Author Affiliations: Pediatrics and Developmental Neuropsychiatry Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Md.
Contempo Updates Section Editor: Stephen
J. Lurie, MD, PhD, Senior Editor.
A 7-year-old second-grader was brought to her pediatrician after an
abrupt onset of abnormal behavior that began on a family trip to the zoo.
She refused to touch or hold anything with her hands (for example, the walkway
railings) and repeatedly requested to wash her hands at each rest room she
passed throughout the day. The contamination fears increased over the next
2 days, until she was unable to clean herself or use the toilet without assistance.
The washing of her hands became a ritual that involved counting to 10 for
each finger she cleaned. She would cry and seem distressed as she washed,
yet refused to leave the sink until the ritual was completed. By the time
medical attention was sought, the fears and rituals had progressed to the
point that her father had turned off the water to all but 1 of the sinks in
the house and her mother had to brush her child's teeth and bathe her at least
twice each day. She also had developed fears that her food might be contaminated
and refused to eat all but a few specific "safe" foods.
Snider LA, Swedo SE. Pediatric Obsessive-Compulsive Disorder. JAMA. 2000;284(24):3104-3106. doi:10.1001/jama.284.24.3104