Introductory Remarks

OCD, obsessive compulsive disorder, is a mental condition characterized by repetitive, unwanted thoughts, feelings and ideas (obsessions) which are uncontrollable. These obsessions are a pattern of unwanted thoughts and fears. They make a person to carry out repetitive actions (compulsions). obsessions and compulsions interfere with most of the normal daily activities and bring a lot of distress to one’s life.

With this disorder, a person is driven to perform compulsive acts so as to ease their stress. Trying to ignore some of them works no good, as these will keep on coming back again and again. This makes individuals to act ritualistically, and this is a cycle of OCD. It is a chronic condition whose symptoms come and go over time.

Three main features of OCD are obsessions, emotions and compulsions:

• Obsessions. These are unwanted and distressing thoughts, pictures or urges repetitively storm the mind.
• Emotions. Feelings of intense anxiety that are caused by the obsessions.
• Compulsions. Due to anxiety and distress that are caused by obsessions, an individual feels driven to carry out repetitive acts.

Even though OCD can lead to embarrassment and frustration, it can be treated effectively especially if diagnosed at an early stage.

Facts & Figures

• OCD can affect any person. It is relatively common.
• It affects less than 2.5% of the population in the US.
• The average age at which it starts to affect people is 19 years. Rarely do persons develop OCD after reaching 40 years.

Risk Elements & Causal Factors

• The exact causes of this disorder are not yet known.
• However, it is believed that several factors play roles in its development. These include:

1. Genetics. If you have a sibling or a biological parent with OCD, you are highly likely to suffer from the same.
2. Changes in brain anatomy. For example, the frontal cortex.
3. PANDAS syndrome. Several conditions can affect children who have previously had streptococcal infections and they are referred to as PANDAS- Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. They include OCD and scarlet fever.
4. Childhood trauma. For example, being neglected.

Signs & Symptoms

• Obsessions and compulsions which interfere with the performance of normal daily activities are the main symptoms in OCD.
• These symptoms may prevent a person from arriving early at their workplace or even preparing a meal within a reasonable amount of time.

Obsessions in OCD

Examples are:

• Being excessively concerned with morality (right or wrong).
• Unwanted mental images related to sex.
• Need for order and perfection.
• Fear of touching perceived contaminated objects.
• Need for persistent reassurance.

Compulsions in OCD

Examples are:

• Regularly washing hands even when they are clean.
• Organizing things in a certain specific way, for example clothes in a closet.
• Rituals related to numbers (as in counting) or letters (having preference for certain numbers or letters).

  

• Speaking certain words while performing unrelated tasks.
• Performing one task a specific amount of times.

• Demanding reassurance.

Diagnostic Procedures

• There is no diagnostic test that can pinpoint OCD.
• Steps for diagnosis are:

1. Psychological evaluation. The patient talks about feelings, thoughts, symptoms and behavioral patterns to help check if they have obsessive or compulsive symptoms.
2. Physical examination. This procedure rules helps in ruling out other conditions that could be causing your symptoms.

• Health-care providers employ criteria mentioned in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to diagnose OCD. These include:

1. Presenting with obsessions, compulsions or both of them.
2. The obsessions and/or compulsions taking more than 1 hour per day.
3. The obsessions and/or compulsions cause distress and affect personal life.
4. Presenting symptoms are not caused by medical drugs, alcohol and substance abuse or another health condition.
5. The symptoms are not explained by a different mental health disorder.

• Proper diagnosis of OCD may present a challenge to health-care practitioners. This is because symptoms of OCD may look similar to those of other mental health disorders, such as:

1. Depression.
2. Schizophrenia.
3. Anxiety disorders.
4. Obsessive-compulsive personality disorder (OCPD).

Treatment & Management

• Treatment strategies:

1. Psychotherapy.
2. Medicines.
3. Transcranial magnetic stimulation (TMS).

Further discussion:

Psychotherapy

• The most effective types of psychotherapy (talk therapy) employed in the treatment of OCD are;

1. Cognitive behavioral therapy.
2. Exposure and response prevention.
3. Acceptance and commitment therapy.

Medicines

• Serotonin reuptake inhibitors (SRIs).
• Selective serotonin reuptake inhibitors (SSRIs). examples are fluoxetine and paroxetine.
• Tricyclic anti-depressants (TCAs).

Transcranial magnetic stimulation (TMS)

• This procedure may be recommended when;

1. Psychotherapy and medications fail to treat OCD symptoms.
2. OCD symptoms are severe.

Complications

• The following are complications of OCD:

1. Spending much time in ritualistic behavior.
2. Troubled relationships.
3. Poor quality of life.
4. Suicidal thoughts and tendencies.
5. Having a difficult time carrying out normal tasks.

Preventive Strategies

• OCD is not preventable.
• However, early diagnosis and treatment can lower its symptoms and effects on life.