• Obsessive-Compulsive Disorder

    (OCD)

    Definition

    Obsessive-compulsive disorder (OCD) is an anxiety disorder. The person suffers from unwanted repetitive thoughts and behaviors. These obsessive thoughts and compulsive behaviors are very difficult to overcome. If severe and untreated, OCD can harm the ability to function at work, school, or home.

    Causes

    The cause is unknown. OCD may be due to neurobiological, environmental, genetic, and psychological factors. An imbalance of serotonin (a brain chemical) may play a major role.
    Genetic Material
    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

    Factors that may increase the risk of OCD include:

    Symptoms

    Symptoms include:
      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
      • 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
    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 medicine and therapy.

    Medications

    Selective serotonin reuptake inhibitors (SSRIs) reduce OCD symptoms by affecting serotonin levels. SSRIs include:
    • Fluoxetine (Prozac)
    • Fluvoxamine (Luvox)
    • Paroxetine (Paxil)
    • Sertraline (Zoloft)
    Clomipramine (Anafranil) is a tricyclic antidepressant drug that can also help treat symptoms.
    Your doctor may try using other psychiatric medicines 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.
    Examples of therapies used to treat OCD include:
    • Exposure and response prevention—involves gradually confronting the feared 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 object that causes OCD behavior
    • Implosion therapy—involves being repeatedly exposed to object that causes fear
    • Thought stopping—involves learning how to stop negative thoughts

    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/

    Obsessive-Compulsive 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 website. Available at: http://www.ebscohost.com/dynamed/ . Updated August 16, 2012. Accessed August 28, 2012.

    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 28, 2012.

    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 . Published April 7, 2008. Accessed August 28, 2012.

    4/16/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : 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;165:621-630. Epub 2008 Mar 3.

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