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Obsessive-compulsive disorder (OCD) is an anxiety disorder in which people have recurrent, persistent thoughts they cannot control (obsessions) and/or an uncontrollable urge to perform certain actions over and over (compulsions). OCD typically begins in early childhood or adolescence, but it may not be actually diagnosed until adulthood. About one in every 200 children has OCD, according to the American Academy of Child and Adolescent Psychiatry (AACAP). Between 2 and 3 percent of people in the United States experience OCD by late adolescence, according to the Obsessive Compulsive Foundation.

Many children have a compulsive nature, such as those who are determined to keep their room especially tidy or to master a new sport or activity. Though such people may be labeled “compulsive,” this type of behavior does not qualify as a mental health disorder and may in fact be a key factor in building self-esteem and contributing to social success. In addition, children may find comfort in certain rituals, such as wearing “lucky” socks to an event or lining up stuffed animals during bedtime. These harmless activities are a normal part of child development and are not signs of OCD.

Children with OCD take these feelings and actions a step further, repeatedly engaging in obsessive thoughts and/or compulsive behaviors until the process becomes disruptive to their lives. For example, younger children may continually worry about someone breaking into a bedroom and may repeatedly check to make sure the windows are locked. Meanwhile, older children may become paralyzed with fear of contracting a disease and may repeatedly wash their hands to get rid of germs. These children may feel a sense of relief when they complete their rituals, but it usually does not last long before the next obsessive thought arises. As the discomfort returns, the child may feel compelled to repeat the obsessive-compulsive cycle again.

Over time, these rituals may take over a child’s life to an increasing degree and interfere with daily functioning. Children with OCD may have struggles with family, friends and at school. The stress of OCD is compounded by the fact that the disorder often prevents children from fitting in with peers. As a result, the child’s quality of life may rapidly deteriorate as obsessive thoughts and compulsive actions take up increasing amounts of time. Children with OCD also may be more likely to be bullied or made fun of by their peers as a result of their odd behavior. This can aggravate symptoms of OCD and lead to feelings of depression and loneliness in children with the disorder.

Adult patients with OCD usually understand that their thoughts and behaviors are irrational and excessive, but cannot free themselves from them. However, children with OCD are less likely to make this connection, especially young children.

The typical OCD patient is someone who has obsessions and/or compulsions for more than an hour each day, and the symptoms cause distress to the patient and are disruptive to their life. OCD can affect people of all age groups, and tends to affect men and women equally. Most patients experience both obsessions and compulsions. About one-third to one-half of adults with this condition first experienced symptoms during early childhood or adolescence, according to the Obsessive Compulsive Foundation. OCD in childhood tends to be diagnosed more frequently in boys than in girls.