Obsessive Compulsive Disorder: Symptoms, Diagnosis

Overview

Obsessive Compulsive Disorder (OCD), often misunderstood as merely a little hand washing or checking light switches, is indeed a mental health disorder characterized by frightening obsessions, time-consuming compulsions, and high levels of anxiety.

Obsessions are the recurrent and disturbing thoughts, and compulsions refer to ritualized behaviors that the person feels driven to perform. Most people with OCD have both obsessions and compulsions, but a minority (about 20 percent) have obsessions alone or compulsions alone (about 10 percent).

OCD affects between 1 and 3 percent of all adults, 80 percent of whom show symptoms before the age of 18. It affects both people of all ages, sexes, and walks of life.

Causes

OCD hasn’t been fully understood yet. However, many medical professionals believe this condition could be the result of a combination of genetic, neurological, behavioral, cognitive, and environmental factors.

OCD runs in families and can be considered as a “familial disorder”. The disease may span generations with close relatives of people with OCD significantly more likely to develop OCD themselves.

Some rapid-onset cases of OCD in children might be consequences of Group A streptococcal infections, which cause inflammation and dysfunction in the basal ganglia.

People with OCD associate certain objects or situations with fear. They learn to avoid those things or learn to perform “rituals” to help reduce the fear. The behavioral theory outlined above focuses on how people with OCD make an association between an object and fear.

OCD may be a result of changes in your body’s own natural chemistry or brain functions. Despite this finding, it is not known exactly how these differences relate to the development of OCD.

Environmental stressors may be a trigger for OCD in people with a tendency toward developing the condition. Somehow, OCD is also related to the habits you may have developed during childhood or over a long period of time.

Symptoms

Obsessive compulsive disorder usually includes both obsessions and compulsions, or either of them. Obsessions and compulsions can involve many different things.

Obsession thoughts can include:

  • Fear of contamination or dirt
  • Needing things be placed in exact order
  • Aggressive or horrific thoughts about harming yourself or others
  • Unwanted thoughts, including aggression, or sexual or religious subjects
  • Constant awareness of blinking, breathing, or other body sensations
  • Unfounded suspicion that a partner is unfaithful

Compulsive habits include:

  • Washing and cleaning
  • Checking
  • Counting
  • Orderliness
  • Following a strict routine
  • Demanding reassurances

Diagnosis

Formal diagnosis may be performed by a psychologist, psychiatrist, clinical social worker, or other licensed mental health professionals. Steps to help diagnose OCD may include:

  • Physical exam.

This may be done to help rule out other problems that could be causing your symptoms and to check for any related complications.

  • Lab tests.

These may include, for example, a complete blood count (CBC), a check of your thyroid function, and screening for alcohol and drugs.

  • Psychological evaluation.

Many healthcare professionals use a tool called a structured clinical interview contained with standardized questions which ask about the nature, severity, and duration of symptoms. Rating scales, such as the Yale–Brown Obsessive Compulsive Scale (Y-BOCS) are used to quantify the severity and impairment..

  • Diagnostic criteria for OCD.

Your doctor may use criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.

Treatment

A combination of the following treatments may not bring OCD to an end, but can effectively help control some symptoms.

  • Psychotherapy

Cognitive behavioral therapy (CBT), a type of psychotherapy, is effective for many people with OCD. This involves gradually learning to tolerate the anxiety associated with not performing the ritual behavior.

  • Medications

Certain psychiatric medications can help control the obsessions and compulsions of OCD. Most commonly, antidepressants are tried first, including Clomipramine (Anafranil), Fluoxetine (Prozac), paroxetine (Paxil, Pexeva), and Sertraline(Zoloft).

  • Deep brain stimulation (DBS)

Deep brain stimulation involves implanting electrodes within certain areas of your brain. These electrodes produce electrical impulses that regulate abnormal impulses. Since DBS hasn’t been thoroughly tested for use in treating OCD, make sure you understand all the pros and cons and possible health risks.

  • Electroconvulsive Therapy (ECT)

Electroconvulsive therapy is a procedure, in which small electric currents are passed through the brain, intentionally triggering a brief seizure. ECT has been found to have effectiveness in some severe and refractory cases.

Keywords: obsessive compulsive disorder.

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* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.