«Constraints have a huge impact on family life»

Mrs Walitza, how can I tell if my child washes his hands frequently, whether it is a habit or already a compulsive symptom? And who can I turn to?

The difference between cherished habits, rituals and compulsive symptoms is that the child suffers from the compulsions, whereas the rituals can trigger a feeling of security and safety or at least do not cause suffering.

In fact, even children suffer greatly from obsessive-compulsive symptoms, as they are unable to complete developmental steps due to the compulsions: For example, they are unable to get dressed, stop repeating certain thoughts or go to nursery or school. Paediatricians can carry out the initial examination and screening. Experts should be consulted for a detailed assessment - i.e. psychiatrists and psychotherapists specialising in children and adolescents.

Compulsions and tics can start early in childhood. What is known about the causes?

Although obsessive-compulsive disorder and tics are two different disorders, they very often occur together and have similar symptoms. Genetic vulnerability and environmental conditions play roughly equal roles in obsessive-compulsive disorders. This means that compulsions are hereditary and can be triggered by stress. Parental behaviour can also have an influence: Some people find it difficult to distance themselves from the obsessive-compulsive symptoms and, for example, buy a lot of soap when they have a washing compulsion.

In the case of tic disorders, which are now recognised as primary neurological disorders, the genetic predisposition is very pronounced. Tics can decrease with increasing age. Whether compulsions and tics can be triggered by infections has been the subject of controversial debate for years. It is important that both disorders are treated.

It is very important to you that affected children are diagnosed as early as possible and receive appropriate treatment. Why is that?

Because both disorders, compulsions and tics, can be extremely stressful for children, adolescents and their families. Obsessive-compulsive disorders tend to worsen constantly if they are not treated. The earlier they are recognised and treated, the better the prognosis. I know some families where everyday life is completely subordinate to the obsessive-compulsive disorder of an affected family member. In the case of tic disorders, you should assess how much suffering the affected person is experiencing. If necessary, you can observe carefully, wait and respond to the needs of the affected child.