This disorder is defined by persistent, intrusive, unwanted thoughts, images, ideas or urges (obsessions) and/or intense uncontrollable repetitive behaviors or mental acts related to the obsessions (compulsions) that are noted by the child or the parent to be unreasonable and excessive.
These obsessions and compulsions cause notable distress and difficulty with day-to-day functioning. The most common obsessions concern dirt and contamination, repeated doubts, the need to have things arranged in a specific way, fearful aggressive or murderous impulses, and disturbing sexual images or thoughts. The most frequent compulsions involve repetitive washing of hands; checking drawers, locks, windows and doors; counting rituals; repeating actions; and requesting reassurance.
Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) are a group of disorders that are believed to be the result of an autoimmune response to streptococcal infections. These disorders can present with obsessions and compulsions. The onset of OCD symptoms is typically more abrupt if associated with PANDAS.