Obsessive Compulsive Disorder in children and
young people: information for parents, carers and anyone
who works with young people
About this leaflet
This is one in a series of leaflets for parents, teachers and
young people entitled Mental Health and Growing Up. The
aims of these leaflets are to provide practical, up-to-date
information about mental health problems (emotional, behavioural
and psychiatric disorders) that can affect children and young
people. This leaflet explains what obsessive-compulsive disorder
(OCD) is, who it affects and what can be done to help.
Introduction
What is obsessive compulsive disorder?
Some people have thoughts or ideas that come into their mind
even when they do not want them to (for example `I must count to
twenty or something bad will happen'). These thoughts often feel
silly or unpleasant and are called
obsessions.
Compulsions are things that people feel they have to do,
even
when they do not
want to (for example repeatedly checking that the light is switched
off). Often people try to stop themselves from doing these things,
but feel frustrated or worried unless they can finish them.
Problems with obsessions and compulsions can cause distress and
worry, and can begin to affect young people at school, with their
friends, and in their families.
Many children have mild obsessions and compulsions at some
time, for example having to organise their toys in a special way,
or saying good night a certain number of times. This is normal. It
may be the result of anxiety due to stress or change.
If you are worried that a child's behaviour is the beginnings
of obsessive compulsive disorder, you need to ask yourself the
following questions:
- Do the compulsions upset the child?
- Do they interfere with the child's everyday life (e.g. school,
friends, etc.)?
If the answer to these questions is `yes', it may be that the
young person has obsessive compulsive disorder,
sometimes called OCD for short. If this is the
case, you should seek professional advice.
Who does OCD affect?
OCD can affect people of all ages, and usually starts in
childhood.
What causes OCD?
We do not know the cause of OCD for certain. However, research
suggests that OCD may be due to an imbalance in a brain chemical
called `serotonin'. The tendency for OCD seems to run in families.
There may also be people with tics (involuntary jerky movements) in
the family. Very occasionally, OCD can start after a bacterial
illness.
How can I get help?
There are two treatments that are helpful. One of these is
behaviour therapy, and the other is medication. Behaviour
therapy and medication can be given on their own or together. If
possible, a young person should have access to both forms of
treatment.
Behaviour therapy involves a detailed
assessment of the problem, often starting with the child and family
keeping a diary of the obsessions and compulsions. The aim of the
treatment is to teach young people how to be in control of the
problem, by tackling it a little bit at a time. The young person
designs the treatment programme with the therapist. Children need
to be actively involved in planning the treatment.
Often parents or other family members get very involved in the
OCD rituals. Families need to learn about OCD, and also about how
to help their child combat it. This can involve parents working
with the child and therapist to find ways of helping their child to
resist the rituals and being able to say `no'.
Medication
Medication helps at least 70% of people with OCD to get
better. Unfortunately, many people who improve on medication become
unwell again when the medication is stopped. Some people who need
medication may have to continue taking it for a long time.
Where can I get help?
OCD is a common problem, and your general practitioner will be
able to help and advise. If the young person needs more specialist
assessment and treatment, the general practitioner may suggest a
referral to a child psychiatrist or a child psychologist (see
leaflet 31 on child and adolescent
psychiatrists).
If the young person has been unwell for a long time, or their
life has become severely affected by OCD, other professionals may
need to help too - for example, teachers or educational social
workers may be able to help the young person get back to ordinary
life at school or college.
References
- Carr, A. (ed.) (2000) 'What Works with Children and
Adolescents?' - A Critical Review of Psychological Interventions
with Children, Adolescents and their Families. London:
Brunner-Routledge.
- Heyman, I. (1997) Children with obsessive-compulsive disorder.
BMJ, 315, 444.
- Rutter, M. & Taylor, E. (eds) (2002) 'Child and
Adolescent Psychiatry' (eth Edn). London: Blackwell.
- Scott, A., Shaw, M. & Joughin, C. (eds) (2001) 'Finding
the Evidence' - A Gateway to the Literature in Child and Adolescent
Mental Health (2nd edn). London: Gaskell.
Sources of further information
- OCD Action is
the national charity for people with obsessive-compulsive disorder
(OCD) and related disorders such as body dysmorphic disorder (BDD),
compulsive skin picking (CSP) and trichotillomania.
Or you may like to look at this website:
- www.ocfoundation.org:
is an international not-for-profit organization made up of people
with Obsessive Compulsive Disorder (OCD) and related disorders, as
well as their families, friends, professionals and others.
- OCD-UK: OCD-UK
is the leading national charity, independently working with and for
people with Obsessive-Compulsive Disorder (OCD).
- The Mental Health and Growing Up series contains 36
leaflets on a range of common mental health problems. To order the
pack, contact Book Sales at the Royal College of Psychiatrists, 17
Belgrave Square, London SW1X 8PG; tel. 020 7235 2351, ext. 146; fax
020 7245 1231; e-mail: booksales@rcpsych.ac.uk, or
you can download them from this website.
© [2004] Royal College of
Psychiatrists. This leaflet may be downloaded, printed out,
photocopied and distributed free of charge as long as the Royal
College of Psychiatrists is properly credited and no profit is
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