How is obsessive-compulsive disorder treated?

* Exposure/response prevention: the person is repeatedly exposed to a situation that triggers anxiety symptoms, and learns to resist the urge to perform the compulsion. * Thought stopping: the person learns to stop unwanted thoughts and focus attention on relieving anxiety.

What is the outlook for obsessive-compulsive disorder?

OCD is a chronic illness which, like other psychiatric illnesses, has periods of exacerbation followed by periods of relative improvement, though a completely symptom free interval is generally unusual. With treatment, most sufferers have considerable improvement, though total remission is fairly uncommon.

What are the complications of obsessive-compulsive disorder?

The most likely long-term consequences of OCD are related to the nature of the obsessions or compulsions. For example, constant handwashing can cause skin breakdown. However, OCD does not ordinarily "progress" into another disease. Calling your health care provider Call for an appointment with your health care provider if your obsession is interfering with daily life, work, or relationships; or if your compulsion is consuming an inordinate amount of time, energy, or resources.

Guide

Obsessive-Compulsive Disorder

David Cohen, M.D.Published 28 November 20043 min read

Key points

Obsessive-compulsive disorder is an anxiety disorder characterized by obsessions or compulsions having one or both is sufficient for the diagnosis.
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 every day 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.

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 (e.g., handwashing) or a mental act (e.g., 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.

Alternative Names

Obsessive-compulsive neurosis; OCD

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, but no link has been proven.

Similarly, although there are several studies showing brain abnormalities in patients with OCD (decreased caudate size, decreased white matter) the results are inconsistent and still under investigation.

Interestingly, 20% of OCD sufferers also have motor tics, suggesting it may be related to Tourette Syndrome, but this link has not been proven or explained.

Symptoms

The symptoms are obsessions or compulsions that cause significant distress or interference with every day life, and are not due to medical illness or drug use. The person 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 examination is performed to rule out physical causes, and a psychological evaluation is given to rule out other psychiatric disorders. Questionnaires, such as the Yale-Brown Obsessive Compulsive Scale, can help in making the diagnosis.
Treatment

OCD is treated using medications and psychotherapy.

The first medication considered is usually an SSRI antidepressant, since these are often effective and do not have severe side effects. SSRIs, or selective serotonin reuptake inhibitors, treat OCD by increasing the serotonin available in the brain. They include fluvoxamine (Luvox), fluoxetine (Prozac), sertraline (Zoloft), and paroxetine ().

Written and revised by

David Cohen, M.D.

Our doctors write and review articles for accuracy and keep them up to date.

health.am provides general information, not medical advice. Always consult a qualified health professional about your own health.

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Obsessive-Compulsive Disorder

David Cohen, M.D.Published 28 November 20043 min read