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Forum Name: Psychiatric Topics

Question: Does my 13 year old son have OCD


 Traceyishere - Tue Sep 02, 2008 11:25 am

I think my son may have OCD but I'm not sure. This past week he was sleeping with only a thin sheet on and seemed very cold, I looked around his room for his blanket and it was on the floor, I went to pick it up and he almost broke out into a sweat because he was so terrified about me putting something on him that had touched the floor. The thing we have the hardest time dealing with is his constant need for reassurance. I couldn't figure out what it was at first but I know now he just wants me to reassure him. For example, on the first day of school last week he had some new black shorts and he took the tags off and brought them too me and asked me if there were any tags on his shorts and told me he took them off. I was a little confused since he told me he took them off but I said I don't see any. He almost pleaded with me to look again. He wanted me to keep checking. I asked if he saw tags and he said no, I just need you to tell me there aren't any tags. He does this a lot with his clothes and his skin. He will ask me, "do you see a line here, or do you see this spot". I will say no and he will say are you sure and I will say no and it keeps going. For a while I thought it was a problem with his eyes because he is severely color blind and I blew it off as having to do with that but then I realized after asking him if he sees something and then he would say no too. I could not understand why he would ask me about something he didn't even see. He again wanted me to reassure him. He apologizes a lot and that really bothers my husband. He worries a lot about germs and wants me to carry hand sanitizer with me everywhere we go. He said when he gets anxious that he counts over and over again. After talking to him about it, he's admitted to me that he counts alot. He counts to 5 over and over again while touching his hand, shoe, etc. until he can finally stop. He's an incredibly well behaved kid. He's very nice, funny, shy and very intelligent. He's in all Advanced glasses in school and hardly if ever studies and always gets straight A's. I've read this is common also in kids with OCD. He's very good at sports. He does not have to open and short doors repeatedly or do anything over and over again. He will have maybe 1 or 2 problems a day. It's not a constant thing, at least I don't see it if it is. He says he does not have bad thoughts about if he doesn't touch something someone might die, etc. He said he doesn't have bad thoughts. But he does say he worrys about things alot but mostly his possessions. The other day he could not get dressed, he was on his bed crying and saying he wanted to wear the shorts on top of his clean laundry basket but could not get them for some reason. He was very upset.I would appreciate any help you can give me.
 Dr. E. Seigle - Thu Oct 02, 2008 8:48 am

Dear Traceyihere,

It does sound likely that your son has OCD. The symptoms of repetitive worry about germs, apologizing often (suggesting feeling inappropriately guilty and perhaps a worry about what might happen if he doesn't apologize) are consistent with OCD. I'm not sure what his worry about the tags are; do you? This may be a sensitivity to the feeling of the tag; his repeated checking of the tags is also consistent with OCD.

OCD typically has its onset in boys a little younger than your son, but 13 yrs. old would not be uncommon. The symptoms can come and go over years, go away for periods of time, and often go away by adulthood. Occasionally, OCD is thought to be triggered by an immune response to the bacterial infection that causes a strept throat.

My suggestion is that you have your son evaluted by a child and adollescent psychiatrist to be ccertain of the diaggnosis and to exclude any others, and to recommend treatment. The research shows that about 65% of kids get much better with a special type of therapy called cognitive-behavioral therapy geared toward kids with OCD, a well researched therapy technique, in which your child (as well as you and his Dad if he is available) are taught some discrete tools to lower the OCD symptoms. The other option is an SSRI type of medication (such as fluoxetine, sertraline, fluvoxamine, citalopram & others, generally known for their use in depression as well as OCD), which has the same percentage effectiveness; its drawback is that it doesn't teach your child anything to empower him to deal with the disorder.

A common approach to consider would be to have a trial of therapy for 2-3 months (be sure the therapist is knowledgable about this particular therapy protocol), and then if significant symptoms remain, medication could be added. One can also do these two steps in the reverse order, at your preference.

This is a very treatable disorder, and I have no reason to doubt that your son can achieve a lot of improvement; sometimes even complete remission can occur, or so much remission that it feels to the child like it is barely present. Good luck!

-E. Seigle MD

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