Early and Later Onset OCD: How They Differ


People must demonstrate certain obsessive-compulsive behaviors over time to receive a diagnosis of OCD.

A diagnosis might also specify an OCD subtype related to variables such as co-occurring disorders or symptom intensity. Research has associated some of these variables to the age of OCD onset—when symptoms first appear.

Childhood vs Young Adult Onset

Early onset OCD generally starts during childhood (mean age of 11). Later onset symptoms develop in the young adult years (mean age of 23).

Young adult/later onset OCD:

  • Affects slightly more females than males.
  • Is more likely to have milder symptoms.
  • Is less often linked to a family history of OCD.
  • Co-occurs more often with anxiety and mood disorders.
  • Tends to respond better to treatment.
  • Is less often diagnosed with tics or other movement symptoms.

Childhood/early onset OCD:

  • Affects males more than females.
  • Tends to have severer symptoms with poorer overall functioning.
  • Is more often treatment resistant.
  • Has more ties to first-degree relatives with OCD symptoms.
  • Is more likely to occur with a tic or movement disorder (but not with anxiety, depression, or ADD).
  • Can involve more neuropsychological impairment.

About ten percent of children who develop OCD between ages three and 13 may have PANDAS, or pediatric autoimmune neuropsychiatric disorder. PANDAS has been linked to streptococcal infections and a sudden onset of obsessive-compulsive behaviors. Research results associating later onset OCD to PANDAS are inconclusive.

Early Onset OCD and PANS

Children who suddenly develop OCD, plus other symptoms, are given a diagnosis of PANS, or Pediatric Acute-onset Neuropsychiatric Syndrome. The other symptoms of PANS include:

  • anxiety, depression, mood swings
  • motor abnormalities or tics
  • increased aggression, opposition, irritability
  • a drop in academic functioning
  • sensory problems

PANS, a diagnosis based on symptoms and behaviors, is likely triggered by infectious organisms (not just strep), or non-infectious variables such as metabolic dysfunction or environmental toxins.

There Is Help For OCD

Although research studies have provided medical and mental health professionals greater insight into OCD, the symptoms remain difficult to treat. Still, many OCD sufferers get relief from the intensity and frequency of their symptoms through CBT (cognitive-behavioral therapy), medication, and/or joining local or online support groups.

Source: psychiatry advisor
Photo credit: Casey Muir-Taylor


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