{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T09:07:57Z","timestamp":1789376877952,"version":"build-2803163510"},"reference-count":13,"publisher":"Royal College of Psychiatrists","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych Bull"],"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Obsessive\u2013compulsive disorder (OCD) is being missed in children with severe intellectual disability. Their compulsive behaviours are routinely attributed to autism spectrum disorder or dismissed as challenging behaviour, without systematic consideration of OCD. I argue that this misattribution is predictable, consequential and correctable. The key diagnostic tool is the ego-dystonic\/ego-syntonic distinction: OCD rituals are distressing to the child and a change from their baseline, whereas autistic repetitive behaviours are typically comforting. When this distinction is applied, and OCD is treated with modified exposure and response prevention and selective serotonin reuptake inhibitors, outcomes can be transformative. A dedicated evidence base for this population is urgently needed.<\/jats:p>","DOI":"10.1192\/bjb.2026.10285","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T09:02:08Z","timestamp":1789376528000},"page":"1-4","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Are we missing obsessive\u2013compulsive disorder in children with severe intellectual disability?"],"prefix":"10.1192","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7074-5978","authenticated-orcid":false,"given":"Annie","family":"Swanepoel","sequence":"first","affiliation":[{"name":"Southend, Essex and Thurrock Child and Adolescent Mental Health Service Learning Disabilities Team (SET CAMHS-LD)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"key":"S205646942610285X_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(22)00067-0"},{"key":"S205646942610285X_ref11","doi-asserted-by":"publisher","DOI":"10.1177\/10445463251366159"},{"key":"S205646942610285X_ref12","doi-asserted-by":"publisher","DOI":"10.1177\/1362361320909177"},{"key":"S205646942610285X_ref5","doi-asserted-by":"publisher","DOI":"10.1192\/bja.2023.14"},{"key":"S205646942610285X_ref13","doi-asserted-by":"publisher","DOI":"10.3109\/15622970903418544"},{"key":"S205646942610285X_ref10","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-007-0841-2"},{"key":"S205646942610285X_ref6","doi-asserted-by":"publisher","DOI":"10.1177\/02698811241239596"},{"key":"S205646942610285X_ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s10803-024-06357-8"},{"key":"S205646942610285X_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.euroneuro.2019.02.002"},{"key":"S205646942610285X_ref1","volume-title":"Obsessive-Compulsive Disorder and Body Dysmorphic Disorder: Treatment (Clinical Guideline CG31) (Last reviewed: 11 Jul 2024)","year":"2005"},{"key":"S205646942610285X_ref8","first-page":"VD01","article-title":"Obsessive compulsive disorder with intellectual disability: a diagnostic and therapeutic challenge","volume":"9","author":"Gautam","year":"2015","journal-title":"J Clin Diagn Res"},{"key":"S205646942610285X_ref4","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291725102882"},{"key":"S205646942610285X_ref9","doi-asserted-by":"publisher","DOI":"10.1586\/ern.11.200"}],"container-title":["BJPsych Bulletin"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S205646942610285X","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T09:02:09Z","timestamp":1789376529000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S205646942610285X\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,14]]},"references-count":13,"alternative-id":["S205646942610285X"],"URL":"https:\/\/doi.org\/10.1192\/bjb.2026.10285","relation":{},"ISSN":["2056-4694","2056-4708"],"issn-type":[{"value":"2056-4694","type":"print"},{"value":"2056-4708","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,14]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}]}}