Contempo Updates
December 27, 2000

Pediatric Obsessive-Compulsive Disorder

Author Affiliations

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.

JAMA. 2000;284(24):3104-3106. doi:10.1001/jama.284.24.3104

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.

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