There is no question that having a child with obsessive-compulsive disorder affects the whole family. I’ve written before about how pediatric OCD results in disrupted routines, stressful social interactions for children, and poor job performance for parents. Elevated stress and anxiety levels, as well as feelings of frustration, anger, and sadness become the norm in a household dictated by OCD.
I’ve also written about how important it is to get the right help as soon as possible. Even if parents or other caregivers think things are “not that bad,” the situation is likely worse than they imagine. Because children (and adults) with OCD can be adept at hiding their symptoms, they are often the only ones who know the real extent of their disorder — parents don’t often recognize the extent of their children’s suffering. And on the off chance that the OCD really isn’t “that bad,” it’s still always better to seek treatment sooner rather than later.
In an interesting review published in Psychiatry Research, predictions related to the effectiveness of Cognitive Behavioral Therapy (CBT) in children and adolescents (all under the age of 18) with OCD were made:
In predictor analyses, worse response to CBT was associated with older age, higher OCD symptom severity, higher level of OCD-related impairment, worse depressive symptoms, the presence of any comorbid mental disorder, and higher family accommodation of OCD symptoms. Medication at baseline was not a predictor of CBT effectiveness.
No surprises there. This analysis confirms the importance of getting help for OCD as soon as possible, before OCD has become firmly entrenched.
It gets a little more complicated when discussing children and adolescents with OCD who have comorbid tic disorders, and it’s not always clear what the best path is to follow. In my own family’s experience, my son Dan experienced facial contortions, twitching, and tics when his OCD was severe. This is not uncommon as tics and Tourette syndrome appear in approximately 50% of children with OCD, and 15% of these children receive a diagnosis of Tourette syndrome. In Dan’s case, it’s possible some of the medications he was taking contributed to his tics. Thankfully, once he was taken off the meds and was working hard on his exposure and response prevention (ERP) therapy, all his tics, twitches and facial contortions disappeared. It’s interesting to note that his comorbid diagnoses of depression and GAD (Generalized Anxiety Disorder) also fell by the wayside.
Another finding from the above review, which was also reported in this 2010 study, is that children and adolescents with a family history of OCD had poorer outcomes with CBT than those with no family history of OCD. It’s not clear what the reason for this is, but might possibly be related to others at home who are dealing with OCD being unable to support their child fully. In these cases, CBT along with medication appears to be the most beneficial treatment approach.
The bottom line is CBT in the form of exposure and response prevention (ERP) therapy works for children and adolescents. The sooner help is sought, the better the results will likely be. Once OCD is under control, an added bonus might be the disappearance of comorbid conditions such as depression, GAD (Generalized Anxiety Disorder) and even tic disorders.
There are no good reasons to delay treatment of obsessive-compulsive disorder for our children. If your child or adolescent is struggling with OCD, do the right thing. Get help for them now.