Obsessive-compulsive disorder ( OCD ) is a mental disorder in which people feel the need to check things over and over, perform certain routines repeatedly (called "rituals"), or have certain thoughts over and over (called "obsessions"). One can not control thoughts or activities for more than a short time. Common activities include washing hands, counting things, and checking to see if the door is locked. Some people may have trouble dumping things. These activities occur in such a way that the person's daily life is negatively affected. It often takes more than an hour a day. Most adults realize that behavior does not make sense. This condition is associated with tics, anxiety disorders, and an increased risk of suicide.
The cause is unknown. There appears to be some genetic component with identical twins more often exposed than non-identical twins. Risk factors include a history of child abuse or other stressful events. Several cases have been documented after infection. Diagnosis is based on symptoms and requires exclusion of other drug-related or medical causes. Rating scales such as Yale-Brown Obsessive Compulsive Scale (Y-BOCS) can be used to assess the severity. Other disorders with similar symptoms include anxiety disorders, major depressive disorders, eating disorders, tic disorders, and obsessive-compulsive personality disorder.
Treatment involves counseling, such as cognitive behavioral therapy (CBT), and sometimes antidepressants such as selective serotonin reuptake inhibitors (SSRIs) or clomipramine. CBT for OCD involves an increasing exposure to what causes problems without letting repetitive behavior occur. While clomipramine seems to work as well as SSRIs, it has a larger side effect that is usually reserved for second-line treatment. Atypical antipsychotics may be useful when used in addition to SSRIs in cases that are resistant to treatment but also associated with an increased risk of adverse events. Without treatment, this condition often lasts for decades.
Obsessive-compulsive disorder affects approximately 2.3% of people at some point in their lives. The rate for a given year is about 1.2%, and it happens all over the world. It is not usually a symptom beginning after age 35, and half of people have problems before 20. Men and women are affected equally. In English, the obsessive-compulsive phrase is often used unofficially unrelated to OCD to describe someone who is too conscientious, perfectionist, absorbed, or fixated on another.
Video Obsessive-compulsive disorder
Signs and symptoms
OCD can present with various symptoms. Certain symptom groups usually occur together. These groups are sometimes viewed as dimensions or groups that may reflect the underlying process. The standard assessment tool for OCD, Yale-Brown Obsessive Compulsive Scale (Y-BOCS), has 13 prescribed symptom categories. These symptoms fall into three to five groupings. The analytic meta-analytic review of the symptom structure finds the most reliable factor (grouping) structure. The observed groups included "symmetry factors", "forbidden thought factors", "cleansing factors", and "hoarding factors". The "symmetry factor" is closely linked to the obsessions associated with ordering, computation, and symmetry, as well as the repetition of the compulsions. The "forbidden mind" is highly correlated with disturbing and troubling thoughts of violence, religion or sexuality. The "cleansing factor" is closely related to the obsession with contamination and compulsions related to cleaning. The "hoards factor" involved only the burden of obsessions and related compulsions, and is identified as distinct from other symptom groupings.
While OCD has been considered a homogeneous disorder from a neuropsychological perspective, many neuropsychological deficits are suspected to be possible due to comorbid disorders. In addition, several subtypes have been associated with performance improvements in certain tasks such as pattern recognition (subtype washing) and spatial working memory (subgroup of obsessive thinking). Subgroups have also been distinguished by neuroimaging findings and treatment responses. Neuroimaging studies on this have been too few, and the subtypes examined have too many differences to draw conclusions. On the other hand, subtype-dependent treatment responses have been studied, and subtype hoarding has consistently responded to at least for treatment.
Obsession
Obsessions are thoughts that reappear and persist, despite attempts to ignore or confront them. People with OCD often perform tasks, or encouragement, to seek help from anxiety associated with obsession. In and between individuals, early obsessions, or disturbing thoughts, vary in clarity and clarity. A relatively obscure obsession can involve a general sense of chaos or tension accompanied by the belief that life can not go as usual while the imbalance persists. A more intense obsession can become a preoccupation with the mind or image of someone close to those who are dying or the disorder associated with "the relationship of truth". Other obsessions concern the possibility that someone or something other than yourself - like God, Satan, or disease - would harm people with OCD or the people or things that the person cares about. Others with OCD may experience an invisible bulge sensation coming from their body, or have the feeling that inanimate objects are forbidden.
Some people with OCD experience sexual obsessions that may involve disturbing thoughts or images from "kissing, touching, fondling, oral sex, anal sex, sexual relations, incest, and rape" with "strangers, acquaintances, parents, children , family members, friends, co-workers, animals, and religious leaders ", and may include" heterosexual or homosexual content "with people of all ages. As with any disturbing thoughts or images, other unpleasant, some disturbing sexual thoughts are sometimes normal, but people with OCD can attach significant significance to the mind. For example, obsessive fears about sexual orientation can appear in people with OCD, and even to those around him, as sexual identity crises. Furthermore, the doubt that accompanies the OCD leads to uncertainty as to whether a person can act upon an intrusive mind, resulting in self-criticism or self-hatred.
Most people with OCD understand that their concepts do not match reality; However, they feel that they must act as if their ideas are true. For example, an individual involved in compulsive hoarding may tend to treat inorganic matter as if it has the feelings or rights of living organisms, while accepting that behavior is irrational at a more intellectual level. There is a debate about whether or not hoards should be considered with other OCD symptoms.
OCD sometimes manifests without blatant compulsions, called OCD Primary Obsessions. Obscure, uncomplicated OCDs can, with one estimate, characterize as much as 50% to 60% of OCD cases.
Compulions
Some people with OCD perform compulsive rituals because they mysteriously feel that they should do it, while others act compulsively to ease the anxiety that comes from certain obsessive thoughts. The person may feel that these actions will somehow prevent a frightening event from happening or will push the event out of their mind. In any case, the individual's reasoning is highly idiosyncratic or distorted resulting in significant suffering for individuals with OCD or for those around him. Excessive skin tapping, hair pulling, nail biting, and other body-focused repetitive disorders are all in the obsessive-compulsive spectrum. Some individuals with OCD are aware that their behavior is irrational, but feel compelled to follow up with them to fend off feelings of panic or fear.
Some common compulsions include hand washing, cleaning, checking items (for example, locking doors), repeating actions (eg switching on and off switches), ordering items in a certain way, and requesting a guarantee. Compulsions are different from tics (such as touching, tapping, rubbing, or flashing) and stereotypical movements (such as hitting the head, body wobble, or self-bite), which are usually not as complicated and not triggered by obsessions. It is sometimes difficult to distinguish between complex compositions and tics. About 10% to 40% of individuals with OCD also have lifelong tic disturbances.
People rely on compulsion as an escape from their obsessive mind; however, they realize that help is only temporary, so disturbing thoughts will soon return. Some people use compulsions to avoid situations that can trigger their obsession. Although some people do certain things over and over, they do not need to do this compulsively. For example, sleeping routines, learning new skills, and religious practices are not mandatory. Whether the behavior is incentive or habit depends only on the context in which the behavior is performed. For example, organizing and ordering DVDs for eight hours a day would be expected from someone working in a video store, but it looks abnormal in other situations. In other words, habits tend to bring efficiency to one's life, while encouragement tends to disrupt it.
In addition to the anxiety and fear that usually accompanies OCD, the patient can spend hours doing the compulsion every day. In such situations, it may be difficult for people to fulfill their work, family, or social role. In some cases, this behavior can also cause adverse physical symptoms. For example, people who obsessively wash their hands with antibacterial soap and hot water can make their skin red and raw with dermatitis.
People with OCD may use rationalizations to explain their behavior; However, this rationalization does not apply to overall behavior but to individual instances. For example, a person who compulsively checks the front door might argue that the time taken and the stress caused by one more front door check is much less than the time and stress associated with being robbed, and thus checking is a better option. In practice, after the examination, the person is still not sure and assumes it is still better to have one more check, and this reason may continue for as long as necessary.
Insights
The DSM-V contains three determinants for the level of insight in OCD. Good or fair insight is characterized by the recognition that obsessive-compulsive beliefs are or may not be true. Bad insights are characterized by the belief that obsessive-compulsive beliefs may be true. The absence of insight makes the obsessive-compulsive mind delusional, and occurs in about 4% of people with OCD.
Overly rated ideas
Some people with OCDs show what is known as overly high ideas . In such cases, people with OCD will be completely uncertain whether the fears that caused them to make their compulsions irrational or not. After some discussion, it is possible to convince individuals that their fears may be unfounded. It may be more difficult to do ERP therapy on such people because they may not cooperate, at least initially. There is a severe case where the person has an unshakable belief in the OCD context that is difficult to distinguish from psychotic disorders.
Cognitive performance
A meta-analysis 2013 reported that people with OCD had mild but broad cognitive deficits; significantly on spatial memory, to a lesser degree with verbal memory, fluidity, executive function, and processing speed, while hearing attention is not significantly affected. People with OCD exhibit disruption in formulating organizational strategies for information encoding, set-shifting, and motor and cognitive impairment.
The specific subtypes of the symptom dimension in OCD have been linked to specific cognitive deficits. For example, the results of a meta-analysis comparing washing and symptom checks reported that the washers outperformed the dam on eight out of ten cognitive tests. The dimensions of contamination and cleansing symptoms may be associated with higher scores on inhibition and verbal memory tests.
Children
Approximately 1-2% of children are exposed to OCD. The symptoms of obsessive-compulsive disorder tend to develop more frequently in children aged 10-14 years, with males showing symptoms at earlier ages and heavier rates than women. In children, symptoms can be grouped into at least 4 types.
Maps Obsessive-compulsive disorder
Cause
The cause is unknown. Both environmental and genetic factors are believed to play a role. Risk factors include a history of child abuse or other stressful events.
Genetics
There appears to be some genetic component with identical twins more often exposed than non-identical twins. Furthermore, individuals with OCDs are more likely to have first-degree family members exhibiting the same disorder than suitable controls. In cases where OCD develops during childhood, there is a stronger family relationship in the disorder than in cases where OCD develops in adulthood. In general, genetic factors account for 45-65% of the variability of OCD symptoms in children diagnosed with the disorder. A 2007 study found evidence supporting the possibility of inherited risk for OCD.
A mutation has been found in the human serotonin transporter gene, hSERT, in families not associated with OCD.
The relationship between the short and long alleles of the 5-HTTLPR gene was examined in OCD, and the meta-analysis found that the S allele was associated with OCD in women alone. A systematic review found that while no alleles were associated with OCD as a whole, the Caucasian allele L was associated with OCD. Other meta-analyzes observed an increased risk in those with the homozygous S allele, but found the LS genotype inversely proportional to OCD.
A broad genomic association study found OCD to be associated with SNPs near BTBD3 and two SNPs in DLGAP1 in a trio based analysis, but no SNPs achieved significance when analyzed with case-control data.
One meta-analysis found a small but significant association between polymorphism in SLC1A1 and OCD.
The relationship between OCD and COMT was inconsistent, with one meta-analysis reporting a significant association, although only in men, and other meta-analyzes reporting no association.
It has been postulated by evolutionary psychologists that a moderate version of compulsive behavior may have an evolutionary advantage. Examples are constant hygiene, fireplaces or environments. Similarly, hoards may have an evolutionary advantage. In this view OCD can be a "tail" of extreme statistics of such behavior, perhaps due to the large number of genes predisposing.
Autoimmune
The controversial hypothesis is that some cases of rapid onset of OCD in children and adolescents can be caused by syndromes linked to Group A streptococcal infection, known as autoimmune pediatric neuropsychiatric disorders associated with streptococcal infection (PANDAS).
A review of studies investigating anti-basal ganglia antibodies in OCD found an increased risk of having anti-basal ganglia antibodies in those with OCD compared with the general population.
Mechanism
Neuroimaging
Functional neuroimaging during symptom provocation has observed abnormal activity in the orbitofrontal cortex, left dorsolateral prefrontal cortex, right right prothal cortex, left superior temporal gyrus, globus pallidus externus, hippocampus and right uncus. A weaker focus of abnormal activity is found in the left caudatus, posterior cingulate cortex and superior parietal lobule. However, the older meta-analysis of functional neuroimaging at OCD reported the only consistent functional neuroimaging findings had increased activity in the orbital gyrus and head of the caudate nucleus, while the ACC activation abnormalities were too inconsistent. A meta-analysis comparing affective and non-affective tasks observed differences with controls in the areas involved in importance, habits, objective behavior, self-reference thinking and cognitive control. For affective tasks, hyperactivity is observed in the insula, ACC, and caudate/putamen head, while hypoactivity is observed in the medial prefrontal cortex (mPFC) and posterior caudate. Affective tasks observed were associated with increased activation in the precuneus and posterior cingulate cortex (PCC), while decreased activation was found in the pallidum, the anterior ventral thral and the caudate postetior. The involvement of the cortico-striato-thalamo-cortical loop in OCD as well as the high level of comorbidity between OCD and ADHD has caused some people to draw relationships in their mechanisms. The observed equations include dysfunction of the anterior cingulate cortex, and the prefrontal cortex, as well as the joint deficit in the executive function. The involvement of the orbitofrontal and dorsolateral prefrontal cortex cortex in the OCD is shared with Bipolar Disorder and may explain high rates of comorbidity. Reduced volumes of dorsolateral prefrontal cortex associated with executive function have also been observed in OCD.
People with OCD showed an increase in gray volume in the bilateral lenticular nucleus, extending to the caudate nucleus, with decreased gray matter volume on the medial bilateral frontal/anterior cingulate gyri. These findings contrast with those with other anxiety disorders, who know the decrease in the volume of gray matter in the bilateral lenticular/caudate nuclei, as well as the decreased gray matter volume in the bilateral medial frontal/anterior cingulate gyri. Increased white matter volume and decreased fractional anisotropy in the anterior midline tracts have been observed in OCD, possibly indicating an increase in fiber crossing.
Cognitive model
Generally two categories of models for OCD have been postulated, the former involves deficits in the executive function, and the second involves deficits in the modulation control. The first category of executive dysfunction is based on structural and functional abnormalities observed in dlPFC, striatum, and thalamus. The second category involving dysfunctional modulation control depends mainly on the functional and structural differences observed in ACC, mPFC and OFC.
One proposed model suggests that dysfunction in OFC leads to improper behavioral judgment and decreased behavior control, while changes observed in amygdala activation lead to excessive fear and representation of negative stimuli.
Due to the heterogeneity of OCD symptoms, studies distinguish between symptoms have been done. Symptoms of specific neuroimaging disorders include hyperactivity of caudate and ACC in ritual examination, while finding increased activity of cortical and cerebellar areas in symptom-related contamination. Neuroimaging distinguishes between mind-numbing contents has found an aggressive difference compared to taboo thoughts, finding increased connectivity from the amygdala, ventral striatum, and ventromedial prefrontal cortex in aggressive symptoms, while observing increased connectivity between ventral striatum and insula in sexual/religious. disturbing thoughts.
Another model proposes that affective dysregulation links excessive dependence on the choice of action based on habit with compulsions. This is supported by the observation that those with OCD showed a decreased activation of the ventral striatum when anticipating monetary rewards, as well as improving functional connectivity between VS and OFC. Furthermore, those with OCD showed decreased performance in the duties of extinction of pavlovian fears, hyper responses in the amygdala to frightening stimuli, and hypo-resonance in the amygdala when exposed to positive valanced stimuli. Stimulation of nucleus accumbens has also been observed to effectively alleviate obsessions and compulsions, supporting the role of affective dysregulation in producing both.
Neurobiologists
From observing the effectiveness of antidepressants in OCD, the OCD serotonin hypothesis has been formulated. Studies of peripheral markers of serotonin, as well as challenges with proserotonergic compounds have yielded inconsistent results, including evidence leading to basal hyperactivity of the serotonergic system. Studies of serotonin receptor binding and transporters have produced conflicting results, including 5-HT2A serotonin receptors and higher and lower serotonin binding carriers normalized by SSRI treatment. Despite inconsistencies in the types of abnormalities found, evidence points to serotonergic system dysfunction in OCD. Overactivity cortex orbitofrontal is attenuated in people who have successfully responded to SSRI drugs, a result believed to be due to increased stimulation of 5-HT2A and 5-HT2C serotonin receptors. The complex relationship between dopamine and OCD has been observed. Although antipsychotics, which act by antagonizing dopamine receptors may increase some cases of OCD, they often aggravate others. Antipsychotics, in low doses used to treat OCD, can actually increase the release of dopamine in the prefrontal cortex, via inhibitors of autoreceptors. The more complicated is amphetamine efficacy, decreased activity of dopamine transporters observed in OCD, and low D2 levels in the striatum. Furthermore, an increase in dopamine release in the nucleus accumbens after deep brain stimulation correlates with symptom improvement, pointing to a reduced dopamine release in the striatum that plays a role in producing symptoms.
Abnormalities in glutaminergic neurotransmission have implications for OCD. Findings such as increased cerebrospinal glutamate, less consistent abnormalities observed in neuroimaging studies, and the efficacy of some glutaminergic drugs such as riluzole have involved glutamate in OCD. OCD has been associated with decreased N-Acetylaspartic acid in mPFC, which is thought to reflect density or neuronal function, although appropriate interpretation has not been established.
Diagnosis
Formal diagnosis may be performed by a psychologist, psychiatrist, clinical social worker, or other licensed mental health professional. To be diagnosed with OCD, one must have an obsession, a compulsion, or both, according to the Diagnostic and Statistical Manual of Mental Disorder (DSM). A Quick Reference to the 2000 edition of the DSM states that some features of obsessions and compulsions are clinically significant. Such obsessions, the DSM says, are repeated, persistent thoughts, impulses or images that are experienced as disturbing and which cause anxiety or marked distress. Thoughts, impulses or images have levels or types that are beyond the normal range of concerns about conventional problems. One may try to ignore or suppress such an obsession, or neutralize them with some other thought or action, and will tend to recognize the obsession as something strange or irrational.
Compulsions become clinically significant when one feels compelled to do so in response to an obsession, or according to rules that should be applied rigidly, and when the person feels or causes significant distress. Therefore, while many people who do not suffer from OCD can perform actions often associated with OCD (such as ordering goods in a pantry with altitude), the difference with clinically significant OCD lies in the fact that people suffering from OCD should > take this action, otherwise they will experience significant psychological distress. This mental behavior or action is intended to prevent or reduce distress or prevent a frightening event or situation; However, these activities are not logically or practically connected to the problem, or they are overkill. In addition, at some point during the disorder, individuals should be aware that their obsessions or compulsions are unreasonable or exaggerated.
In addition, obsessions or compulsions should take time (take more than one hour per day) or cause disruption in social, occupational or scholastic functions. It will be helpful to measure the severity of symptoms and disorders before and during treatment for OCD. In addition to the platform estimates of the time spent each day by harboring thoughts or obsessive-compulsive behaviors, concrete tools can be used to measure the condition of society. This can be done on an assessment scale, such as the Obsessive Yale-Brown Compulsive Scale (Y-BOCS). With such measurements, psychiatric consultation can be more appropriately determined because it has been standardized.
OCD is sometimes placed in a group of disorders called the obsessive-compulsive spectrum.
Differential diagnosis
OCD is often confused with obsessive-compulsive personality disorder (OCPD). OCD is egodystonic, which means that the disorder does not match the patient's self-concept. Because the distorted ego interferes with one's self-concept, they tend to cause a lot of trouble. OCPD, on the other hand, is egosyntonic - characterized by a person's acceptance that the characteristics and behaviors are displayed as a result compatible with their self-image, or otherwise precise, true or reasonable.
As a result, people with OCD often realize that their behavior is irrational, not happy with their obsessions but still feel compelled by them. Conversely people with OCPD are unaware of anything abnormal; they will easily explain why their actions are rational, it is usually impossible to convince them otherwise, and they tend to derive pleasure from their obsession or compulsion.
Management
A form of psychotherapy called "cognitive behavioral therapy" (CBT) and psychotropic drugs is the first-line treatment for OCD. Other forms of psychotherapy, such as psychodynamics and psychoanalysis can help in managing some aspects of the disorder, but in 2007 the American Psychiatric Association (APA) notes the lack of controlled studies showing their effectiveness "in dealing with core OCD symptoms". The fact that many individuals do not seek treatment may be due in part to the stigma associated with OCD.
Therapy
The specific technique used in CBT is called exposure and response prevention (ERP) which involves teaching people to deliberately come into contact with situations that trigger obsessive and fearful thinking ("exposure"), without the usual obsessive-related compulsive action ("prevention response" ), thus gradually learning to tolerate the discomfort and anxiety associated with not performing ritual behaviors. In the beginning, for example, a person may touch something that is only very "contaminated" (like a tissue that has been touched by another network that has been touched by a toothpick tip that has touched a book that comes from a "contaminated" location, such as a school.) It is " exposure ". "Ritual prevention" does not wash. Another example might leave the house and check the key only once (exposure) without going back and checking again (ritual prevention). People who are fast enough accustomed to situations that produce anxiety and find that their anxiety levels dropped dramatically; they can then come forward to touch something more "contaminated" or do not check the key at all - again, without performing ritual washing or checking behavior.
ERP has a strong evidence base, and is considered the most effective treatment for OCD. However, this claim was questioned by several researchers in 2000 who criticized the quality of many studies.
It has generally been accepted that psychotherapy, in combination with psychiatric drugs, is more effective than choice alone.
Medication
The most commonly used drug is selective serotonin reuptake inhibitor (SSRI). Clomipramine, a drug belonging to the tricyclic antidepressant group, seems to work as well as SSRIs but has a higher rate of side effects.
SSRIs are second-line treatment of obsessive-compulsive obsessive disorders (OCD) with mild functional impairment and as first-line treatment for those with moderate or severe disturbances. In children, SSRIs may be considered second-line therapy in those with moderate to severe disturbances, with close monitoring for psychiatric side-effects. SSRI efficacious in the treatment of OCD; people treated with SSRIs were about twice as likely to respond to treatment as treated with placebo. Efficacy has been shown both in the short term (6-24 weeks) of treatment trials and in termination trials with a duration of 28-52 weeks.
In 2006, the National Institute of Clinical and Health Excellence (NICE) guidelines recommended antipsychotics for OCD that did not improve with SSRI treatment. For OCD, evidence for atypical risperidone antipsychotic drugs is temporary with insufficient evidence for olanzapine. While quetiapine was no better than placebo related to primary outcome, but little effect was found in terms of YBOCS score. The efficacy of quetiapine and olanzapine is limited by insufficient number of studies. A 2014 review article found two studies indicating that aripiprazole is "effective in the short term" and found that "[t] here is a small measure of the effect for risperidone or anti-psychotic in general in the short term"; However, the study authors found "there is no evidence for the effectiveness of quetiapine or olanzapine compared with placebo." While quetiapine may be useful when used in addition to SSRIs in drug-resistant OCD, it is often poorly tolerated, and has metabolic side effects that limit its use. None of the atypical antipsychotics seem to be useful when used alone. Other reviews have reported that there is no evidence to support the use of first-generation antipsychotics in OCD.
A guideline by APA suggests that dextroamphetamine may be considered on its own after better supported treatment has been attempted.
Procedures
Electroconvulsive therapy (ECT) has been found to have effectiveness in some severe cases and is difficult to cure.
Surgery can be used as a last resort for people who do not improve with other treatments. In this procedure, surgical lesions are made in the brain area (cingulate cortex). In one study, 30% of participants benefited significantly from this procedure. Deep brain stimulation and vagus nerve stimulation are possible surgical options that do not require the destruction of brain tissue. In the United States, the Food and Drug Administration approves deep brain stimulation for the treatment of OCD under the release of humanitarian devices which requires that the procedure be performed only in hospitals with special qualifications to do so.
In the United States, psychosurgicals for OCD are the last treatment and will not be done until the person fails several attempts at the drug (at full dose) with augmentation, and months of cognitive therapy-intensive behavior with exposure and ritual/prevention of response. Similarly, in the UK, psychosurgery can not be performed unless a treatment program of an appropriate cognitive behavioral therapist has been performed.
Children
Therapeutic therapy may be effective in reducing OCD ritual behavior for children and adolescents. Similar to adult treatment with OCD, CBT stands as the first-line treatment of OCD in effective and validated children. Family involvement, in the form of observations and behavioral reports, is a key component to the success of such treatment. Parental interventions also provide positive reinforcement for a child who exhibits appropriate behavior as an alternative to compulsive responses. In a recent meta-analysis of evidence-based OCD treatment in children, family-focused CBTs are labeled "may be efficacious", making it one of the leading psychosocial treatments for adolescents with OCD. After a year or two of therapy, where a child learns the nature of his obsession and gains coping strategies, the child can gain a larger circle of friends, show shame, and become less critical of himself.
Although the cause of OCD in younger age groups ranges from brain abnormalities to psychological preoccupation, life stresses such as bullying and traumatic family death may also contribute to childhood OCD cases, and recognize this stress may play a role in treating the disorder.
Epidemiology
Obsessive-compulsive disorder affects approximately 2.3% of people at some point in their lives. The rate for a given year is about 1.2% and it happens all over the world. Not usually the symptoms begin after the age of thirty-five and half people have problems before the age of twenty. Men and women are affected equally.
Related conditions
People with OCD can be diagnosed with other conditions, like or not OCD, such as personality disorders obsessive-compulsive mentioned earlier, major depressive disorder, bipolar disorder, generalized anxiety disorder, anorexia nervosa, social anxiety disorder, bulimia nervosa, Tourette's syndrome, Asperger syndrome , attention deficit hyperactivity disorder, dermatillomania (decision-compulsive compulsive), body dysmorphic disorder and trichotillomania (hair pulling). More than 50 percent of people experiencing suicidal tendencies, and 15 percent had attempted suicide. Depression, anxiety and previous suicide attempts increase the risk of suicide attempts in the future.
Individuals with OCD have also been found to be affected by delayed phase sleep syndrome at a much higher rate than the general population. In addition, severe OCD symptoms are consistently associated with larger sleep disorders. Reduced total sleep time and sleep efficiency has been observed in people with OCD, with slow sleep onset and offset and an increased prevalence of delayed sleep phase disorder.
Behaviorally, there are several studies that show the relationship between drug addiction and the disorder as well. For example, there is a higher risk of drug addiction among those with anxiety disorders (perhaps as a way of coping with high levels of anxiety), but drug addiction among people with OCD may serve as a type of compulsive behavior and not just as a coping mechanism. Depression is also very common among people with OCD. One explanation for high rates of depression among OCD populations is assumed by Mineka, Watson and Clark (1998), which explains that people with OCD (or other anxiety disorders) may feel depressed because of the "uncontrollable" type of feeling.
Someone who shows the OCD sign does not have to have OCD. Behavior that is present as (or appears to be) obsessive or compulsive may also be found in a number of other conditions as well, including obsessive-compulsive disorder (OCPD), autism, disorders in which perseverance is a possible feature (ADHD, PTSD , body disorders or habitual problems) or sub-clinical.
Some with OCD come with features typically associated with Tourette's syndrome, such as compulsions that may appear to resemble motor tics; this has been called "tic-related OCD" or "Tourettic OCD".
A myth that Sigmund Freud spread about the average intelligence in OCD recently denied.
OCD often coincides with bipolar disorder and major depressive disorder. Between 60% -80% of those with OCD have episodes of major depression in their lives. Comorbidity rates have been reported between 19% -90% due to methodological differences. Between 9% -35% of those with bipolar disorder also have OCD, compared with 1% -2% in the general population. About 50% of those with OCD have cyclothymic traits or hypomanic episodes. OCD is also associated with anxiety disorders. Lifetime comorbidity for OCD has been reported at 22% for specific phobias, 18% for social anxiety disorder, 12% for panic disorder, and 30% for generalized anxiety disorder. Comorbidity rates for OCD and ADHD have been reported as high as 51%.
Prognosis
Quality of life is reduced across all domains in OCD. While psychological or pharmacological treatment may lead to a reduction in OCD symptoms and improved quality of life, symptoms may persist at moderate levels even after adequate treatment, and periods that are completely symptom-free are rare. In pediatric OCD, about 40% still have a disorder in adulthood, and about 40% qualify for remission.
History
In the seventh century, John Climacus recorded an example of a young monk who was plagued by the constant and persistent "temptation to blasphemy" against an older monk who told him, "My son, I take upon me all the sin that these temptations cause, you, or may lead you, to commit.I need from you is that for the future you are not paying any attention to them. " The Cloud of Unknowing , a text Christian mysticism from the late fourteenth century, recommends dealing with recurring obsessions by first trying to ignore it, and, if it fails, "mourn under them like the unfortunate and cowardly overcome in battle, and consider it a waste of your time for you to fight longer against them, "a technique now known as" emotional floods. "
From the fourteenth to the sixteenth centuries in Europe, it was believed that people who experienced blasphemy, sexual, or other obsessive thoughts were possessed by Satan. For this reason, treatment involves removing the "crime" of a "possessed" person through exorcism. Most people who think they are possessed by Satan do not suffer from hallucinations or other "spectacular phenomena," but "complain of anxiety, religious fear, and evil thoughts." In 1584, a woman from Kent, England named Ny. Davie, described by peace justice as a "good wife", was almost burned at the stake after she confessed that she experienced constant and unwanted pressure to kill her family.
The term obsessive-compulsive English derives from the translated term used to describe OCD's first conception by Carl Westphal, "zwangsvorstellung". The Westphal description then affects Pierre Janet who further documents the OCD feature. In the early 1910s, Sigmund Freud attributed obsessive-compulsive behavior to unconscious conflict manifesting as a symptom. Freud describes the clinical history of a typical case of "touch phobia" as a beginning in early childhood, when the person has a strong desire to touch an item. In response, the person develops an "external ban" against this type of touch. However, "this ban does not remove" the desire to touch; all you can do is suppress the desire and "force it into the subconscious". Freudian psychoanalysis remained the dominant treatment for OCD until the mid-1980s, although medication and therapeutic treatment were well known and available, since it was widely assumed that this treatment would adversely affect the effectiveness of psychotherapy. In the mid-1980s, psychiatry made sudden "faces" on the subject and began treating OCD primarily through drugs and practical therapies rather than psychoanalysis.
Important case
John Bunyan (1628-1688), author of The Pilgrim's Progress , has OCD (unnamed). During the worst period of his condition, he would mutter the same phrase over and over to himself as he swayed back and forth. He then describes his obsession in his autobiography Abundant Grace to the Heads of Sinners, stating, "These things may seem foolish to others, even as ridiculous as they are to themselves, but to me they is the most agonizing cogitations. "He wrote two pamphlets advising those who suffer similar anxiety. In one of them, he warned against pushing himself into the compulsion: "Be careful to get rid of your spirit problem in the wrong way: by promising to reform yourself and live a new life, with your appearance or task."
The English poet, essayist and lexicographer Samuel Johnson (1709-1784) also suffered from OCD. He has a complicated ritual to cross the threshold, and repeatedly runs up and down stairs counting steps. He will touch every post on the road as he walks past, just stepping in the middle of a paving stone, and repeatedly performing the task as if they have not done it right the first time. American aviator and filmmaker Howard Hughes is known to have OCD. Hughes's friends also mentioned his obsession with a small mistake in clothes. This is stated in The Aviator (2004), a biography of the movie about Hughes.
Society and culture
Art, entertainment and media
Movies and television shows often represent idealized interference representations such as OCD. This depiction can lead to increased public awareness, understanding and sympathy for such disorders.
- In the movie Well Like It Got (1997), actor Jack Nicholson described a man "with Obsessive Compulsive Disorder (OCD)". "Throughout the film, [he] engages in ritualistic behavior (ie, encouragement) that interferes with interpersonal and professional life", "a cinematic representation of psychopathology that accurately describes the functional disorders and pressures associated with OCD".
- The Matchstick Men movie (2003), directed by Ridley Scott, describes a fraudster named Roy (Nicolas Cage) who has an obsessive-compulsive disorder. The film "opens with Roy, at home, suffers with many of his obsessive compulsive symptoms, which takes the form of need for orderliness and cleanliness and the necessity to open and close the door three times, while counting aloud before he can walk through it."
- In the United States The network of the American mystery detective-comedy series Buddhist monk (2002-2009), titular Adrian Monk is afraid of human contact and dirt.
Research
Natural sugar inositol has been suggested as a treatment for OCD.
Lack of nutrients can also contribute to OCD and other mental disorders. Vitamin and mineral supplements can help in the disorder and provide the necessary nutrients for proper mental functioning.
? -Opioids, such as hydrocodone and tramadol, can improve the symptoms of OCD. Administration of opiate treatment may be contraindicated in individuals simultaneously using CYP2D6 inhibitors such as fluoxetine and paroxetine.
Much current research is devoted to the therapeutic potential of agents that affect the release of glutamate neurotransmitters or binding to their receptors. These include riluzole, memantine, gabapentin, N-acetylcysteine, topiramate and lamotrigine.
Other animals
References
![Full text] Etiopathology and neurobiology of obsessive-compulsive ...](https://lh3.googleusercontent.com/blogger_img_proxy/AEn0k_tPl9z1PUOE77t1Afpl8_rAgi38kMrjo7BSdSFufpBYfk1r_za7wS8eDmdIPeMutkpPJJzF9SIsiTlo43HYiC99Fb1X0n1j7I1WxyXXtNz7qnDAw1kgGaB_7n2Cq1K7q4JTe6D08D3bJw=s0-d "Full text] Etiopathology and neurobiology of obsessive-compulsive ...")
External links
- Obsessive-compulsive disorder in Curlie (based on DMOZ)
- National Institute of Mental Health
- American Psychiatric Association
- Division 12 APA care page for obsessive-compulsive disorder
- Davis, Lennard J. (2008). Obsession: A History . University of Chicago Press. ISBN 978-0-226-13782-7. Source of the article : Wikipedia
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