By Thonburi Healthcare Group
Welcome to Health Talk programme. We’re at Thonburi Hospital’s Pediatric Centre. Dr Tanatip, please talk about the Obsessive Compulsive Disorder (OCD) in children as well as adults. Generally, a classic OCD case is when someone happens to wash their hands countless times or maybe spend an hour doing so until their hands are hurt. In other words, we could say that if someone do something repeatedly in a compulsive manner that negatively affects the normal lifestyle or a person’s functionality. Th
However, some people may do things repeatedly, but their way of life is not significantly affected. For example, when I myself go to the airport for overseas business travel, I often touch my pocket to check if my passport is there. I could do it three times just to make sure I really have the passport with me. Doctors say that’s ok or sometimes people are worried if their cars are properly locked because they may have something valuable inside or may have just purchased a new and expensive item left inside the car. So you want to make sure your vehicles are really secured.
In other words, you are alright if your behavior is not affecting your functionality. Many adults have some mild forms of compulsive behavior which are positive. However, if you keep doing these things repeatedly for hours or for days, then it’s OCD since you would not be able to do things properly.
In children, there are also cases of OCD caused by anxiety. There is a term, Tiger’s Mum, used to depict Asian mothers in the US following the Korean and Vietnam wars. These so-called Tiger’s Mums were very strict with their children (in terms of discipline on education) after they had emigrated to the US. Later on, we should discuss OCD in children with the pediatrician.
Next, we will talk to Dr Chalermpol, who specializes in children’s OCD. Dr Chalermpol, what’s OCD in children? OCD is quite common in Thailand. We have seen cases of patients who are excessively fearful of germs and diseases so they wash their hands very often. Some people use up a bar of soap in one day and their hands are hurt due to excessive washing.
Such a behavior is sometimes said to be a personal trait, but medically, it’s an OCD when someone spends more than one hour per day doing this kind of thing repeatedly, negatively affecting one self as well as other people. An OCD also includes some form of cognitive problem.
There are many examples of OCD. For instance, there was a household which had never disposed their garbage. One day their neighbors reported the matter to police because the mountain of garbage had resulted in foul odor and a potential outbreak of diseases.
What’s about someone collecting a huge number of stuffs such as handbags. In that case, it’s rather different since the collector may be a collector and trader of those goods which are useful and the behavior hurts no one. Some people may be a toys’ collector. However, if you collect garbage, it hurts you and your neighbors due to the bad smell and lack of hygiene which could result in infectious diseases.
Other examples include those compulsively fearful of germs and disease contraction as happened in some people cleaning their personal belongings excessively or avoiding to eat something because they cannot be sure if they are perfectly clean. Some people are also compulsive in the sense that they want to adjust an object’s setting even though the things do not belong to them.
One patient wanted to move a picture frame in a public place just because it wasn’t placed exactly the way he liked it. That’s a problem. It’s kind of perfectionism even though it’s not your belongings.
What is the remedy for these people? First of all, we have to do tests to make sure if it’s an OCD case, not just some personality traits. Once diagnosed as an OCD case, it is believed that there is some form of cognitive problem regarding brain chemistry resulting in the repetitive pattern of thoughts. Normally, people when they are worried they may think about the same topic many times but after a while they tend to move to something else. But OCD patients cannot move to the next topic or it takes them a very long time to do so.
For those who like to double-check or triple-check their house’s lock before leaving, the border line is whether such a behavior is excessive or counter-productive. If you have to do it for hours and could not leave your home, then, it’s an OCD case, but if you do it for two minutes that’s not an OCD.
Some people have an obsession with bad and good omen in the form of certain colors or numbers so they could not function properly unless they are changed. For example, if you happen to get a hotel room with a certain room number you may not like, it could be a problem if the room could not be changed due to full occupancy.
OCD cases also have the heredity element. In some cases, the parents have some forms of OCD which could genetically affect their children. The condition is worse when there is stress and anxiety at home and school due to the environmental factor. In addition, there are brain chemistry and other problems. If a kid with OCD grow ups in a household very strict on cleanliness, the kid’s condition could worsen.
If there is some form of brain infection, it will also contribute to the existing condition. In terms of treatment, we have to diagnose first if it’s really an OCD and we also have to find out the underlying psychological factors behind the fears. Family and school also have to play their role in the treatment process involving various therapeutic measures. We also need medication to address the brain’s chemical imbalance.
Time is up. We thank Thonburi Hospital and Thonburi Healthcare Group for this programme. Good Bye and Sawasdee Krub.