that 80% of adults with OCD have symptoms before the age of 18.
The onset of OCD is usually insidious and in childhood or adolescence. OCD is more severe in boys, and comorbid psychiatric disorders are more common than girls.
The time elapsed between the onset of OCD and its diagnosis is usually 2-3 years. The reasons for the diagnosis of the disease so late are that families accompany obsessions and compulsions with the thought that children’s anxiety and repeated questions will decrease, families and children hide symptoms, parents with subclinical obsessions and compulsions do not notice their children’s symptoms, children have poor insight into their own obsessions and compulsions. Because of its normal perception, adolescents think that they will be stigmatized as a result of learning from others about the abnormalities in their thoughts and behaviors, OCD is not well known by the medical personnel and doctors dealing with child and adolescent health.
The intelligence level of children with OCD is within normal society norms.
The most common obsession in all age groups is recurrent thoughts about contagion. Compulsions are repetitive behaviors (eg, washing hands, ordering, checking) or mental acts (praying, counting, repeating words silently). The purpose of compulsions is to prevent or reduce anxiety. The most common compulsions are washing and cleaning.
In 95% of the cases, obsessions and compulsions coexist.
RITUALS THAT MAY OCCUR IN NORMAL CHILDREN
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Ritual |
Age ( | 08) |
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Bed and eating rituals |
Young children (can last up to 6 years old) |
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Resistance to change in daily actions |
Young children (2-4 years) |
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Not stepping on lines |
Young children |
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Control/supervision |
Young and older children |
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Counting and chance numbers |
Old children |
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Touch |
Older children (playing) |
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Bathing |
Preschool children (lightly) , sometimes in adolescents |
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Fear of contamination/infection |
Young and older children (mildly) |
MENTAL DISORDERS ACCORDING TO OCD IN CHILDREN
The prevalence of comorbidity in OCD is 40-50%. The lifetime prevalence of major depressive disorder in children and adolescents with OCD is reported to be quite high, 65-80%. The incidence of one or more of the anxiety disorders (generalized anxiety disorder, panic disorder, …) together with OCD is around 50%. In addition, other mental disorders such as tic disorders, attention deficit hyperactivity disorder, and conduct disorder can often accompany OCD in children and adolescents.
