DOCSLIB.ORG

Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) Is an Autoimmune Response to a Strep Infection

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) Is an Autoimmune Response to a Strep Infection PANDAS PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) is an autoimmune response to a strep infection. The disorder involves sudden and often major changes in personality and movement. Symptoms can arise as many as 4-6 weeks after the initial infection. PANDAS symptoms often interfere with daily routines and can become debilitating. The symptoms worsen over time and can have a relapsing and remitting pattern. The psychological symptoms may include OCD and repetitive behavior, severe anxiety or panic disorder, mood changes, emotional and developmental regression, depression, and suicidal thoughts. Physical symptoms may include tics and/or unusual movements, increased sensitivities to light, sound and touch, deterioration of small motor skills such as handwriting, sleeping difficulty, memory issues, refusal to eat, and near catatonic state. (Pietrangelo, 2018) PANDAS is thought to be caused by the antibodies that are produced to attack the strep bacteria. The antibodies become confused and attack the body’s tissue due to streptococci’s camouflaging abilities. The antibodies target an area of the brain called the basal ganglia. PANDAS is typically found in children ages 3 to 12 years old who have had a recent strep infection and exhibit symptoms as noted above. A single course of antibiotics can be successful in treating PANDAS, but symptoms may return with another strep infection. In many cases, long-term, low-dose antibiotics may be used to prevent flares. Chronic cases can require a combination of treatments including corticosteroids and NSAIDS. For severe cases, IVIG treatment or blood plasma exchange may be recommended. Read JCAP Treatment Guidelines Here I chose this medical condition because it has affected me personally. Several years ago, a member of my family who was 10 years old at the time, suddenly became debilitated by OCD intrusive thought disorder with frequent thoughts of dying or harming themselves. We noticed an onset of tics and an impairment of the child’s daily functioning. The child was literally afraid of their own thoughts and unable to escape them to function as they normally would. As family members witnessing these sudden and unexplainable symptoms it was hard to know where to turn for help. Through the help of several psychologists and a pediatrician we tried to make sense of what was going on. We saw improvements for periods of time only to relapse several months later. This pattern continued for several years. The breaking point came about a year ago. When the thoughts of self-harm were so severe and asked us to take them to the hospital, and was admitted. We were devastated by this news. However, this event was likely the best thing that could have happened. The psychiatrist assigned to this child specialized in OCD intrusive thought disorder, and with a description of the child’s history she immediately suspected PANDAS. She ordered strep and blood tests which were all positive. Immediate treatment was started with NSAIDS, steroids, and antibiotics, and within several days the child had finally begun to feel normal again. The doctor suspected that one of the family members may be a strep carrier and had all of us tested. The child’s father was positive for strep with no symptoms at all and was likely the carrier. The father was also treated with antibiotics while continuing to treat the child with low-dose antibiotics on an ongoing basis. The child has had a full recovery with no repeat of symptoms. 1 I would like to bring awareness to this medical condition so that others are aware of the potential risks of strep infection, and how it can affect not only the heart and kidneys but the brain as well. Below are my recommendations for life ratings based on my research and personal knowledge of this medical condition. Recommended Underwriting Guidelines Life Ratings Ages 0-18 Onset less than 3 years Postpone Mild symptoms +50 Otherwise Decline Ages 18 and older Onset less than 3 years Postpone Mild symptoms Stable less than 2 years +50 stable more than years +0 Moderate symptoms Favorable features +150 Unfavorable features Decline Severe symptoms Decline Additional rating factors With history of other psychiatric or Decline behavioral disorders With attempted suicide Less than 2 years ago Decline More than 2 years IC With alcohol suspi- Decline cion or substance abuse 2 Disease Classification Mild minimal anxiety symptoms; no tics; no restrictive eating; quick response to antibiotic treatment; resolution within 6 months to 1 year Moderate mild tics; mild to moderate anxiety with low dose anti-anxiety medications; use of NSAIDS and/or corticosteroids for short term; resolution within 2 years of onset Severe ongoing or chronic with restrictive eating; severe anxiety or severe behavior changes including regression; treatment with IVIG or plasma exchange Favorable features Unfavorable features Symptoms lasting less than 2 years Symptoms lasting more than 2 years Good support system History of restrictive eating Good response to treatment Missed time from work/school No family history of mental disorders In-patient treatment Compliance with treatment Plasma exchange No time off school/work Associated mental disorders Treated with IVIG Poor compliance with treatment Laurie Kaiser Senior Underwriting Consultant SCOR Global Life Americas Sources: https://www.medicinenet.com/pandas/article.htm#what_is_the_history_of_pandas http://view.liebertpubmail.com/?qs=96fe299c9aa8dd4a19dfbc80aa826564ae2ec58 bbce35 15043820952c61d 8a4ccf7005d7cc19a460298f7ac1cbb7b67e2f5417a130e823f5e 115e9beae3312e6de4cca617224cca0 https://www.healthline.com/health/pandas-syndrome#symptoms 3.
Load more

Recommended publications
  • OCD As a Dynamical Disease and the Familial Context of Ritual Rigidity: a Nonlinear Dynamics Perspective
    Marquette University e-Publications@Marquette Dissertations, Theses, and Professional Dissertations (1934 -) Projects OCD as a Dynamical Disease and the Familial Context of Ritual Rigidity: A Nonlinear Dynamics Perspective Robert W. Bond Marquette University Follow this and additional works at: https://epublications.marquette.edu/dissertations_mu Part of the Psychiatry and Psychology Commons Recommended Citation Bond, Robert W., "OCD as a Dynamical Disease and the Familial Context of Ritual Rigidity: A Nonlinear Dynamics Perspective" (2011). Dissertations (1934 -). 127. https://epublications.marquette.edu/dissertations_mu/127 OCD AS A DYNAMICAL DISEASE AND THE FAMILIAL CONTEXT OF RITUAL RIGIDITY: A NONLINEAR DYNAMICS PERSPECTIVE by Robert W. Bond, Jr., B.S., M.S. A Dissertation submitted to the Faculty of the Graduate School, Marquette University, in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Milwaukee, Wisconsin August, 2011 ABSTRACT OCD AS A DYNAMICAL DISEASE AND THE FAMILIAL CONTEXT OF RITUAL RIGIDITY: A NONLINEAR DYNAMICS PERSPECTIVE Robert W. Bond, Jr., B.S., M.S. Marquette University, 2011 Comparatively few studies of obsessive-compulsive disorder (OCD) have addressed the interpersonal dynamical patterns within families that could exacerbate or quell symptom severity in the ill relatives or hypothesize other roles for familial variables. Furthermore, the extant studies have relied primarily upon linear models. Methodological limitations of linear models, such as assuming that change occurs as the result of unidirectional influences and that the scores obtained for each variable are independent of each other are at variance with temporal, dynamic phenomena and have restricted the empirical investigations of the dynamics of OCD. The current study investigated whether OCD could be considered a dynamical disease such that the complex rhythmic processes that are the norm for living things would be replaced by relatively constant dynamics or by periodic dynamics.
    [Show full text]
  • Poor Insight in Obsessive-Compulsive Disorder: Examining the Role of Cognitive, Metacognitive, and Neuropsychological Variables
    POOR INSIGHT IN OBSESSIVE-COMPULSIVE DISORDER: EXAMINING THE ROLE OF COGNITIVE, METACOGNITIVE, AND NEUROPSYCHOLOGICAL VARIABLES by Heather K. Hood Master of Arts, Ryerson University, 2009 Bachelor of Arts, University of Guelph, 2007 A dissertation presented to Ryerson University in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Program of Psychology Toronto, Ontario, Canada, 2014 ©Heather K. Hood 2014 AUTHOR'S DECLARATION FOR ELECTRONIC SUBMISSION OF A DISSERTATION I hereby declare that I am the sole author of this dissertation. This is a true copy of the dissertation, including any required final revisions, as accepted by my examiners. I authorize Ryerson University to lend this dissertation to other institutions or individuals for the purpose of scholarly research. I further authorize Ryerson University to reproduce this dissertation by photocopying or by other means, in total or in part, at the request of other institutions or individuals for the purpose of scholarly research. I understand that my dissertation may be made electronically available to the public. ii Abstract Poor Insight in Obsessive-Compulsive Disorder: Examining the Role of Cognitive, Metacognitive, and Neuropsychological Variables Doctor of Philosophy, 2014 Heather K. Hood Psychology Ryerson University The purpose of this study was to examine the cognitive and neuropsychological constructs that are conceptually related to poor insight in obsessive-compulsive disorder (OCD). The relationship between dimensions of insight (Brown Assessment of Beliefs Scale; BABS) and cognitive (magical thinking, paranoia/suspiciousness), metacognitive (metacognition, decentering, cognitive flexibility), and neuropsychological indices of cognitive flexibility were examined. Participants with OCD (N = 80) referred for treatment at an outpatient anxiety disorders clinic completed a clinical interview, a brief battery of neuropsychological measures, and a computer-administered questionnaire package assessing the variables of interest.
    [Show full text]
  • Self-Ambivalence in Obsessive-Compulsive Disorder
    Self-Ambivalence in Obsessive-Compulsive Disorder Sunil S Bhar Submitted in total fulfilment of the requirements of the degree of Doctor of Philosophy July, 2004 Produced on acid-free paper Department of Psychology University of Melbourne ii iii Abstract According to the cognitive model, Obsessive-compulsive disorder (OCD) is maintained by various belief factors such as an inflated sense of responsibility, perfectionism and an overestimation about the importance of thoughts. Despite much support for this hypothesis, there is a lack of understanding about the role of self-concept in the maintenance or treatment of OCD. Guidano and Liotti (1983) suggest that individuals who are ambivalent about their self-worth, personal morality and lovability use perfectionistic and obsessive compulsive behaviours to continuously restore self- esteem. This thesis develops a model of OCD that integrates self-ambivalence in the cognitive model of OCD. Specifically, it explored the hypothesis that the OCD symptoms and the belief factors related to the vulnerability of OCD are mechanisms that provide relief from self- ambivalence. It addressed three questions. First, is self-ambivalence related to OCD symptoms and OCD-related beliefs? Second, to what extent is self-ambivalence specific to OCD, compared to other anxiety disorders? Third, to what extent is self-ambivalence important in accounting for response and relapse of OCD to psychological interventions? In order to explore these questions, a questionnaire measuring self- ambivalence was first developed and evaluated. Non clinical and clinical participants were recruited for research. Non-clinical participants (N = 269) comprised undergraduate students (N = 226: mean age = 19.55; SD = 3.27) and community controls (N = 43; mean age = 43.78; SD = 3.92).
    [Show full text]
  • Berrypub5102.Pdf
    A review of obsessive intrusive thoughts in the general population Author Berry, Lisa-Marie, Laskey, Ben Published 2012 Journal Title Journal of Obsessive-Compulsive and Related Disorders DOI https://doi.org/10.1016/j.jocrd.2012.02.002 Copyright Statement © 2012 Elsevier. Licensed under the Creative Commons Attribution-NonCommercial- NoDerivatives 4.0 International Licence (http://creativecommons.org/licenses/by-nc-nd/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited. Downloaded from http://hdl.handle.net/10072/352184 Griffith Research Online https://research-repository.griffith.edu.au Obsessive Intrusive Thoughts 1 Obsessive Intrusive Thoughts in the General Population Lisa-Marie Berrya and Ben Laskeya,b aDivision of Clinical Psychology, University of Manchester, UK bCornwall CAMHS (CiC Team), Truro, UK Address for correspondence: Lisa-Marie Berry Division of Clinical Psychology University of Manchester M13 9PL. UK Tel: +44 (0) 161 306 0400 Fax: +44 (0) 161 306 0406 Email: [email protected] Running head: Obsessive Intrusive Thoughts Abstract: 132 words Body text: 6473 Figures: 0 Tables: 0 Obsessive Intrusive Thoughts 2 Abstract Intrusive thoughts feature as a key factor in our current understanding of Obsessive- Compulsive Disorder (OCD). Cognitive theories of OCD assume that the interpretation of normal intrusive thoughts leads to the development and maintenance of the disorder. Research that supports the role of beliefs and appraisals in maintaining distress in OCD is based on the supposition that clinical obsessions are comparable to normal intrusive thoughts. This paper reviews research investigating the occurrence of intrusive thoughts in a non-clinical population, in order to assess if these thoughts are comparable to obsessions.
    [Show full text]
  • The Appraisal of Intrusive Images Among Outpatients with Social Anxiety Disorder
    The Appraisal of Intrusive Images Among Outpatients with Social Anxiety Disorder Undirtitill Jóhann Pálmar Harðarson Lokaverkefni til cand. psych-gráðu Sálfræðideild Heilbrigðisvísindasvið The Appraisal of Intrusive Images Among Outpatients with Social Anxiety Disorder Jóhann Pálmar Harðarson Lokaverkefni til cand. psych-gráðu í sálfræði Leiðbeinandi: Andri Steinþór Björnsson Sálfræðideild Heilbrigðisvísindasvið Háskóla Íslands Júní 2016 2 Ritgerð þessi er lokaverkefni til cand. psych gráðu í sálfræði og er óheimilt að afrita ritgerðina á nokkurn hátt nema með leyfi rétthafa. © Jóhann Pálmar Harðarson og Andri Steinþór Björnsson, 2016 Prentun: Háskólaprent Reykjavík, Ísland 2016 3 Table of Contents Abstract ...................................................................................................................................... 6 Introduction ................................................................................................................................ 7 Methods .................................................................................................................................... 12 Participants ........................................................................................................................... 12 Measures ............................................................................................................................... 15 The Imagery and Social Trauma Interview .......................................................................... 15 The MINI International
    [Show full text]
  • The Examination of Inhibition in Obsessive Compulsive Disorder
    Modern Psychological Studies Volume 23 Number 2 Article 6 2018 The Examination of Inhibition in Obsessive Compulsive Disorder Stephanie J. Glover University of Denver, [email protected] Christopher A. Moyer [email protected] Follow this and additional works at: https://scholar.utc.edu/mps Part of the Psychology Commons Recommended Citation Glover, Stephanie J. and Moyer, Christopher A. (2018) "The Examination of Inhibition in Obsessive Compulsive Disorder," Modern Psychological Studies: Vol. 23 : No. 2 , Article 6. Available at: https://scholar.utc.edu/mps/vol23/iss2/6 This articles is brought to you for free and open access by the Journals, Magazines, and Newsletters at UTC Scholar. It has been accepted for inclusion in Modern Psychological Studies by an authorized editor of UTC Scholar. For more information, please contact [email protected]. INHIBITION IN OBSESSIVE COMPULSIVE DISORDER 1 Abstract Obsessive compulsive disorder (OCD) is characterized by intrusive, anxiety-provoking obsessions and irresistible compulsions that are performed to relieve anxiety. It is theorized that a deficit in inhibition may play a role in obsessive-compulsive symptomology. Areas of cognitive functioning that are affected by inhibition deficits may lead to obsessions and intrusive thoughts, while behavioral inhibition deficits may lead to compulsions. In the current paper, inhibition is examined in individuals with OCD, how such a deficit affects attention, recall, and response control, and how this relates to the disorder’s symptoms. A better
    [Show full text]
  • Compulsions Pdf, Epub, Ebook
    COMPULSIONS PDF, EPUB, EBOOK Rockne S O'Bannon,Keith R A DeCandido,Will Sliney | 112 pages | 27 Dec 2011 | Boom! Studios | 9781608866397 | English | Los Angeles, United States Compulsions PDF Book In other words, finding a way to discontinue compulsions is the way to decondition anxiety and have less frequent and intense obsessions. Patients who do not respond to one medication sometimes respond to another. Obviously, putting oneself through this process is uncomfortable and often very depressing, but letting oneself off the hook does not feel like an option. A teacher may fear she is not adequately understood when she speaks and never feels she can explain things perfectly enough. In most cases, individuals with OCD feel driven to engage in compulsive behavior and would rather not have to do these time consuming and many times torturous acts. Compulsive overeating is the inability to control one's amount of nutritional intake, resulting in excessive weight gain. This leads to more ritualistic behavior — the vicious cycle of OCD. About the Author: Stacey Kuhl Wochner. Environment An association between childhood trauma and obsessive-compulsive symptoms has been reported in some studies. It is this heightened sense of responsibility, and need to protect loved ones that often drives the person with OCD to repeat the endless cycle of ritualistic behaviours compulsions. These thoughts have to be pervasive and cause problems in health, occupation, socialization, or other parts of life. The goal of clinical trials is to determine if a new test or treatment works and is safe. Mayo Clinic does not endorse companies or products.
    [Show full text]
  • Developing a Model to Predict Prevalence of Compulsive Behavior in Individuals with OCD Lindsay D
    University of South Florida Scholar Commons Graduate Theses and Dissertations Graduate School June 2018 Developing a Model to Predict Prevalence of Compulsive Behavior in Individuals with OCD Lindsay D. Fields University of South Florida, [email protected] Follow this and additional works at: https://scholarcommons.usf.edu/etd Part of the Mathematics Commons Scholar Commons Citation Fields, Lindsay D., "Developing a Model to Predict Prevalence of Compulsive Behavior in Individuals with OCD" (2018). Graduate Theses and Dissertations. https://scholarcommons.usf.edu/etd/7286 This Thesis is brought to you for free and open access by the Graduate School at Scholar Commons. It has been accepted for inclusion in Graduate Theses and Dissertations by an authorized administrator of Scholar Commons. For more information, please contact [email protected]. Developing a Model to Predict Prevalence of Compulsive Behavior in Individuals with OCD by Lindsay D. Fields A thesis submitted in partial fulfillment of the requirements for the degree of Master of Arts Department of Mathematics and Statistics College of Arts and Sciences University of South Florida Major Professor: Gregory McColm, Ph.D. Eric Storch, Ph.D. Nataša Jonoska, Ph.D. Date of Approval: May 29, 2018 Keywords: compulsive, brain, game theory, Society of Mind, behavior Copyright © 2018, Lindsay D. Fields DEDICATION To my mother, for showing me how. For making your textbooks my first bedtime stories, for taking me to the library, for helping me with my math homework, even after geometry, for being my first copyeditor, and for coming to every one of my graduations. We never learned to keep our voices down.
    [Show full text]
  • Risk Assessment and Management in Obsessive–Compulsive Disorder David Veale, Mark Freeston, Georgina Krebs, Isobel Heyman & Paul Salkovskis
    Advances in psychiatric treatment (2009), vol. 15, 332–343 doi: 10.1192/apt.bp.107.004705 ARTICLE Risk assessment and management in obsessive–compulsive disorder David Veale, Mark Freeston, Georgina Krebs, Isobel Heyman & Paul Salkovskis David Veale is an honorary harm to children may be tempted to play for safety SUMMARY senior lecturer and a consultant when conducting a risk assessment. However, a psychiatrist in cognitive behaviour Some people with obsessive–compulsive disorder person with OCD can be harmed by an incorrect or therapy at the NIHR Biomedical (OCD) experience recurrent intrusive sexual, Research Centre for Mental Health, unduly lengthy risk assessment, responding with aggressive or death-related thoughts and as a The South London and Maudsley increased doubts and fears about the implications result may be subjected to lengthy or inappropriate NHS Foundation Trust, King’s of their intrusive thoughts. At best this will lead College London, and The Priory risk assessments. These apparent ‘primary’ risks Hospital North London. Mark can be dealt with relatively easily through a careful to greater distress, avoidance and compulsive Freeston is Professor of Clinical understanding of the disorder’s phenomenology. behaviours, and mistrust of health professionals; Psychology at Newcastle University, However, there are other, less obvious ‘secondary’ at worst, to complete decompensation of the patient Newcastle upon Tyne. Georgina risks, which require more careful consideration. or break-up of the family. In reality, there is no need Krebs is a clinical psychologist working in the service for young This article discusses the differentiation of intrusive for overcautious reactions. Provided the clinician people with obsessive–compulsive thoughts and urges in people with OCD from has appropriate expertise in OCD, there are very disorder at the Maudsley Hospital, those experienced by sexual or violent offenders; rarely any serious doubts about the diagnosis.
    [Show full text]
  • What Are People's Lay Theories About Mind Wandering and How Do Those Beliefs Affect Them?
    What Are People’s Lay Theories About Mind Wandering and How Do Those Beliefs Affect Them? Claire M. Zedelius and Jonathan W. Schooler Many of the thoughts that pass through our minds each day are disconnected from the here and now. While we may seem engaged with our current activity or environment—our eyes scanning a page of text or locking with those of a con- versation partner—our attention is often directed inwardly, to thoughts about cur- rent concerns, future plans, or fantasies. These types of thoughts, studied under the (somewhat interchangeably used) terms stimulus- or task-unrelated thoughts, de- coupled thought, daydreaming, and mind wandering (e.g., Antrobus, 1968; Singer & Schonbar, 1961; Smallwood & Schooler, 2006), are often spontaneous and unsolicited (Seli, Carriere, & Smilek, 2014; Seli, Risko, Smilek, & Schacter, 2016), yet occupy an astonishing 30–50% of our waking life (Kane et al., 2007; Killingsworth & Gilbert, 2010; Klinger & Cox, 1987; McVay, Kane, & Kwapil, 2009), with far-reaching and often negative consequences for our performance (see Mooneyham & Schooler, 2013 for a review), mood (Franklin et al., 2013; Killingsworth & Gilbert, 2010), and safety (e.g., Galera et al., 2012). Sometimes stimulus-unrelated thoughts have an intrusive character. Intrusive thoughts tend to be repetitive and revolve around fears or traumatic events (Clark & Rhyno, 2005). Like normal mind wandering, intrusive thoughts are highly common among healthy individuals (Clark & Rhyno, 2005), but they are also a hallmark feature of a surprising range of disorders, including depression, generalized anxiety disorder, insomnia, obsessive–compulsive disorder (OCD), and posttraumatic stress disorder (PTSD; Clark, 2005; Davies & Clark, 1998).
    [Show full text]
  • Horizon Scanning Status Report Volume 2, Issue 1 March 2020
    PCORI Health Care Horizon Scanning System Horizon Scanning Status Report Volume 2, Issue 1 March 2020 Prepared for: Patient-Centered Outcomes Research Institute 1828 L St., NW, Suite 900 Washington, DC 20036 Contract No. MSA-HORIZSCAN-ECRI-ENG-2018.7.12 Prepared by: ECRI Institute 5200 Butler Pike Plymouth Meeting, PA 19462 Investigators: Randy Hulshizer, MA, MS Damian Carlson, MS Christian Cuevas, PhD Andrea Druga, PA-C Marcus Lynch, PhD Misha Mehta, MS Brian Wilkinson, MA Donna Beales, MLIS Jennifer De Lurio, MS Eloise DeHaan, BS Eileen Erinoff, MSLIS Maria Middleton, MPH Diane Robertson, BA Kelley Tipton, MPH Rosemary Walker, MLIS Karen Schoelles, MD, SM Statement of Funding and Purpose This report incorporates data collected during implementation of the Patient-Centered Outcomes Research Institute (PCORI) Health Care Horizon Scanning System, operated by ECRI Institute under contract to PCORI, Washington, DC (Contract No. MSA-HORIZSCAN-ECRI-ENG- 2018.7.12). The findings and conclusions in this document are those of the authors, who are responsible for its content. No statement in this report should be construed as an official position of PCORI. An intervention that potentially meets inclusion criteria might not appear in this report simply because the Horizon Scanning System has not yet detected it or it does not yet meet inclusion criteria outlined in the PCORI Health Care Horizon Scanning System: Horizon Scanning Protocol and Operations Manual. Inclusion or absence of interventions in the horizon scanning reports will change over time as new information is collected; therefore, inclusion or absence should not be construed as either an endorsement or rejection of specific interventions.
    [Show full text]
  • Obsessive-Compulsive Disorder?
    WHAT IS OBSESSIVE-COMPULSIVE DISORDER? BASIC FACTS • SYMPTOMS • FAMILIES • TREATMENTS RT P SE A Mental Illness Research, Education and Clinical Center E C I D F I A C VA Desert Pacific Healthcare Network V M R E E Long Beach VA Healthcare System N T T N A E L C IL L LN A E IC S IN Education and Dissemination Unit 06/116A S R CL ESE N & ARCH, EDUCATIO 5901 E. 7th Street | Long Beach, CA 90822 basic facts Obsessive-compulsive disorder (OCD) is a psychiatric disor- Course of OCD der characterized by the presence of obsessions and/or compul- The average age of onset in the U.S. is late teens/early 20’s. sions. Obsessions are repeated thoughts, images, or urges that are However, OCD can begin as early as childhood, and about a quar- unwanted and cause significant distress and anxiety. Compulsions ter of cases emerge before age 14. An earlier age of onset is more are repetitive behaviors or mental acts that a person feels like they common in males. If left untreated, OCD tends to be a chronic con- need to do, usually in response to an obsession. People’s experienc- dition, often with symptom severity fluctuating over time. Some es of OCD vary greatly in terms of specific symptoms. For example, people might experience acute OCD episodes during times of one person might be excessively concerned with germs or contami- stress, but then the symptoms remit after a period of time. Both nation and spends excessive amounts of time washing or cleaning, pregnancy and the postpartum period are associated with an in- whereas another person might have disturbing violent or sexual creased risk of developing OCD or a worsening of symptoms for images that they struggle to control.
    [Show full text]