smartification octA few days ago, I received an urgent personal message from a friend. For some reason, his child, a dear happy-go-lucky daughter, has started to grow increasingly distant to her family and and irritable. Her parents are extremely worried and are not sure what to do . One thing they notice is that that she has started to wash her hands a lot more frequently … till the point that they are beginning to bleed.

What happened?

You may have read of children who take things to extreme. Some children refuse to write certain numbers because the believe the numbers are evil. Some ensure that they step on certain lines as they walk on paths and some keep things till they are unable to store them anymore. What does it have to do with constant hand-washing? They are all signs of Obsessive Compulsive Disorder. 

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What is Obsessive Compulsive Disorder?

You may have heard of adults who are compulsive hoarders or really sticky about cleanliness – so much so that it affects their social lives. They do things repeatedly because they are really feeling uncomfortable and repetition allows them to relieve the anxiety. In fact, it is one of the top 3 mental disorders in Singapore and affect 3% of the population here.

One little known fact is  that this issue occurs at the age of 97 to 12 and it is fairly common in children.

The IMH Child Guidance Clinic runs an OCD programme for children and teens up to 19 years old with moderate to severe forms of the disorder. It sees between 100 and 200 children and teens with OCD each year. – Today Online

Children with OCD will be constantly thinking that something harmful, dangerous, wrong or dirty can happen to them. These thoughts are very hard to shake off and they will constantly be thinking about them or obsessed. The only way for them to  gain relief from these thoughts will be to do things repeatedly in a ‘correct way ‘s as to relieve their anxiety.

To the child, it can a very scary experience as they do not understand why they are so. They do not comprehend the need for constant repetition of a ritual to ‘feel right’ and would need the support of the family to guide them through.

OCD interferes with Life

When there is a natural obsession to complete something repeatedly, it tends to interfere with life and make one more irritable than usual. Since they feel like they are the only ones going through this, they may have low self-esteem.

Among kids and teens with OCD, the most common obsessions include:

  • fear of dirt or germs
  • fear of contamination
  • a need for symmetry, order, and precision
  • religious obsessions
  • preoccupation with body wastes
  • lucky and unlucky numbers
  • sexual or aggressive thoughts
  • fear of illness or harm coming to oneself or relatives
  • preoccupation with household items
  • intrusive sounds or words

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These compulsions are the most common among kids and teens:

  • grooming rituals, including hand washing, showering, and teeth brushing
  • repeating rituals, including going in and out of doorways, needing to move through spaces in a special way, or rereading, erasing, and rewriting
  • checking rituals to make sure that an appliance is off or a door is locked, and repeatedly checking homework
  • rituals to undo contact with a “contaminated” person or object
  • touching rituals
  • rituals to prevent harming self or others
  • ordering or arranging objects
  • counting rituals
  • hoarding and collecting things of no apparent value
  • cleaning rituals related to the house or other items

Causes of OCD

No one knows the exact cause for OCD. It can be related to the environment or even stress. Researchers believe that the constriction of the flow of serotonin, a transmitter that relates messages to brains, can cause the brain to misinterpret information as ‘danger’ and keeps dwelling on them.

They also believe that OCD runs in families who have one or more members who also variations of anxiety influenced by the brain’s serotonin levels.

Imaging scans also show that there are structures change within the brain itself.


I suspect my Child is suffering from OCD. What should I do now?

If you believe your child is suffering from OCD, you should consider taking to see a specialist as soon as possible. Here are the types of treatments available:

  • Mild to moderate OCD is the use of cognitive behavioural therapy (CBT), which may span up to 14 sessions over a three-month period
  • Medication for more severe cases where they would provide serotonin
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