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OBSESSIVE-COMPULSIVE
DISORDER
Obsessive-Compulsive
Disorder is a type of anxiety disorder in which time-consuming
obsessions and compulsions significantly interfere with
a person's routine, making it difficult to work or to
have a normal social life or relationships. At some
point in the course of the disorder, the person realizes
that the obsessions or compulsions are excessive or
unreasonable
Obsessions
are recurrent, persistent, intrusive, unwanted thoughts
that cause distressing emotions such as anxiety and
disgust. Many such thoughts center on fears, such as
fear of catching or spreading germs and fear of suffering
bodily harm or of hurting others.
People who experience these strong obsessions recognize
that the thoughts are a product of their own mind and
are excessive or unreasonable. But they cannot rid themselves
of these thoughts by logic or reasoning. Often, people
with obsessive-compulsive disorder (OCD) find that certain
behaviors or rituals reduce their fear and discomfort,
and so they feel compelled to repeat them.
Compulsions
are urges to do something repeatedly that will lessen
a fearful thought or the discomfort it produces. Rituals
are the behaviors people rigidly employ to reduce the
tension of a compulsion. In the most severe cases, a
constant repetition of rituals may fill the day, making
a normal routine impossible. Compulsions include:
- Cleaning:
Provoked by the fear that real or imagined germs,
dirt, or chemicals will "contaminate" them.
Some people spend hours and hours washing themselves
or cleaning their surroundings.
- Repeating:
To dispel anxiety, some people repeatedly utter a
name or phrase or perform a behavior several times.
Although they understand that the repetitions won't
actually guard against injury, their fear that they
will be harmed if they don't repeat the behavior compels
them to act.
- Completing:
People with this compulsion must perform a series
of complicated behaviors in an exact order, repeating
them until they are done perfectly.
- Checking:
The fear of harming oneself or others by forgetting
to lock the door or turn off appliances can develop
into the ritual of checking. Some people repeatedly
retrace routes they drive to be sure they haven't
hit anyone or caused any accidents.
- Hoarding:
Hoarding involves the collection of useless items.
People who hoard may collect anything-newspapers,
clothing, stones, garbage-to the point hat rooms are
filled, doorways are blocked, and health hazards occur.
HOW IS OCD TREATED?
Obtaining treatment is critical because OCD rarely resolves
on its own. Many people suffer for years before getting
help.
Behavior therapies are intended to help people decrease
and ultimately stop the obsessions and compulsions that
plague their lives. Various studies indicate that behavioral
therapy is successful for 50 to 90 percent of people
with OCD.
One of the most effective treatments is a type of behavioral
therapy known as exposure and response prevention. During
treatment sessions, patients are slowly exposed to the
situations that give rise to their anxiety and that
provoke compulsive behavior or rituals. A patient may
also follow guidelines, sometimes in the form of an
agreement between the psychiatrist and the patient.
For example, the guidelines may permit the patient to
perform only a part of a ritualistic behavior and may
limit the number of repetitions.
Psychotherapy, group therapy, and family therapy have
been helpful for some patients, especially when combined
with medication and behavioral techniques.
Medication.
For many years clomipramine, was the best-recognized
and most studied pharmacotherapy for OCD for many years.
However, the introduction of selective serotonin reuptake
inhibitors (SSRIs), has added substantially to the effective
treatment of this disorder. For some people who have
only a partial response to an SSRI, combining an SSRI
with another medication can improve symptoms.
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MORE INFORMATION…
©
Copyright 2001 The American Psychiatric Association
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