Health Scan: When orderliness may be sign of OCD

Children who are very rigid with rituals and become anxious when unable to engage in them may have OCD.

By JUDY SIEGEL-ITZKOVICH
Scientists 311 (photo credit: Thinkstock/Imagebank)
Scientists 311
(photo credit: Thinkstock/Imagebank)
Children who have steady habits such as regular schedules for eating, bathing and going to bed are considered by parents to have desirable behavior. However, when these routines are combined with oral and tactile sensitivities such as discomfort at the dentist or irritation caused by specific fabrics, these rituals could be an early warning sign of adult obsessive compulsive disorder (OCD).
So says Prof. Reuven Dar of Tel Aviv University’s psychology department.
He first suspected the link while working with OCD patients who reported sensitivity to touch and taste as children. Now, in the first comprehensive study of its kind, Dar and his colleagues have established a direct correlation between sensory processing – the way the nervous system manages incoming sensory information – and ritualistic and obsessive-compulsive behaviors.
The study, which appears in the Journal of Behavior Therapy and Experimental Psychiatry, suggests that when children have heightened levels of sensitivity, they develop ritualistic behaviors to better cope with their environment. In the long term, this is one potential pathway to OCD. Two studies were devised to map the connection between sensory processing, rituals and OCD. In the first, parents of kindergarten children were asked to complete three questionnaires on their child’s behavior.
They were asked about their level of ritualism, such as the need to repeat certain acts or to order objects in a particular way; level of anxiety and reactions to everyday sensory events such as being touched or exposed to unusual tastes or smells.
In the second study, the researchers asked 314 adult participants to answer surveys online in relation to their OCD tendencies, their anxiety levels and their past and current sensitivity to oral and tactile stimulation. Results from both studies indicated a strong connection between compulsive tendencies and hypersensitivity. In children hypersensitivity was an indicator of ritualism, while in adults it was related to OCD symptoms. As a whole, these findings provide preliminary support for the idea that such sensitivities are a precursor to OCD symptoms.
When children are extremely sensitive to certain types of touch or smell, they may feel that they are being attacked or that the environment is threatening them, Dar believes. Ritualism could develop as a defense mechanism, helping these children to regain a sense of control, which is also true of adults with OCD. Dar now intends to conduct a longitudinal study to better understand the connection between hypersensitivity in children and adults.
All children have particular habits and preferences, and they don’t all mean a future of OCD, concludes Dar. So what should parents watch for to correctly characterize normal versus potentially pathological behavior? “If you see that a child is very rigid with rituals, becoming anxious if unable to engage in this behavior, it is more alarming,” he explains. Age is also a factor; a habit exhibited by a child of five or six is not necessarily a predictor of OCD. If the same behavior continues to the ages of eight and above, it could be a warning sign, especially if accompanied by anxiety or distress, he suggests.
TARGETED CANCER STRATEGY
A strategy for inhibiting a protein associated with the spread of cancer has won a Hebrew University doctoral student in chemistry one of this year’s Kaye Innovation Awards at the university. The innovation, developed by Yftah Tal-Gan, a student of Prof.
Chaim Gilon and Prof. Alexander Levitzki at the chemistry institute, focuses on the inhibition of protein kinase B (PKB). Since the activation of PKB is associated with cancer, selective inhibition of this protein is a promising strategy for targeted cancer therapy.

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Tal-Gan’s method is based on mimicking the interaction of PKB with other proteins it comes into contact with. He accomplished this through the use of peptides, which can be used as protein “mimics” because they are built from the same amino acid building blocks as proteins.
However, peptides lack some important pharmacological properties, such as stability.
Through chemical engineering, Tal-Gan managed to convert an active peptide inhibitor of PKB, named PTR6154, into a stable “mimic” that combines biological activity with favorable pharmacological properties.
Selectively inhibiting PKB would prevent it from inducing cancer cell survival and division. As a result, the cancer cells would become susceptible to “death signals.” This could also potentially be combined with specific anti-cancer drugs, thus further enhancing the efficacy of the treatment method.
The Kaye Awards were established in 1994 by England’s Isaac Kaye, an industrialist in pharmaceuticals, to encourage HU faculty, staff and students to develop innovative methods and inventions with good commercial potential that will benefit the university and society.
DISPOSING OF OLD PILLS
New Health Ministry regulations will require all the health funds to dispose safely of people’s medications that have passed their expiration date so they are not abused by addicts or used by children and do not leech into the ground and pollute water sources. Until now, only Maccabi Health Services and Clalit Health Services have voluntarily installed locked bins in their pharmacies and elsewhere so members may dispose of outdated or unneeded medications.
Meanwhile, forced to balance protecting public health against the inability of poor people to buy expensive, lifesaving drugs that are not in the subsidized basket of medical technologies, the ministry has issued new regulations allowing soon-to-expire medications to be donated to special pharmacies run by voluntary organizations that will supply them free to the needy.
Friends for Health (Haverim Lerefuah in Hebrew), a non-profit religious organization that matches up needy patients with the families of patients who have unused expensive drugs at home, has been authorized to set up its first pharmacy that can receive medications from drug importers and manufacturers that are close to expiry but still usable.
This allows the organization (www@haverim.org.il) to supply for free medications such as expensive chemotherapy drugs not used up by patients who have recovered and no longer need them or those who have died. Until now, the organization has collected unneeded or unused drugs from such families then supplied them directly to patients. With the new arrangement involving an official Haverim pharmacy, the drugs will be kept in proper conditions (for example, under refrigeration if necessary) and set aside for those who need them but cannot afford them.
They will arrive at hospitals or clinics so they do not have to be stored by the families themselves.
Ministry deputy director-general Dr. Yoel Lipschitz said that he cannot intervene in the work of religious charities (known in Hebrew as gemachim) around the country that have for years given out cheap medications such as antibiotics to people on Shabbat and holidays when the families will not go out and purchase them. Those medicines requiring a doctor’s prescription are given the when a prescription is shown, and for those and for over-the-counter drugs, the recipient later brings the medication that he obtained from a pharmacy. The ministry worries about this practice because the drugs may not have been stored in proper conditions, but it is impossible to halt such private initiatives, Lipschitz said.