Obsessive-compulsive disorder (OCD)

verifier1

Department of General Medicine

DEFINITION

Obsessive compulsive disorder (OCD), a type of disorder characterized by unreasonable thoughts, feelings,fears,ideas and sensations (obsessions),that lead to do repetitive thoughts and behaviors (compulsions).

Obsessions are involuntary, recurring and undesirable thoughts that cause feelings of anxiety or dread.They are irrational and interfere with normal thinking. People with this disorder can't control these obsessions and compulsions.

OCD cycle behaviors can become extremely time-consuming and impede with normal functioning. People with OCD may aware that their obsessions and compulsions are unrealistic or senseless ,and they will nearly always need to perform the ritual later.

About 20% of people with OCD have spasms, which suggests the condition may be related to Tourette syndrome. It is a common psychiatric disorder, affecting approximately 2.2 million American adults each year. People with OCD often go several years without treatment. It has a detrimental impact on many factors of quality of life, including level of education,financial independence and employment status.

SYMPTOMS

OCD has 3 main parts. They include

1. Obsessions (The thoughts that make anxious )
2. The anxiety you feel
3. Compulsions (The things you do to reduce the anxiety)

Obsessions  : Obsessions  are images,thoughts or impulses that occur over and over again and feel uncontrollable.

Compulsions : Compulsions  are actions taken to alleviate anxiety.

People are unable to control either the thoughts or the activities. A person may experience obsessions, compulsions or both. Common activities include

Common Obsessions :

• Contamination fears of germs, dirt, etc
• Intrusive thoughts or urges
• A need to have things ‘just right’
• Imagining having harmed oneself or others
• Excessive concern with order, arrangement, or symmetry
• Fear of losing things
• Being afraid of social embarrassment
• Concern with getting a physical illness or disease
• Forbidden or unwanted sexual thoughts, images or urges
• Stabbing or abusing someone, or being unfaithful
• Wonder for hours whether you might have caused an accident or misfortune to someone

Common Compulsions

• Cleaning/washing :  Repetedly washing of hands ,Bathing or Cleaning household items.
• Repeating :  Unable to stop repeating  a nameor any activity etc.
• Checking :  Checking or rechecking several times a day  ,that the stove is turned off,Doors are locked, Iron Box is unplugged etc.
• Touching and tapping
• Arranging/Organizing : Making sure things are just right, or consistent with a specific rule, such as bed sheets or notes on the desk.
• Hoarding : Collecting  apparently useless items, such as paper, magazines, towels, bottles or pieces of garbage ; and unable to throw these same things away.  

CAUSES

The exact cause of OCD  is  unknown. Both environmental and genetic factors are believed to play a role, although a number of factors have been suggested.

Chemical and brain dysfunction

The chemical messenger, Serotonin appears to be heavily involved. Serotonin is a chemical called a neurotransmitter that helps the nerve cells to communicate with each other by working in the space between nerve cells, called the synaptic cleft. The  research shows that, Serotonin is involved with biological processes such as mood, sleep, aggression, appetite and pain. and also capable of connecting to nerve cells in the brain in many different ways and can cause many responses. It is not even fully established if  all or part of the Serotonin chemical or another chemical entirely acting on it; or a malfunction in one or more receptors in the brain that Serotonin attaches to that causes the OCD problems.

Genetics

OCD  often appears to run in the family. In fact, almost half of all cases show a familial pattern. Research studies shows that siblings and children of a person with OCD have a greater chance of developing OCD than does someone with no family history of the disorder.

Depression

People with depression sometimes develop Obsessive compulsive disorder symptoms, and those with OCD may develop depression.

Infection

A streptococcal infection of the throat may sometimes result in the infection of healthy cells and causing cellular damage. If this occur with the brain, the body’s infection fighting system can attack the outside of nerve cells present in the Basal Ganglial part of the brain and the result that OCD symptoms  may occur. Some research suggests that these symptoms don’t appear to last very long and the occurrence of this ‘infection OCD’ seems to be very rare.

TREATMENT

As in adults, treatment includes medication therapy, behavior therapy, or a combination of both.  Drugs suggested for OCD are those that act upon the imbalance of serotonin.

Medication :  Mainly the antidepressant called a selective serotonin reuptake inhibitor (SSRI) such as  Fluoxetine  or a tricyclic antidepressant, such as Clomipramine is helpful for many people to reduce the compulsions and obsessions.

Pharmacological Treatments for OCD

Clomipramine

SSRIs

Fluoxetine

Fluvoxamine

Sertraline

Cognitive behavioral therapy (CBT) for OCD helps the patients to change their  ideas or thought patterns related to obsessive thoughts and compulsions.

CONCLUSION

Obsessive-compulsive disorder is a tough disorder to live with. OCD cannot prevent  from starting. It affects every aspect of the persons life, whether it be interact with family or friends, or simple everyday tasks that we all take for granted. The best way to prevent a relapse of OCD symptoms is by staying with your therapy and taking any medicines exactly as they have been prescribed.

REFERENCE

• Obsessive Compulsive Disorder ; International OCD Foundation.  
• Obsessive-Compulsive Disorder;  Anxiety Disorders Association of America.
• Obsessive-Compulsive Disorder: An Overview for School Personnel    Herbenson, Kristi L ; American Psychological Association, 5th edition.
• Obsessive-compulsive disorder Core interventions in the treatment of obsessivecompulsive disorder and body dysmorphic disorder; Issued: November 2005 NICE clinical guideline 31.
• Obsessive-Compulsive Disorder (OCD); by Lawrence Robinson, Melinda Smith, M.A, and Jeanne Segal, Ph.D; Help guide.org.
• Obsessive-compulsive disorder; Psych Guides.com.  
• Obsessive-Compulsive Disorder ; by Wayne K. Goodman, M.D ; Psych Central.
• Obsessive-Compulsive Disorder; by Dr Philip Timms,Dr Paul Blenkiron ; Royal College of Psychiatrists.
• Obsessive-Compulsive Disorder ; William M Greenberg ; medscape.
• Obsessive compulsive disorders; The National Alliance on Mental Illness by Ken Duckworth, M.D., and Jacob L. Freedman, M.D.