Children with mild obsessive-compulsive symptoms exhibit distinct anatomical differences in the cerebrum, according to a new study conducted by researchers at the Bellvitge Biomedical Research Institute (IDIBELL) and the Institute of Global Health of Barcelona (ISGlobal).
The findings, published in the Journal of the American Academy of Child and Adolescent Psychiatry, may positively impact the development of prevention strategies for long-term mental health disorders.
Mild symptoms of obsessive compulsive disorder (OCD) are far more common among children and adults than the more serious cases of the disorder that require medical and psychological attention. While OCD affects between 1 and 2 percent of the population, mild obsessive-compulsive symptoms may be present in up to nearly one-third of the population.
These milder symptoms may include, for example, recurrent thoughts about catching a disease after being in contact with objects in public spaces, fear of having inadvertently carried out some potentially dangerous behavior (such as leaving the door open when leaving home), or the need to place the objects of house or the workspace in perfect order and symmetry.
Likewise, these fears are often accompanied by compulsions such as repetitive and unnecessary cleaning and checking or organization behaviors that, although they are generally perceived as excessive, are difficult to control.
Although the majority of these mild cases do not interfere with daily life and do not require special attention, some cases — such as after a prolonged stressful situation — can lead to the appearance of a more severe condition than requires specialized treatment.
Childhood is a period particularly sensitive to the presence of obsessive-compulsive symptoms. For example, it is relatively normal for children to “need” to touch each and every one of the bars of a fence, line up their shoes in a certain way, or add up or repeat aloud the numbers of car license plates.
“In a small percentage of cases, however, these symptoms may be indicators of an increased risk of developing an obsessive-compulsive disorder that requires treatment, during childhood or in adulthood,” said Dr. Carles Soriano-Mas, lead author of the study.
For the study, 255 boys and girls aged 8 to 12, all healthy, and without any diagnosis of any mental health disorder, were asked to answer a questionnaire about the presence of mild obsessive-compulsive symptoms.
The most frequently observed symptoms were those related to behaviors of checking, ordering and looking for symmetry, the unnecessary accumulation of objects, as well as the repeated presence of negative and disturbing thoughts.
The children also underwent structural magnetic resonance, a harmless technique that allowed researchers to explore in great detail the cerebral anatomy. The cerebrum is the largest and most prominent part of the brain, where things like perception, imagination, thought, judgment and decision-making occur.
“When comparing the results of the questionnaire to the cerebral anatomy, we found out that the different symptoms observed, in spite of their mild character, could be associated to specific anatomical characteristics,” said Soriano-Mas.
“Interestingly, these same anatomical characteristics have also been observed in patients with more severe symptoms, with a diagnosed obsessive-compulsive disorder.”
The findings suggest that some mental disorders, including OCD, can be considered an extreme manifestation of certain characteristics that frequently appear among the healthy population.
“It is also necessary to consider other factors of a diverse nature, such as social, educational and general welfare ones, to determine why in some cases these symptoms remain mild and under control, and in others they evolve to more severe forms that require specialized attention,” said Soriano-Mas.
The results may also have an impact on prevention strategies for mental health disorders. For example, brain anatomy could be more closely monitored in high-risk individuals (the children of parents with psychiatric disorders, for example), so that the probability of developing a condition that interferes with their normal development can be estimated.