A person with obsessive-compulsive disorder have either obsessions, or compulsions, or both. The obsessions and/or compulsions are strong enough to cause significant distress in their employment, schoolwork, or personal and social relationships. This includes: anankastic neurosis, obsessional neurosis and obsessive-compulsive neurosis
- The person has obsessions or compulsions, or both.
Obsessions. The patient must have all of:
Recurring, persisting thoughts, impulses or images inappropriately intrude into
awareness and cause marked distress or anxiety.
These ideas are not just excessive worries about ordinary problems.
The person tries to ignore or suppress these ideas or to neutralize them by thoughts
or behavior.
There is insight that these ideas are a product of the patient’s own mind.
Compulsions. The person must have all of:
The person feels the need to repeat physical behaviors (checking the stove to be sure it is off, hand washing) or mental behaviors (counting things, silently repeating words).
These behaviors occur as a response to an obsession or in accordance with strictly applied rules.
The aim of these behaviors is to reduce or eliminate distress or to prevent something that is dreaded.
These behaviors are either not realistically related to the events they are supposed to
counteract or they are clearly excessive for that purpose.
- During some part of the illness the patient recognizes that the obsessions or compulsions are unreasonable or excessive.
- The obsessions and/or compulsions are associated with at least 1 of:
Cause severe distress.
Take up time (more than an hour per day).
Interfere with the patient’s usual routine or social, work or personal functioning. - The symptoms are not directly caused by a general medical condition or by substance use, including medications and drugs of abuse.
Some of the most prevalent compulsions are:
Repeated checking of doors, locks, electrical appliances, or light switches.
Frequent cleaning of hands or clothes.
Strict attempts to keep various, personal items in careful order.
Mental activities that are repetitious, such as counting or praying.
Associated Features:
Depressed Mood
Somatic or Sexual Dysfunction
Guilt or Obsession
Anxious or Fearful or Dependent Personality
Differential Diagnosis:
Some disorders have similar or even the same symptom. The clinician, therefore, in his diagnostic attempt, has to differentiate against the following disorders which he needs to rule out to establish a precise diagnosis
Obsessive-Compulsive Disorder;
Narcissistic Personality Disorder;
Antisocial Personality Disorder;
Schizoid Personality Disorder;
Personality Change Due to a General Medical Condition;
Symptoms that may develop in association with chronic substance use.
Cause:
In one-third of obsessive-compulsive individuals, onset of the disorder occurs by the age of 15. A second peak of incidence occurs during the third decade of life. Once established, obsessive-compulsive disorder is likely to persist throughout life with varying degrees of severity. However, the exact cause is still unknown. There is some evidence to suggest that OCD may be inherited. There is a link between a shortage of serotonin, which is a neurotransmitter in a person’s brain, and OCD. Stress has also been linked to OCD. It has been found that when a person’s life is consumed by stress, they are more likely to develop OCD.
Treatment:
There is no cure for OCD, However, there are several types of treatments for obsessive-compulsive disorder.
Counseling and Psychotherapy [ See Therapy Section ]:
Individual therapy is the most common treatment and frequently involves response prevention and exposure. Response prevention therapy consists of keeping the person from acting on his/her obsessions and compulsions.
Pharmacotherapy [ See Psychopharmacology Section ] :
Current medications used for the treatment of OCD include Anafranil (clomipramine), Luvox (fluvoxamine), Paxil (paroxetine), and Prozac (fluoxetine). These medications can help diminish obsessive thinking and the subsequent compulsive behaviors.
Other Treatment:
Electroconvulsive therapy is sometimes helpful in individuals with severe primary depression and secondary obsessions and Neurosurgery-Stereotactic limbic leukotomy (combining anterior cingulotomy and subcaudate tractotomy) and anterior.
