Childhood-onset OCD

Meet the patient

A 12-year-old is two hours late for school most mornings. His hands are cracked to the knuckle. He asks his mother the same question — "are you sure the door is locked?" — an estimated forty times a night, and she answers every time, because when she stops he cries until 2am. His homework is rewritten until the letters look right. He has told nobody about the thought that he might hurt his little sister, because he is certain it means he is dangerous.[4][10]

Two things in that story are treatable this month: the rituals and the answering. The examiner's question is "who else in this house is doing the OCD's work?"[4][10]

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2. [2]Franklin ME, Sapyta J, Freeman JB, et al. Cognitive behavior therapy augmentation of pharmacotherapy in pediatric obsessive-compulsive disorder: the Pediatric OCD Treatment Study II (POTS II) randomized controlled trial JAMA, 2011.PMID 21934055
3. [3]Freeman J, Sapyta J, Garcia A, et al. Family-based treatment of early childhood obsessive-compulsive disorder: the Pediatric Obsessive-Compulsive Disorder Treatment Study for Young Children (POTS Jr)—a randomized clinical trial JAMA Psychiatry, 2014.PMID 24759852
4. [4]American Academy of Child and Adolescent Psychiatry Practice parameter for the assessment and treatment of children and adolescents with obsessive-compulsive disorder J Am Acad Child Adolesc Psychiatry, 2012.PMID 22176943
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11. [11]Swedo SE, Leonard HL, Garvey M, et al. Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections: clinical description of the first 50 cases Am J Psychiatry, 1998.PMID 9464208
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