Obsessive compulsive disorder (OCD) in children is relatively common, with about 1% of all children suffering with the often debilitating illness. The average onset age is approximately 10  - over 80% of adults with OCD showed signs of onset before they were 18.
You can read more about OCD in children and adolescents as well as the causes of OCD in children.
The term ‘OCD’ is used as an umbrella term to describe several different types of the disorder, which we shall explore in more detail next.
1. Checking - checking is a common compulsion for those with OCD. It can take many different forms, from physically checking items to mentally checking thoughts. Often the checking process can become progressively worse over time and for some the process can take several hours to complete. The most common forms of checking are:
Doors, lights, windows, locks, seeking reassurance, looking in mirrors, referring to lists and checking one’s thoughts to make sure they have not happened in reality.
2. Contamination – the fear that an object is contaminated and may cause harm or even death to a loved one or oneself is also common amongst those with OCD. Often, the compulsion that accompanies these types of obsessive thoughts is cleaning and washing, with some sufferers developing skin conditions through excessive hand washing. Common sources of the contamination are:
Public spaces and toilets, touching other people, door handles, touching ‘red’ objects (associated with blood), communal family spaces such as kitchens.
The sources of contamination OCD are not just physical, some children and adults with this type of OCD may also struggle with mental contamination. This is where they feel dirty or unclean if they have had a difficult day, if someone has said something unkind to them or if they think they have done a bad job at something.
3. Hoarding – children with a hoarding disorder find it incredibly hard to part with their belongings. Whilst it is perfectly normal for children to enjoy collecting items, even peculiar things like straws or rocks, hoarders develop a strong emotional attachment to their belongings, becoming often fanatical about how they are stored and finding it impossible to part with them, even when they are broken or dirty.
4. Ruminations and intrusive thoughts – ruminations are the term used to describe prolonged thoughts about a topic that is often not very productive – for instance ‘why are we here?’. A child or adolescent who struggles with rumination OCD may seem quite detached and deep in thought for a great deal of time. It can be very distressing as often there is no definitive answer to the questions they ask themselves and more often than not other people simply do not understand why they can’t let the subject go.
Intrusive thoughts are different to ruminations and are unwanted thoughts that can be disturbing in nature – for instance thoughts of harming a stranger or loved one. Intrusive thoughts can be terribly isolating and distressing, but we know that those who suffer with intrusive thoughts are far less likely to commit any of the acts they think about, as they often go to huge lengths to avoid certain situations.
There are several types of intrusive thoughts, including sexual, religious or violent thoughts as well as ‘magical thinking’. Magical thinking is where a child or teenager with OCD will believe that by even thinking of certain words, seeing certain colours, standing on pavement cracks or other uncontrollable things will result in something terrible happening. Their compulsive actions are a way of mitigating the risks.
There are also other disorders which are linked to OCD.
5. Body Dysmorphic Disorder – BDD is a type of OCD and refers to a preoccupation and often imagined perception of their body. Sufferers are often not able to see a true image of themselves in the mirror and may skin pick, spend a lot of time looking in the mirror, obsess about clothes and makeup or exercise fanatically.
6. Pure-O – this differs from a more traditional type of OCD in that there is often no physical manifestation of the compulsions, such as hand washing or checking. Instead the obsessions and compulsions take place in the mind and may include counting, repeating certain phrases and mentally checking oneself. As there are no physical actions that accompany this type of OCD it can be well hidden and often sufferers feel they are ‘going mad’.
7. Obsessive Compulsive Personality Disorder – This might sound like it is a type of OCD, but it is actually very different. Whilst those with OCPD may share a similar preoccupation with lists, order and routine, the will not share the compulsions found in OCD.
Having a child who is showing signs of OCD can be a worrying time for parents as it is hard to know what to do and how to help. We know that seeking help early is one of the most important steps, as it helps break the cycle of obsessions and compulsions that can become progressively more powerful over time. So speaking to a GP or other mental health professional about getting an assessment for your child is the first step to take.
Clinical Partners is the UK’s largest private mental health partnership, working from 22 locations nationwide. We are able to help adults, children, families and businesses every year overcome their mental health concerns. If you would like to discuss how we can help you please call 0203 326 9160 to talk to one of our qualified clinical advisors today.
 Swedo et al.Obsessive compulsive disorder in children and adolescents: clinical phenomenology of 70 consecutive cases. Archives of General Psychiatry 1989: 45(4) 335-41
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