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Back to Psychiatry Diseases
Obsessive-compulsive disorder (OCD)
Obsessive-compulsive disorder (or OCD), as categorized by the DSM-IV,
is an anxiety disorder. It is characterised by the obsessive need to
perform some task. These tasks are often known as rituals. Note that the
DSM-IV Axis II Obsessive-compulsive personality disorder is considerably
different from Obsessive-compulsive disorder, and is often what people
mean when they refer to somebody as "obsessive-compulsive".
Causes and related disorders
Recent research has revealed a possible genetic mutation that could be
the cause of OCD. Researchers funded by the National Institutes of
Health have found a mutation in the human serotonin transporter gene,
hSERT, in unrelated families with OCD.
Violence is rare among OCD sufferers, but the disorder is often
debilitating to the quality of life. Also, the psychological
self-awareness of the irrationality of the disorder can be painful. For
people with severe OCD, it may take several hours a day to carry out the
compulsive acts. More often, they avoid certain situations or places
altogether.
Some people with OCD also suffer from other conditions such as Tourette
syndrome, attention deficit disorder, trichotillomania, hypochondria or
Pure Obsessional OCD (rumination).
Symptoms and prevalence
Today it is well-accepted that OCD is much more common than was thought
previously. Typically 2?3 % of the general population is believed to
have OCD or OCD-like symptoms.
In many cases the task that an OCD sufferer does may seem simple to the
layperson, but the sufferer feels that they must perform it in some
particular way for fear of dire consequences. Examples might include
checking that one has locked one's car many times over before leaving it
parked, or turning the lights on and off a set number of times every
time one leaves a room. Such a person, when addicted to cigarettes, may
argue that they can only quit smoking on the 13th or 27th of each month,
and only when they possess four cigarettes at noon. Some people who have
OCD may be completely aware that such obsessions are not rational, but
feel bound to comply with them because otherwise they suffer from panic
or irrational dread.
Obsessions are ideas that the person cannot stop thinking about. These
are often fears about getting a disease, getting hurt, or causing harm
to someone. The main features of obsessions are that they are automatic,
frequent, upsetting or distressing, and difficult to control or get rid
of. Compulsions refer to actions that the person performs, usually
repeatedly, in an attempt to make the obsession go away. These are often
cleansing or avoidance actions. Common compulsions include excessive
washing and cleaning, checking, repetitive actions such as touching,
counting, arranging and ordering, hoarding, ritualistic behaviours that
lessen the chances of provoking an obsession. Compulsions can be
observable actions, for example washing, but they can also be mental
rituals such as, repeating words or phrases, counting, or saying a
prayer.
Treatment
OCD can be treated with a variety of anti-depressants, such as Anafranil,
or selective serotonin reuptake inhibitors such as Paxil, Zoloft,
Prozac, Luvox, and Anafranil. Some medications like Gabapentin have also
been found to be useful in the treatement of OCD. Symptoms tend to
return, however, once the drugs are discontinued. There are claims that
long-term remission of symptoms has been achieved without medications
through cognitive-behavioral therapy making use of the principles of
extinction and habituation.
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