---
title: "Psych News Alert: Obsessions May Start Very Early in Childhood"
description: Symptoms for obsessive-compulsive disorder may appear as early as age 3, Michael Miller, M.D., editor-in-chief of the Harvard Mental Health ...
image: https://alert.psychnews.org/hubfs/Imported_Blog_Media/OCD%20Handwashing_81195922-Jun-24-2025-09-42-14-6455-PM.jpg
---

 1/23/12 12:00 AM

# Obsessions May Start Very Early in Childhood

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Symptoms for obsessive-compulsive disorder may appear as early as age 3, Michael Miller, M.D., editor-in-chief of the *Harvard Mental Health Letter, *reported on January 17. Signs of the disorder in these young children  may include concern about sameness and symmetry, insisting that things be perfect, insisting on certain bedtime routines, or developing superstitions and rituals such as avoiding cracks in the sidewalk.

Over the past decade, several randomized controlled trials as well as literature reviews have concluded that both cognitive-behavioral therapy (CBT) and medication can help children better manage obsessive-compulsive disorder, but a combination of both interventions is best, Miller said. The ideal approach is to try CBT before turning to medication, he noted.

Read much more about this topic in two volumes from American Psychiatric Publishing—[*Obsessive Compulsive Disorder in Children and Adolescents*](http://www.appi.org/SearchCenter/Pages/SearchDetail.aspx?ItemId=8282)* *and *[Impulsivity and Compulsivity](http://www.appi.org/SearchCenter/Pages/SearchDetail.aspx?ItemId=8676)*.

Image: Caimacanul/Shutterstock.com

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