Obsessive Compulsive Disorder (OCD) can be an extremely debilitating and troublesome mental illness. Although most children have worries, a child with OCD may become so preoccupied with their thoughts that they may become obsessions. The content of these obsessions generally concerned with something being harmful or dirty wrong. These obsessions may not always seem rational outsiders but to the child themselves, they can be extremely obtrusive and upsetting. In order to relieve the negative experience of the obsessions, a child with OCD will engage in compulsive behaviours. These behaviours can include excessive checking, washing hands repeatedly, doing something a set number of times, or avoiding something completely. These compulsions may initially relieve the anxiety associated with the obsessions but in the long term they only serve to maintain the anxious thoughts. Obsessions and compulsions can make life extremely difficult for a child.

Not only can OCD be extremely distressing for a child, but it can also impact negatively on that child’s development in that the restrictive lifestyle that often comes with living with OCD can significantly limit a child’s experiences and interactions with the world. The distress and restrictiveness caused by OCD has been shown to lead to significant decreases in overall levels of quality of life for young people and children affected by the disorder. Measures of quality of life typically account for a number of domains including physical well-being, emotional well-being, self-esteem, family, friends and school or work. Measures of quality of life are usually quite robust and when used in assessing mental illness can usually provide a good understanding of the overall impact that a particular disorder is having on that individual’s life.

Imagine a child who has obsessions that touching off of things like door handles or even a person will cause him to become contaminated and ill. This child may then have compulsions such as excessive cleaning and may also avoid situations and people in general as he is extremely distressed by the idea of touching them. How would this child manage in school and how would they build relationships with those around them? Their quality of life would clearly be impaired.

In terms of what can be done in order to treat symptoms of OCD in children and therefore increase their overall quality of life, evidence suggests that Cognitive Behaviour Therapy or CBT for short is the most effective form of treatment. Until recently little was known about the specific impact of CBT on children with OCD’s quality of life. However a Scandinavian research team led by Dr. Bernhard Weidle recently sought to explore the direct impact that participation in a CBT program had on overall measures of quality of life in children with OCD. What Dr. Weidle and his team found was that participation in 14 sessions of individual CBT led to significant improvements on this measure and what is more is that these improvements were demonstrated to be independent of other potentially influential variables and therefore provide further support for the role of CBT in paediatric OCD treatment.

Ms. Niamh Allen, M.A. B.Sc.

Quality of life concerns for children with OCD

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