Case Series: Sensory Intolerance as a Primary Symptom of Pediatric OCD

Abstract

Introduction Marked intolerance or intrusive re-experiencing of ordinary sensory stimuli that in turn drive functionally impairing compulsive behaviors are occasionally seen in young children with OCD. Methods We describe a number of children with DSM-IV OCD ascertained from a family genetic study of pediatric OCD, whose intolerance of ordinary sensory stimuli created significant subjective distress and time-consuming ritualistic behavior that was clinically impairing. Results In each case, these sensory symptoms were the primary presenting symptoms and were experienced in the absence of intrusive thoughts, images, or ideas associated with “conventional” OCD symptoms. Conclusions These symptoms suggest abnormalities in sensory processing and integration in at least a subset of OCD patients. Recognition of these sensory symptoms and sensory-driven behaviors as part of the broad phenotypic variation in children with OCD could help clinicians more easily identify OCD patients and facilitate treatment.

The relationship between sensory processing, childhood rituals and obsessive–compulsive symptoms

“…At any rate, the proposed link between childhood oral and tactile hypersensitivity and adult OC symptoms is consistent with and may integrate several diverse findings. These include the increased disgust sensitivity (Shapira et al, 2003;Stein et al, 2001) and hypofunctioning in the sensory gating mechanism in OCD (Rossi et al, 2005), the association between childhood OCD and sensory sensitivity (Hazen et al, 2008), and the deficient sense of control in OCD (Obsessive Compulsive Cognitions Working Group, 2001;Sookman, Pinard, & Beck, 2001;Steketee, Frost, & Cohen, 1998).…”

“…A potential link between sensory hypersensitivity and the use of excessive rituals has been suggested independently in research on ObsessiveeCompulsive Disorder (OCD) (Hazen et al, 2008;Shapira et al, 2003;Stein, Liu, Shapira, & Goodman, 2001) and in the discipline of occupational therapy (Baranek, Foster, & Berkson, 1997a,b). So far, no research has attempted to integrate these findings into a more comprehensive model.…”

“…This case series suggested that children with OCD exhibit intolerance of ordinary sensory stimuli, which leads to significant subjective distress and time-consuming ritualistic behavior. In this series, the sensory sensitivity symptoms were the primary presenting symptoms, rather than the intrusive thoughts, images, or ideas that are usually associated with OCD (Hazen et al, 2008).…”

Sensory Over-Responsivity in a Sample of Children Seeking Treatment for Anxiety

“…However, this information is largely based on anecdotal case reports, 20,21 studies using a broader definition of sensory problems 14 (e.g., including both over- and under-responsiveness), and research using unsystematically diagnosed or poorly characterized samples. In the Carter et al 3 and Van Hulle et al 15 studies, rates of specific psychiatric disorders were not reported, but the rate of diagnoses within the broad domains of internalizing disorders among those with SOR ranged from 10.0% 3 to 70.4% 15 and externalizing disorders from 18.5% 3 to 50.4%.…”

Sensory Processing Differences in Children Diagnosed With Tourette's Disorder

“…Specifically, there is no information about how these children differ from typically developing children in the way they manage sensory information from inside and outside of their bodies. There is growing support, however, for differences in sensory processing in children with ADHD (Cheung & Siu, 2009;Dunn & Bennett, 2002;Hazen et al, 2008;Lane, Reynolds, & Thacker, 2010;Yochman, Parush, & Ornoy, 2004) and obsessive-compulsive symptoms (Dar, Kahn, & Carmeli, 2012;Hazen et al, 2008). The objective of this study was to determine whether sensory processing differences existed in children with TD compared to a normative sample.…”