Preschool-onset OCD: A review of literature and clinical experience

Abstract

Obsessive-compulsive disorder (OCD) has been described in preschool children as young as 2–3 years old. A preschool age onset of OCD has unique diagnostic and therapeutic challenges. In this article, the authors review published literature on preschool onset OCD and present data on preschool-onset OCD (age of onset ≤ 5 years) from clinical records at a tertiary care child and adolescent psychiatry center in India. Literature suggests that OCD that starts this early is phenomenologically similar to OCD in older individuals; however, it has very high rates of comorbidity and a family history of OCD. There is a paucity of data on course, treatment, and long-term outcome in this group. At their center, the authors found a 3% prevalence of preschool-onset OCD, with a male predominance (69%) and fairly high comorbidity rates (62%). Qualitative review highlighted delay in treatment seeking, poor follow-up rates, frequent use of pharmacological treatment, and a high remission rate in those treated adequately.

Comorbidities in Obsessive-Compulsive Disorder Across the Lifespan: A Systematic Review and Meta-Analysis

“…Obsessive-compulsive disorder (OCD) is a common and disabling psychiatric illness characterised by obsessions (repetitive, intrusive, unwanted and distressing thoughts, images, or urges) and compulsions (repetitive behaviours or mental acts that a person feels driven to perform in response to the obsessions, or according to rigid rules) ( 1 , 2 ). Affecting children as young as 3–4 years old ( 3 , 4 ), as well as the elderly over 70-years old ( 5 ), OCD incidence is generally highest during pre-adolescence (mean onset 11 years), and early adulthood (mean onset 23 years) ( 6 , 7 ).…”