Obsessive-compulsive disorder is marked by obsessive thoughts and compulsive behaviors. OCD is generally understood as a mental disorder, which has little or no effect on physical development including fine motor skills. A growing body of evidence, however, shows that a specific form of childhood-onset OCD might be linked to physical symptoms including problems with fine motor skills.
In May 2013, the DSM-V reorganized several disorders and changed some of the diagnostic criteria. In the DSM-V, OCD is no longer considered an anxiety disorder, but is a top-level disorder in a category that also includes such conditions as body dysmorphic disorder and hoarding. The symptoms of OCD and related disorders focus on obsessions, which are repetitive thought patterns that are intrusive and inappropriate, and compulsions, which are repetitive behaviors that the person uses to try to quiet the obsessions. Although physical symptoms sometimes occur, such as cracked and bleeding skin from too much hand washing, they are not typically associated with OCD.
PANDAS and PANS
In the Harvard Medical School Health Blog, clinical psychology instructor Jeff Szymanski notes that strep throat infections in children sometimes lead to sudden-onset OCD or other disorders such as tics or Tourette’s syndrome. Known as PANDAS, which stands for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections, this rare diagnosis was first discovered in 1998. Today, researchers recognize that some other bacteria can cause similar results, so many experts use the more inclusive term PANS, for pediatric acute-onset neuropsychiatric syndrome. Symptoms of PANS generally include sudden OCD symptoms such as compulsive hand washing or fear of germs, eating challenges, panic attacks and difficulty concentrating. In addition, PANS often causes new difficulties with fine motor skills. Often the first clue is a sudden deterioration of the child’s handwriting.
If your child’s fine motor skills suddenly deteriorate, call his pediatrician immediately. Let the doctor know if he also shows signs of OCD, anxiety or other changes in mood or behavior, as well as whether he has recently suffered from strep throat or any other infection. According to the International OCD Foundation, in many children, PANS responds well to treatment with intravenous immunoglobulin, or IVIG. It also responds to other medical treatments such as high-dose antibiotics. The sooner your child is treated, the more likely treatment is to be successful.
Numerous conditions can cause both OCD-like symptoms and fine motor skills deficits. In addition, some children have more than one condition. Avoid armchair diagnosis or making assumptions about what is wrong with your child. Even mental health experts sometimes face challenges in deciding which of a myriad of conditions a specific child has. Contact the doctor if you suspect something is wrong with your child.
- PsychCentral.com: DSM-V Changes Obsessive-Compulsive and Related Disorders
- InterMountainHealthCare.org: Summary of DSM-IV Diagnostic Criteria
- Harvard Medical School Health Blog: Can an Infection Suddenly Cause OCD?
- International OCD Foundation: Sudden and Severe Onset OCD -- Practical Advice for Practitioners and Parents
- Adam Gault/Digital Vision/Getty Images