Obsessive-compulsive neurosis
Key points
- Obsessive-compulsive disorder is an Anxiety disorder characterized by obsessions or compulsions.
- However, recent data show that 2-3% of people, or about 7 million Americans, suffer from this disorder.
- The symptoms are obsessions or compulsions that cause significant distress or interference with everyday life, and are not due to medical illness or drug use.
- The person's own description of the behavior usually leads to diagnosis of the disorder.
Alternative names
Obsessive-compulsive disorder; OCD
Definition
Obsessive-compulsive disorder is an Anxiety disorder characterized by obsessions or compulsions. Having one or both is sufficient for the diagnosis. An obsession is a recurrent and intrusive thought, feeling, idea, or sensation. A compulsion is a conscious, recurrent pattern of behavior a person feels driven to perform.
This behavior can be a physical action (such as handwashing) or a mental act (such as praying, repeating words silently, counting). The behavior is aimed at neutralizing anxiety or distress. One example of this is excessive handwashing intended to ward off infection.
Causes, incidence, and risk factors
OCD was previously believed to be rare. However, recent data show that 2-3% of people, or about 7 million Americans, suffer from this disorder. OCD usually is noticed between the ages of 20 and 30, and 75% of those who will develop it show symptoms by age 30.
There are several psychological theories about the cause of OCD, but none has been confirmed. Some reports associate OCD with head trauma or infections.
Similarly, although there are several studies showing brain abnormalities in patients with OCD, but these inconsistent results require more investigation.
Interestingly, 20% of OCD sufferers also have motor tics, suggesting it may be related to Tourette Syndrome, but this link is not clear.
Symptoms
The symptoms are obsessions or compulsions that cause significant distress or interference with everyday life, and are not due to medical illness or drug use. The person usually recognizes that the behavior is excessive or unreasonable.
Signs and tests
The person's own description of the behavior usually leads to diagnosis of the disorder. A physical exam is performed to rule out physical causes, and a psychiatric evaluation is given to rule out other psychiatric disorders. Questionnaires, such as the Yale-Brown Obsessive Compulsive Scale, can help diagnosis OCD and track the progress of treatment.
Treatment
OCD is treated using medications and psychotherapy.
The first medication considered is usually an antidepressant, which is often effective and lacks severe side effects. These antidepressants are known as Selective Serotonin Reuptake Inhibitors (SSRI). They seem effective in treating OCD by increasing the serotonin available in the brain. SSRIs include fluvoxamine (Luvox), fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and citalopram (Celexa).
Written and revised by
Gerald Hurowitz, M.D.
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