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.
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.
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.
