Obsessive-compulsive disorder

Obsessive-compulsive disorder

Obsessive-compulsive neurosis; OCD

250/365: Welcome to the Psych Ward: Obsessive-...

250/365: Welcome to the Ward: Obsessive-Compulsive Disorder (Photo credit: by Janine)

Obsessive-compulsive disorder is an anxiety disorder in which people have unwanted and repeated thoughts, feelings, ideas, sensations (obsessions), or behaviors that make them feel driven to do something (compulsions).

Often the person carries out the behaviors to get rid of the obsessive thoughts, but this only provides temporary relief. Not performing the obsessive rituals can cause great anxiety.

Causes, incidence, and risk factors

Obsessive-compulsive disorder (OCD) is more common than was once thought. Most people who develop it show symptoms by age 30.

There are several theories about the cause of OCD, but none have been confirmed. Some reports have linked OCD to head injury and infections. Several studies have shown that there are brain abnormalities in patients with OCD, but more research is needed.

About 20% of people with OCD have tics, which suggests the condition may be related to Tourette syndrome. However, this link is not clear.

Symptoms

  • Obsessions or compulsions that are not due to medical illness or drug use
  • Obsessions or compulsions that cause major distress or interfere with everyday life

There are many types of obsessions and compulsions. Examples include:

  • Checking and rechecking actions (such as turning out the lights and locking the door)
  • Excessive counting
  • Excessive fear of germs
  • The compulsion to repeatedly wash the hands to ward off infection

The person usually recognizes that the behavior is excessive or unreasonable.

Signs and tests

Your own description of the behavior can help diagnose the disorder. A physical exam can rule out physical causes, and a psychiatric evaluation can rule out other mental disorders.

Questionnaires, such as the Yale-Brown Obsessive Compulsive Scale (YBOCS), can help diagnose OCD and track the progress of treatment.

Treatment

OCD is treated using medications and therapy.

The first medication usually considered is a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI). These drugs include:

  • Citalopram (Celexa)
  • Fluoxetine (Prozac)
  • Fluvoxamine (Luvox)
  • Paroxetine (Paxil)
  • Sertraline (Zoloft)

If an SSRI does not work, the doctor may prescribe an older type of antidepressant called a tricyclic antidepressant. Clomipramine is a TCA, and is the oldest medication for OCD. It usually works better than SSRI antidepressants in treating the condition, but it can have unpleasant side effects, including:

  • Difficulty starting urination
  • Drop in blood pressure when rising from a seated position
  • Dry mouth
  • Sleepiness

In some cases, an SSRI and clomipramine may be combined. Other medications, such as low-dose atypical antipsychotics (including risperidone, quetiapine, olanzapine, or ziprasidone) have been shown to be helpful. Benzodiazepines may offer some relief from anxiety, but they are generally used only with the more reliable treatments.

Cognitive behavioral therapy (CBT) has been shown to be the most effective type of psychotherapy for this disorder. The patient is exposed many times to a situation that triggers the obsessive thoughts, and learns gradually to tolerate the anxiety and resist the urge to perform the compulsion. Medication and CBT together are considered to be better than either treatment alone at reducing symptoms.

Psychotherapy can also be used to:

  • Provide effective ways of reducing stress
  • Reduce anxiety
  • Resolve inner conflicts

Expectations (prognosis)

OCD is a long-term (chronic) illness with periods of severe symptoms followed by times of improvement. However, a completely symptom-free period is unusual. Most people improve with treatment.

Complications

Long-term complications of OCD have to do with the type of obsessions or compulsions. For example, constant handwashing can cause skin breakdown. However, OCD does not usually progress into another disease.

Calling your health care provider

Call for an appointment with your health care provider if your symptoms interfere with daily life, work, or relationships.

Prevention

There is no known prevention for this disorder.

For help please call health helpline +91 9811771875 or visit http://healthsewak.com

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About Anuj Agarwal

I am a professional with varied working experience of more than 18 years in India, USA and Middle East. My areas of work and interest are Information Technology, Corporate Social Responsibility, Health and Wellness. Please feel free to contact me through the blog or write me at agarwalanuj@yahoo.com
This entry was posted in Obsessive compulsive neurosis, Uncategorized and tagged , . Bookmark the permalink.

5 Responses to Obsessive-compulsive disorder

  1. Pingback: OCD and Tourette Syndrome

  2. NARESH KUMAR GARG says:

    MY WIFE IS SUFFERING FROM OCD SINCE LAST 10 YEARS NOW FROM LAST 8 YEARS SHE TAKE SERTRALINE 250MG DAILY AT NIGHT IS THERE ARE SIDE EFFECTS OF THIS AND IS THERE ANY IMPROVED MEDICINE FROM THIS

    • Anuj Agarwal says:

      Dear nkg,

      This drug is safe except some common side effects like constipation, dry mouth and some such things in some people.

      Please let me know the dose distribution also, it is bed time or distributed over the day.

      Regards, Team HealthSewak

      On Tue, Jan 1, 2013 at 6:01 PM, Anuj Agarwal's Blog

      • NARESH KUMAR GARG says:

        SIR,DOSE OF 250MG AT NIGHT

      • Anuj Agarwal says:

        Dear NKG,

        The dose is definitely high but I am presuming that it has been prescribed keeping in mind the condition of the patient.

        There are no major side effects except, lack of sleep/dryness in mouth/some nausea/constipation/ and withdrawal symptoms when the drug is stopped.

        If the condition of the patient is satisfactory then continue with the drug, but keeping in mind the long duration of the treatment and high dosage a second opinion from a senior consultant is highly recommended.

        Regards,

        On Sat, Jan 5, 2013 at 8:36 PM, Anuj Agarwal's Blog

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