• Obsessive-Compulsive Disorder

    (OCD)

    Definition

    Obsessive-compulsive disorder (OCD) is an anxiety disorder. A person with OCD has unwanted repetitive thoughts and behaviors.

    Causes

    The cause is of OCD is unknown. OCD may be due to a combination neurobiological, environmental, genetic, and psychological factors. An imbalance of a brain chemical called serotonin may play a major role.
    Chromosome DNA
    The genes that you inherit from your family may play a role in the development of OCD.
    Copyright © Nucleus Medical Media, Inc.

    Risk Factors

    OCD is more common in late adolescence into early adulthood. Your risk is also higher if you have family members with a history of OCD.

    Symptoms

    OCD may cause:
      Obsessions—unwanted, repetitive, and intrusive ideas, impulses, or images; common obsessions include:
      • Persistent fears that harm may come to self or a loved one
      • Unreasonable concern with being contaminated
      • Unreasonable concerns about safety
      • Unacceptable religious, violent, or sexual thoughts
      • Excessive need to do things correctly or perfectly
      • Persistent worries about a tragic event
      Compulsions—repetitive behaviors or mental acts to reduce the distress associated with obsessions; common compulsions include:
      • Excessive checking of door locks, stoves, water faucets, and light switches
      • Repeatedly making lists, counting, arranging, or aligning things
      • Collecting and hoarding useless objects
      • Repeating routine actions a certain number of times until it feels right
      • Unnecessary rereading and rewriting
      • Mentally repeating phrases
      • Repeatedly washing hands
    Conditions associated with OCD include:
    If you have OCD, you may know that your thoughts and compulsions do not make sense, but you are unable to stop them.

    Diagnosis

    OCD is usually diagnosed through a psychiatric assessment. OCD is diagnosed when obsessions and/or compulsions either:
    • Cause significant distress
    • Interfere with your ability to properly perform at work, school, or in relationships

    Treatment

    Treatment reduces OCD thoughts and compulsions, but does not completely eliminate them. Common treatment approaches include a combination of medication and therapy.

    Medications

    Selective serotonin reuptake inhibitors (SSRIs) reduce OCD symptoms by affecting serotonin levels. Tricyclic antidepressants can also help treat symptoms.
    Your doctor may try using other psychiatric medications to help control your condition.

    Therapy

    Behavioral therapy addresses the actions associated with OCD. Cognitive-behavioral therapy (CBT) addresses both the thought processes and the actions associated with OCD.
    Treatment of OCD is tailored to meet your particular needs.
    Examples of therapies used to treat OCD include:
    • Exposure and response prevention—involves gradually confronting the problem object or obsession without giving into the compulsive ritual linked to it
    • Aversion therapy—involves using a painful stimulus to prevent OCD behavior
    • Thought switching—involves learning to replace negative thoughts with positive thoughts
    • Flooding—involves being exposed to an object that causes OCD behavior
    • Implosion therapy—involves being repeatedly exposed to an object that causes fear
    • Thought stopping—involves learning how to stop negative thoughts
    Electroconvulsive therapy (ECT) has had some success for those with OCD that is difficult to treat. However, the treatment is not for everyone. Be sure to discuss the benefits and harms of ECT treatment with your doctor.

    Prevention

    There are no guidelines for preventing OCD because the cause is not known. However, early intervention may be helpful.

    RESOURCES

    Anxiety Disorders Association of America http://www.adaa.org

    International OCD Foundation http://ocfoundation.org

    CANADIAN RESOURCES

    Canadian Mental Health Association http://www.cmha.ca

    Canadian Psychological Association http://www.cpa.ca

    References

    Obsessive compulsive disorder (OCD). EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114503/Obsessive-compulsive-disorder-OCD. Updated June 13, 2016. Accessed September 26, 2016.

    Obsessive-compulsive disorder (OCD). National Institute of Mental Health, National Institutes of Health website. Available at: http://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml. Accessed August 21, 2014.

    OCD risk higher when several variations in gene occur together. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/science-news/2008/ocd-risk-higher-when-several-variations-in-gene-occur-together.shtml. Accessed August 21, 2014.

    4/16/2009 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T114503/Obsessive-compulsive-disorder-OCD: Simpson HB, Foa EB, Liebowitz MR, et al. A randomized, controlled trial of cognitive-behavioral therapy for augmenting pharmacotherapy in obsessive-compulsive disorder. Am J Psychiatry. 2008;165(5):621-630.

    7/15/2016 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T114503/Obsessive-compulsive-disorder-OCD: Fontenelle LF, Coutinho ES, Lins-Martins NM, Fitzgerald PB, Fujiwara H, Yücel M. Electroconvulsive therapy for obsessive-compulsive disorder: a systematic review. J Clin Psychiatry. 2015;76(7):949-957.

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