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Obsessive-compulsive disorder is an anxiety disorder in which people have unwanted and repeated thoughts, feelings, ideas, sensations (obsessions), or behaviors that make them feel driven to do something (compulsions).
Often the person carries out the behaviors to get rid of the obsessive thoughts, but this only provides temporary relief. Not performing the obsessive rituals can cause great anxiety.
Obsessive-compulsive disorder (OCD) is more common than was once thought. Most people who develop it show symptoms by age 30.
There are several theories about the cause of OCD, but none have been confirmed. Some reports have linked OCD to head injury and infections. Several studies have shown that there are brain abnormalities in patients with OCD, but more research is needed.
About 20% of people with OCD have tics, which suggests the condition may be related to Tourette syndrome. However, this link is not clear.
Obsessions or compulsions that are not due to medical illness or drug use
Obsessions or compulsions that cause major distress or interfere with everyday life
There are many types of obsessions and compulsions. One example is an excessive fear of germs and the compulsion to repeatedly wash the hands to ward off infection.
The person usually recognizes that the behavior is excessive or unreasonable.
Your own description of the behavior can help diagnose the disorder. A physical exam can rule out physical causes, and a psychiatric evaluation can rule out other mental disorders.
Questionnaires, such as the Yale-Brown Obsessive Compulsive Scale (YBOCS), can help diagnose OCD and track the progress of treatment.
OCD is treated using medications and therapy.
The first medication usually considered is a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI). These drugs include:
Citalopram (Celexa)
Fluoxetine (Prozac)
Fluvoxamine (Luvox)
Paroxetine (Paxil)
Sertraline (Zoloft)
If an SSRI does not work, the doctor may prescribe an older type of antidepressant called a tricyclic antidepressant. Clomipramine is a TCA, and is the oldest medication for OCD. It usually works better than SSRI antidepressants in treating the condition, but it can have unpleasant side effects, including:
Difficulty starting urination
Drop in blood pressure when rising from a seated position
Dry mouth
Sleepiness
In some cases, an SSRI and clomipramine may be combined. Other medications, such as low-dose atypical antipsychotics (includingrisperidone, quetiapine, olanzapine, or ziprasidone) have been shown to be helpful. Benzodiazepines may offer some relief from anxiety, but they are generally used only with the more reliable treatments.
Cognitive behavioral therapy (CBT) has been shown to be the most effective type of psychotherapy for this disorder. The patient is exposed many times to a situation that triggers the obsesive thoughts, and learns gradually to tolerate the anxiety and resist the urge to perform the compulsion. Medication and CBT together are considered to be better than either treatment alone at reducing symptoms.
Psychotherapy can also be used to:
Provide effective ways of reducing stress
Reduce anxiety
Resolve inner conflicts
OCD is a long-term (chronic) illness with periods of severe symptoms followed by times of improvement. However, a completely symptom-free period is unusual. Most people improve with treatment.
Long-term complications of OCD have to do with the type of obsessions or compulsions. For example, constant handwashing can cause skin breakdown. However, OCD does not usually progress into another disease.
Call for an appointment with your health care provider if your symptoms interfere with daily life, work, or relationships.
There is no known prevention for this disorder.
Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by uncontrollable, unwanted thoughts and repetitive, ritualized behaviors you feel compelled to perform. If you have OCD, you probably recognize that your obsessive thoughts and compulsive behaviors are irrational – but even so, you feel unable to resist them and break free.
Like a needle getting stuck on an old record, obsessive-compulsive disorder (OCD) causes the brain to get stuck on a particular thought or urge. For example, you may check the stove twenty times to make sure it’s really turned off, you’re your hands until they’re scrubbed raw, or drive around for hours to make sure that the bump you heard while driving wasn’t a person you ran over.
Obsessions are involuntary, seemingly uncontrollable thoughts, images, or impulses that occur over and over again in your mind. You don’t want to have these ideas – in fact, you know that they don’t make any sense. But you can’t stop them. Unfortunately, these obsessive thoughts are usually disturbing and distracting.
Compulsions are behaviors or rituals that you feel driven to act out again and again. Usually, compulsions are performed in an attempt to make obsessions go away. For example, if you’re afraid of contamination, you might develop elaborate cleaning rituals. However, the relief never lasts. In fact, the obsessive thoughts usually come back stronger. And the compulsive behaviors often end up causing anxiety themselves as they become more demanding and time-consuming.
Most people with obsessive-compulsive disorder fall into one of the following categories:
Just because you have obsessive thoughts or perform compulsive behaviors does NOT mean that you have obsessive-compulsive disorder. Many people have mild obsessions or compulsions that are strange or irrational, but they’re still able to lead their lives without much disruption. But with obsessive-compulsive disorder, these thoughts and behaviors cause tremendous distress, take up a lot of time, and interfere with your daily routine, job, or relationships.
Most people with obsessive-compulsive disorder (OCD) have both obsessions and compulsions, but some people experience just one or the other. The symptoms of OCD may wax and wane over time. Often, the symptoms get worse in times of stress.
While the onset of obsessive-compulsive disorder usually occurs during adolescence or young adulthood, younger children sometimes have symptoms that look like OCD. However, the symptoms of other disorders, such as ADD, autism, and Tourette’s syndrome can also look like obsessive-compulsive disorder, so a thorough medical and psychological exam is essential before any diagnosis is made. It’s also important to note that OCD is an anxiety disorder, and in children, the symptoms of anxiety usually change over time. So a child with OCD symptoms will not necessarily have OCD as an adult. What’s most important is to make environmental and behavioral changes to reduce your child’s anxiety.
There are many effective treatments for obsessive-compulsive disorder (OCD), ranging from therapy to self-help and medication. However, the treatment for OCD with the most research supporting its effectiveness is cognitive-behavioral therapy.
Cognitive-behavioral therapy for obsessive-compulsive disorder involves two components:
Exposure and response prevention involves repeated exposure to the source of your obsession. Then you are asked to refrain from the compulsive behavior you’d usually perform to reduce your anxiety.
For example, if you are a compulsive hand washer, you might be asked to touch the door handle in a public restroom and then be prevented from washing up. As you sit with the anxiety, the urge to wash your hands will gradually begin to go away on its own. In this way, you learn that you don’t need the ritual to get rid of your anxiety – that you have some control over your obsessive thoughts and compulsive behaviors.
Studies show that exposure and response prevention can actually “retrain” the brain, permanently reducing the occurrence of obsessive-compulsive disorder symptoms. This type of OCD therapy can even extinguish compulsive behaviors entirely.
The cognitive therapy component for obsessive-compulsive disorder (OCD) focuses on the catastrophic thoughts and exaggerated sense of responsibility you feel. A big part of cognitive therapy for OCD is teaching you healthy and effective ways of responding to obsessive thoughts, without resorting to compulsive behavior.
Psychiatrist Jeffrey Schwartz, author of Brain Lock: Free Yourself from Obsessive-Compulsive Behavior, offers the following four steps for dealing with OCD:
In addition to cognitive-behavioral therapy, the following treatments are also used for obsessive-compulsive disorder (OCD):
This OCD (Obsessive-Compulsive Disorder) screening test can help determine whether you might have the symptoms of OCD. Use the results to decide if you need to see a doctor or other mental health professional to further discuss diagnosis and treatment of OCD.
This OCD screening test can help determine the severity of your OCD symptoms. Use the results to help decide if you need to see a doctor or other mental health professional to further discuss diagnosis and treatment of OCD (obsessive-compulsive disorder). |
Instructions: Check the appropriate score below. Choose only one item per question. Scores should reflect the composite effect of all obsessive compulsive symptoms. Rate the average occurence of each item during the prior week up to and including now. |
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