Obsessive compulsive disorder

Obsessive–compulsive disorder (OCD) is a mental disorder where people feel the need to check things repeatedly, have certain thoughts repeatedly, or feel they need to perform certain routines repeatedly. People are unable to control either the thoughts or the activities for more than a short period of time. Common activities include hand washing, counting of things, and checking to see if a door is locked. Some may have difficulty throwing things out. These activities occur to such a degree that the person's daily life is negatively affected. Often they take up more than an hour a day. Most adults realize that the behaviors do not make sense. The condition is associated with tics, anxiety disorder, and an increased risk of suicide.

Signs and symptoms

Obsessive–compulsive disorder affects about 2.3% of people at some point in their life. Rates during a given year are about 1.2%. It is more common in women than men. The usual age of onset is in childhood or adolescence. Risk factors include a history of child abuse or other stress-inducing event. Some cases have been documented to occur following infections. The underlying cause is believed to involve the brain's neurotransmitter serotonin.

Causes

The cause is unknown. Both environmental and genetic factors are believed to play a role. In some cases, it is associated with head injury or infections. Diagnosis is based on the symptoms and requires ruling out other drug-related or medical causes. Rating scales such as the Yale–Brown Obsessive Compulsive Scale can be used to assess the severity. Other disorders with similar symptoms include anxiety disorder, major depressive disorder, eating disorders, tic disorders, and obsessive–compulsive personality disorder.

Treatment

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 increasing exposure to what causes the problems while not allowing the repetitive behavior to occur. While clomipramine appears to work as well as SSRIs, it has greater side effects so is typically reserved as a second-line treatment. Atypical antipsychotics may be useful when used in addition to an SSRI in treatment-resistant cases but are also associated with an increased risk of side effects. Without treatment, the condition often lasts decades.

See also

• Anxiety disorder
• Major depressive disorder
• Eating disorders
• Tic disorders
• Obsessive–compulsive personality disorder

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