Children with neurodegenerative disease and obsessive-compulsive behaviour.

BACKGROUND

Children with neurodegenerative diseases progressively lose skills and develop somatic and psychiatric symptoms. Obsessive-compulsive disorder (OCD) may occur, a disorder for which effective medical and psychological treatments are available. However, whether these treatments are useful for children with neurodegenerative disease is unknown.

CASE PRESENTATION: A child with an uncommon form of neurodegenerative disease (with loss of sight and incipient cognitive decline) had during the previous year developed time-consuming compulsive behaviours. The child spent much of the day at home (> 8 hours), turning on/off switches, opening/closing doors, repeating after others and so on. A diagnostic assessment concluded that the child fulfilled the criteria for OCD, with predominantly compulsive acts. The child began combined treatment with sertraline and exposure and response prevention therapy (ERP). It was necessary to adapt the ERP to the neurodegenerative disease, with strong parental involvement. After six months the compulsive acts were gone.

INTERPRETATION: Children with neurodegenerative disease may have a high risk of psychiatric disorders, but the literature is sparse on phenomenology and treatments. The present case study documents that OCD can occur in a child with neurodegenerative disease and that the combined medical and psychological treatments were effective.