In screening for OCD, your child's doctor or mental health professional will ask about obsessions and compulsions in language that your child will understand, such as the following questions:

*Do you have worries, thoughts, images, feelings, or ideas that bother you?

*Do you have to check things over and over again?

*Do you have to wash your hands a lot, more than most kids?

*Do you count to a certain number or do things a certain number of times?

*Do you collect things that others might throw away (like hair or fingernail clippings)?

*Do things have to be "just so"?

*Are there things you have to do before you go to bed?

Because it can be normal for children to answer yes to any of these questions, your child's doctor will also ask about your family's history of OCD, Tourette syndrome, and other motor or vocal tic disorders. OCD has a genetic component, which means that children whose family members have had any of these disorders may be more prone to OCD.

Tic disorders often resemble OCD symptoms: approximately 35% to 50% of people with Tourette syndrome also have OCD (but only a small percentage of children with OCD also have Tourette syndrome).

Disorders that frequently occur with OCD include other anxiety disorders, depression, disruptive behavior disorders (attention deficit hyperactivity disorder and oppositional defiant disorder), learning disorders, trichotillomania (compulsive hair pulling), and habit disorders such as nail biting or skin picking.

Rarely, OCD symptoms or tics that come on very suddenly may be associated with a recent Group A streptococcus infection (strep throat or, less commonly, scarlet fever). This phenomenon is known as PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections). No one knows for sure why PANDAS occurs, but research is underway to learn more about it. One theory is that strep infections may trigger an antibody response in some children that causes changes in the brain, leading to symptoms of OCD. Presently there are no lab tests to diagnose PANDAS.

Of course, just because your child has had strep throat doesn't mean he or she will also have PANDAS. Almost all school-age children have strep throat at some point, and the vast majority recover with no complications. Similarly, most children with OCD or tics do not have PANDAS. The condition may be considered only if a child's OCD symptoms or tics are directly preceded by, or significantly worsen after, a strep infection.

Updated and reviewed by: Lori Kasmen, PsyD
Date reviewed: October 2001
Originally reviewed by: Paul Robins, PhD