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Pediatric Obsessive-Compulsive Disorder

What is Obsessive-Compulsive Disorder?

Obsessive-compulsive disorder (OCD) includes thoughts and obsessions (impulses or images) that occur over and over, and that cause a child or teen to feel a great deal of distress. Obsessions often seem very strange and may be embarrassing for children or teens to talk about. Children and teens often try to control these obsessions by repeating behaviors and even making up compulsive acts – things they feel they cannot control – in order to reduce their fear and anxiety. Obsessions and compulsions are upsetting to the child or teen and their loved ones. These obsessions and compulsions can take up several hours per day in severe cases. Some research shows a link between streptococcal infections (like the infections that cause strep throat) and sudden onset or increase in obsessive-compulsive thoughts and behaviors.

What are the Symptoms of Obsessive-Compulsive Disorder?

These are the most common symptoms of OCD in children and teens ages six to 18. However, a child or teen may have different experiences.

  • Extreme concern with dirt, germs, or contamination
  • Extreme concern about order, symmetry, or exactness
  • Uncontrollable thoughts of forbidden or taboo behaviors
  • Uncontrollable thoughts that are against personal religious beliefs
  • An urgent need to know or remember things that are trivial
  • Graphic images of terrible or horrifying events
  • Uncontrollable aggressive thoughts or impulses
  • Repeated doubts (for example, checking repeatedly whether or not the door is locked)

Examples of compulsive behaviors include:

  • Repeated hand washing or showering
  • Checking and rechecking repeatedly (for example, that something is turned off)
  • Following rigid rules of order (for example, putting on clothes in the very same sequence, or keeping belongings in a very particular way)
  • Hoarding unneeded objects
  • Repeated counting and recounting
  • Arranging or sequencing of objects
  • Repeating certain words, number, or phrases

How is Obsessive-Compulsive Disorder Diagnosed?

At Children’s National, child psychologists, psychiatrists, and other mental health professionals may interview the child or teen and his or her parents. We may have the patient and family fill out questionnaires about different aspects of the child’s or teen’s life, including physical health concerns, difficulties at school, or behavior with friends and family.

Treatment for Obsessive-Compulsive Disorder

Following a full assessment, a member of the Children’s National care team will discuss treatment options with the child or teen and his or her family. Both behavioral treatment (called exposure with response prevention) and certain types of medicines are effective in treating OCD.

  • Exposure with response prevention (ERP) includes gradually exposing children to their obsessive thoughts while at the same time preventing them from connecting those thoughts to their compulsive behaviors or rituals.
  • Behavior therapy also helps parents learn to manage their child’s OCD symptoms in other settings.
  • Medicines most often used to treat OCD are called selective serotonin reuptake inhibitors (SSRIs). These medications affect neurotransmitters (nerve cells in the brain that carry signals) linked to anxiety.
  • If a strep infection is found, a series of antibiotic medicines may be given.
Children's Team

Children's Team




Psychiatry and Behavioral Sciences

Psychiatry and Behavioral Sciences at Children’s National offers assessment, diagnosis and care for children and teens with behavioral, emotional and developmental disorders.

Psychology and Behavioral Health

In the Division of Psychology and Behavioral Health, our child psychologists and other mental health professionals work exclusively with children and teens, emphasizing patient and family-focused care.

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