Obsessive Compulsive Disorder (OCD)

What is obsessive compulsive disorder?

Obsessions are intrusive thoughts, images or urges that are recognized by the individual to be irrational and unwanted and which are usually resisted. Compulsions are repetitive behaviors or mental acts that the person feels driven to perform. Obsessive compulsive disorder is a mental health condition where obsessions and compulsions drives a person to behave in a manner that affects daily routine, quality of life and interpersonal relations.

The person with OCD tends to be driven by their obsessions and compulsions which are often carried out in order to avoid or neutralize the feared consequences of not doing so. For instance, someone with a fear that he might fall ill by contracting germs from the environment or other may therefore engage in frequent and excessive hand washing.

What are the symptoms of OCD?

The patients with this disorder usually have a particular type of personality which is characterized by ritualistic, rigid, perfectionist and meticulous tendencies. There are four major patterns of symptoms.

  • Obsession of contamination is the most common which is followed compulsion of washing.
  • Obsession of doubt with compulsion of checking.
  • Obsessional thought without compulsion, usually repeated thoughts of some sexual or aggressive act, is the third one.
  • Obsessional slowness is the fourth pattern in which daily tasks are done very slowly and is often mistaken for a perfectionist tendency.

Most patients show features of depression because of the psychosocial impact of these symptoms. People with OCD understand the irrationality of their behavior but are often unable to prevent it from controlling them.

What causes obsessive-compulsive disorders?

Though obsessive type of personality can be due to genetic or constitutional factors, environmental factors are of primary importance in the development of the. These patients may have a disturbed psychosexual development. Anxiety associated with sexuality is repressed to the unconscious mind and displaced to neutral ideas or acts.

Other defense mechanisms that come into operation are isolation, undoing and reaction formation. In obsession, neutral ideas become anxiety provoked stimuli. Compulsions become fixed because it tends to relieve the anxiety. Obsessive-compulsive disorders are rare condition. OCDs tend to become evident around early adulthood and affect males and females to the same degree.

How is obsessive compulsive disorder treated?

OCD is difficult to treat. Psychotherapy is the cornerstone of treatment where a person is taught to deal with the associated emotional states and symptoms. Drugs such as serotonin reuptake inhibitors (SSRIs) fluoxetine, fluvoxamine, paroxetine, sertraline and citalopram have been effective. Antidepressants such as chlorimipramine are found to be effective but have more side effects than the SSRIs.

If treatment is effective, it should be continued for at least 12 months to prevent relapse and allow for further improvement. Continued treatment over two years halves the relapse rate. Behavioral techniques such as systematic desensitisation, flooding, thought stopping, response prevention and negative practice are reported to be useful.

Family members are counseled so that they know to respond to the patient’s symptoms. Relapses are common with drug therapy but benefits of behavioral therapy tend to be maintained for a longer time and is the treatment of choice for obsessive-compulsive disorder.


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