What is obsessive-compulsive disorder (OCD)?

Frequently occurring disturbing thoughts or images are called obsessions, and the repeated rituals performed to try to prevent or dispel them are called compulsions.

During the normal growth and developmental processes of children and adolescents, rituals and obsessive thoughts normally occur with a purpose and focus based on age. Preschool children often use rituals and routines around mealtimes, bath, and bedtime to help them stabilize their expectations and understanding of their world. School-aged children normally develop group rituals as they learn to play games, team sports, and recite rhymes. Older children and teens begin to collect objects and develop hobbies. These rituals help children to socialize and learn to master anxiety.

A child or adolescent with OCD has obsessive thoughts that are unwanted and related to fears (such as a fear of touching dirty objects) and uses compulsive rituals to control the fears (such as excessive hand-washing). When OCD is present, obsessive thoughts cause distress and compulsive rituals can become so frequent or intense that they interfere with activities of daily living (ADLs) and normal developmental activities.

While symptoms of OCD do occur in children, it is recognized as a relatively common mental health disorder in adolescents, with up to 2 percent to 3 percent of children and adolescents having OCD. The ratio of males affected by OCD is twice that of females. The mean age of onset for pediatric OCD can be between 9 and 11 for boys, and 11 and 13 in girls. Twenty percent of children and adolescents with OCD also have another family member with OCD.