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Obsessive-compulsive disorder (OCD)

Obsessive-compulsive disorder ( OCD ) is classified by DSM-IV (one of the classifications of psychiatric diseases) within anxiety disorders, (which, in turn, are a type of neurotic), and is characterized by the appearance of obsessions and compulsions (terms that will be explained later).

Its onset may be sudden, perhaps caused by some stressful event; It affects both sexes equally and usually begins in adolescence or youth, although it is generally earlier in men.

About 2% of the population suffers from this disease, which is frequently chronic, and which is related to previous personality disorders and other mental disorders such as social phobia and major depression. It seems that it occurs preferentially in singles and in people with a high IQ and / or high social class.

Why is it produced?

As in other psychiatric illnesses, there is not a single specific cause, but several possible ones. Among them, we can highlight the appearance of a triggering event, either psychological (an event that involves an emotional drama: family or relationship problems, death of a loved one, etc.) or organic (a head trauma , for example).

Other somatic abnormalities related to obsessive-compulsive disorder (OCD) have also been described, such as alterations in the frontal lobe and failures in serotonin regulation .

Recent studies show a certain degree of genetic association in the appearance of this disease.

In the psychological field, there is talk of a dysfunction in the assimilation of external stimuli, which causes patients to suffer exaggerated fears and excessive insecurity, inducing them to resort to rituals to check their actions.

Psychoanalysis places the origin of this disorder in a regression to the anal-sadistic phase of development, which acts as a defense mechanism.

Nowadays, theories about the existence of a relationship between organic and psychic alterations are increasingly gaining strength and, specifically, this is the case in this disease, whose treatment, as we will see, combines the correction of neurotransmission disorders of serotonin (already mentioned) and psychotherapy.

Symptoms of OCD

As we have already pointed out, the clinical manifestations of this disorder are obsessions and compulsions.

Obsessions

Obsessions are intrusive, unwanted mental phenomena that cause discomfort and anxiety to those who suffer from them. They can be ideas, images, thoughts, fears, beliefs, convictions, or impulses.

The most frequent are those of contamination (50% of patients fear they are dirty, even though they know they are not) and those of doubt (25% of patients need to make sure of something, even if they have checked it several times); Also typical are those that are not followed by compulsions (about 15%), hypochondriacs (the patient fears being ill for no real reason), morals (about sex or religion), fear of causing harm (for absurd reasons, such as stepping on the sidewalk lines) and impulsive reasons (sometimes with a violent component, such as imagining that someone is run over or raped).

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The patient knows that the obsessions are irrational and the result of his mind, so he tries to resist them, or control them (divert them from his thoughts).

Compulsions

Compulsions are behaviors or acts, of a motor or mental nature, that the patient needs to consummate, as a consequence of obsessive ideas. He resists doing them, because he knows they are absurd, which puts a great mental pressure on him that decreases when doing them.

When a compulsion is complex and elaborate, it is called ritual, and it is for the patient a defense mechanism against an obsession, something that reduces discomfort and tension (although in some cases the opposite may happen, that it increases them). Through stereotyped, repetitive actions with a “magical” meaning, it is sought to remove the “danger” latent in the obsession. Some examples of these rituals are that of cleaning or washing many times a day, due to an exaggerated fear of dirt, contamination or infections (the most frequent, as we have already seen), that of repeatedly checking something unnecessarily (if it is closed the door of the car, or the door of the house, etc.), to avoid committing some banal action (the example, of the stripes on the street), in order to avoid some supposed risk, etc.

When the disorder is already very advanced, the entire life of the patient is ritualized and slowed down, in such a way that to perform each of the daily tasks (such as showering or dressing), it can take several hours.

Obsessions can also appear in other diseases, in addition to OCD. Thus, it is possible that they are detected in encephalitis , Gilles de la Tourette syndrome and dementias.

How is it diagnosed?

The diagnosis of this pathology is made through a good medical history and a psychiatric examination.

According to DSM-IV, OCD is defined by the appearance of obsessions, followed or not by compulsions, repetitive and persistent, numerous and important enough to prevent the patient from leading a normal life.

Other mental disorders that may have traits in common with OCD, such as depression, schizophrenia or phobias, should be ruled out.

Obsessive compulsive disorder treatment

The treatment of OCD has two fundamental pillars:

  • Antidepressant drugs that act on serotonin, mainly selective serotonin reuptake inhibitors (SSRIs, such as fluoxetine), clomipramine (tricyclic antidepressant), or monoamine oxidase inhibitors (MAOIs, such as phenelzine) . These drugs are mainly used to treat obsessions.
  • Behavioral psychotherapy, aimed, above all, at improving compulsions and rituals. Putting both treatments into practice and in the absence of poor prognostic factors (long-term symptoms, premature onset, presence of compulsions, coexistence with other mental abnormalities), generally quite satisfactory results are achieved. For very serious cases that do not respond to the aforementioned treatment, there is psycho-surgery (cingulotomy, subcaudate tractotomy, anterior bilateral capsulotomy).

As with other mental illnesses, OCD is unfortunately not preventable.

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Hello Readers, I am Nikki Bella a Psychology student. I have always been concerned about human behavior and the mental processes that lead us to act and think the way we do. My collaboration as an editor in the psychology area of ​​Well Being Pole has allowed me to investigate further and expand my knowledge in the field of mental health; I have also acquired great knowledge about physical health and well-being, two fundamental bases that are directly related and are part of all mental health.

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