Identifying and Managing Obsessive-Compulsive Disorder in Primary Care

Obsessive-compulsive disorder (OCD) affects an estimated 1% to 3% of children and adolescents, and frequently results in significant academic, social, and family impairment. Early onset is associated with increased severity, chronicity, and psychiatric comorbidity, yet delays in recognition remain common. Pediatricians are often the first clinicians to encounter affected youth and are therefore essential in early identification and referral. Diagnosis is clinical, supported by validated screening instruments, such as the Children's Yale–Brown Obsessive-Compulsive Scale. Cognitive-behavioral therapy with exposure and response prevention is the first-line treatment, with selective serotonin reuptake inhibitors serving as evidence-based adjuncts for moderate to severe cases. Family-based interventions and psychoeducation further enhance outcomes. For treatment-resistant cases, augmentation with clomipramine or low-dose antipsychotics may be considered under specialist guidance. Sustained therapy and relapse prevention strategies are critical to maintaining remission. Early recognition and coordinated care can substantially improve prognosis for youth with OCD.