OCD

From WikiMD's Wellness Encyclopedia

Obsessive-Compulsive Disorder
SpecialtyPsychiatry
SymptomsObsessions, compulsions
Usual onsetTypically in childhood or early adulthood
DurationChronic
CausesGenetic, environmental, neurobiological factors
Risk factorsFamily history, stressful life events
TreatmentCognitive behavioral therapy, medication
Frequency2-3% of the population


Obsessive-Compulsive Disorder (OCD) is a chronic mental health condition characterized by persistent, unwanted thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) that an individual feels driven to perform. OCD can significantly interfere with daily functioning and quality of life.

Clinical Features[edit | edit source]

OCD is marked by the presence of obsessions and compulsions:

Obsessions[edit | edit source]

Obsessions are intrusive and unwanted thoughts, images, or urges that cause significant anxiety or distress. Common themes include:

  • Contamination fears (e.g., fear of germs or dirt)
  • Harm (e.g., fear of harming oneself or others)
  • Symmetry and order (e.g., needing things to be "just right")
  • Forbidden or taboo thoughts (e.g., aggressive, sexual, or religious obsessions)

Compulsions[edit | edit source]

Compulsions are repetitive behaviors or mental acts that an individual feels compelled to perform in response to an obsession or according to rigid rules. These actions are aimed at reducing anxiety or preventing a feared event or situation. Common compulsions include:

  • Washing and cleaning
  • Checking (e.g., locks, appliances)
  • Counting
  • Arranging items symmetrically
  • Repeating words or phrases

Diagnosis[edit | edit source]

The diagnosis of OCD is based on clinical assessment and the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Key diagnostic criteria include:

  • Presence of obsessions, compulsions, or both
  • The obsessions or compulsions are time-consuming (e.g., take more than one hour per day) or cause clinically significant distress or impairment
  • The symptoms are not attributable to the physiological effects of a substance or another medical condition

Etiology[edit | edit source]

The exact cause of OCD is unknown, but it is believed to result from a combination of genetic, neurobiological, and environmental factors:

  • Genetic factors: Family studies suggest a hereditary component, with first-degree relatives of individuals with OCD having a higher risk.
  • Neurobiological factors: Abnormalities in brain circuits involving the orbitofrontal cortex, anterior cingulate cortex, and striatum have been implicated.
  • Environmental factors: Stressful life events, trauma, and infections (e.g., PANDAS) may trigger or exacerbate symptoms.

Treatment[edit | edit source]

Effective treatment for OCD typically involves a combination of psychotherapy and medication:

Psychotherapy[edit | edit source]

Cognitive Behavioral Therapy (CBT), particularly Exposure and Response Prevention (ERP), is the most effective form of psychotherapy for OCD. ERP involves gradual exposure to feared objects or situations and prevention of the associated compulsive response.

Medication[edit | edit source]

Selective Serotonin Reuptake Inhibitors (SSRIs) are the first-line pharmacological treatment for OCD. Common SSRIs used include fluoxetine, sertraline, and fluvoxamine. In some cases, clomipramine, a tricyclic antidepressant, may be used.

Prognosis[edit | edit source]

OCD is a chronic condition, but with appropriate treatment, many individuals experience significant improvement in symptoms. Early intervention and adherence to treatment are crucial for better outcomes.

Also see[edit | edit source]

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Contributors: Prab R. Tumpati, MD