Obsessive Compulsive Disorder, also known as OCD, is characterized by a pattern of unreasonable thoughts and fears (obsessions) that lead you to do repetitive behaviors (compulsions). Many individuals try to ignore or stop their obsessions, but that only increases the distress and anxiety experienced by these individuals. These obsessions and compulsions interfere with daily activities and cause significant distress. Many individuals with OCD know or suspect their obsessions are not true; others may think they could be true (which is known as poor insight). About 1.2 percent of Americans have OCD and the typical age of onset is around 19 years old and about 2% of cases start by age 14. The onset age for individuals after the age 35 is unusual, but does occur. Males have an earlier onset of OCD than females and are more likely to have comorbid tic disorders.
Obsessive compulsive disorder is an anxiety disorder in which people have recurring, unwanted thoughts, ideas or sensations (obsessions) that make them feel driven to do something repetitively (compulsions). For people with OCD, thoughts are persistent, and unwanted routines and behaviors are rigid, and not doing them causes great distress. Many individuals with OCD have dysfunctional beliefs that may include: an inflated sense of responsibility and the tendency to perfectionism, overestimate threat, intolerance of uncertainty, over importance of thoughts, and the need to control thoughts. Some individuals with obsessive compulsive disorder may use alcohol or drugs to calm themselves. OCD is treatable, but if left untreated, the course can be chronic. Poor insight has been linked to worse long-term outcomes.
While there are not different types of obsessive compulsive disorders, there are 3 levels of insight in the Diagnostic and Statistical Manual of Mental Disorders.
The cause of obsessive compulsive disorder can depend on environment, genetics, and or brain structure and functioning. Research shows that in many cases individuals who have experienced abuse (physical or sexual) in childhood or other trauma are at an increased risk for developing OCD. Genetically, the risk is higher if the first-degree relative developed OCD as a child or teen. Twin and family studies have shown that individuals with first-degree relatives (such as a parent, sibling, or child) who have OCD are at a higher risk for developing OCD themselves. Research has found a connection between abnormalities in certain parts of the brain and OCD symptoms. These parts include frontal cortex and subcortical structures of the brain.
To be diagnosed with general obsessive compulsive disorder, according to the Diagnostic and Statistical Manual of Mental Disorders, the following criteria must be met:
A. Presence of obsessions and compulsions, or both:
Obsessions are defined by (1) and (2):
Compulsions are defined by (1) and (2):
* Young children may to be able to articulate the aims of these behaviors or mental acts.*
B. The obsessions or compulsions are time-consuming (e.g., take more than 1 per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
C. The obsessive- compulsive symptoms are not attributable to the physiological effects of a substance (e.g., a drug abuse or a medication) or another medical condition.
D. The disturbance is not better explained by the symptoms of another mental disorder e.g; excessive worries, as in generalized anxiety disorder, preoccupation with appearance, like body dysmorphic disorder; difficulty with discarding or parting with possessions, as in hoarding disorder; hair pulling, as in trichotillomania (hair picking disorder); skin picking, as in excoriation (skin picking disorder); stereotypes, such as stereotypic movement disorder; ritualized eating behaviors, like eating disorders; preoccupation with gambling or substances, like substance-abuse-related disorders or gambling disorders, repetitive patterns of behavior, as in autism spectrum disorder; thought insertion or delusion, as in schizophrenia; sexual urges or fantasies; as in paraphilic disorders; impulses, as in disruptive, impulse- control, and conduct disorders; and guilty rumination, as in major depressive disorders.
There is not a perfect way to approach a loved one that you assume or know has obsessive compulsive disorder. People with obsessive compulsive disorder may be embarrassed and try to hide symptoms or rituals, and mental rituals can be very difficult to recognize. While preventing a loved one from developing an obsessive compulsive disorder is not possible, providing support and being aware of what they’re learning in treatment can be helpful. For more information on how to approach a loved one with a obsessive compulsive disorder visit: https://www.psychguides.com/guides/how-to-find-help-treating-obsessive-compulsive-disorder/
Treating obsessive compulsive disorder usually includes the combination of medication and therapy. It is important to distinguish the best course of treatment individually.
The most common forms of medication used to reduce OCD symptoms are serotonin reuptake inhibitors (SRIs) and selective serotonin reuptake inhibitors (SSRIs). Some medications that are effective in both adults and children with OCD include fluoxetine, fluvoxamine, and sertraline.
Research has also shown that antipsychotic medication (like risperidone) can also be effective if the other listed medications do not work. When using medication, it is important to talk with a doctor or a pharmacist to make sure the risks and benefits are understood. Do not stop taking a medication without talking to a doctor first.
Psychotherapy is also an effective treatment for adults and children with obsessive compulsive disorder. Research shows that certain types of psychotherapy, like cognitive behavior therapy (CBT) can be as effective as medication for many individuals. Specifically, Exposure and Response Prevention (EX/RP). This form of treatment, which is used in reducing compulsive behaviors in OCD, is usually the add-on treatment of choice when SRIs or SSRIs medication does not effectively treat OCD symptoms.
There are other disorders that may resemble general obsessive compulsive disorder, so it is important to differentiate the difference between common disorders that may get confused with this disorder.
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders.
(5th ed.) Arlington, VA: American Psychiatric Association.
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