OCD

• OCD is a common, chronic condition, often associated with marked anxiety and depression

  Characterised by obsessions and compulsions

  Must cause distress or interfere with the persons social or individual function and not be the result of another psychiatric disorder

  At some point in the disorder, the person recognizes that the symptoms are excessive
• Obsessions:

  • Unwanted or controlled thoughts and intrusive images that the person finds very difficult to ignore
  • Contamination
  • Order of symmetry
  • Safety
• Compulsions:

  • Repetitive actions that the person feels they must do
  • Generate anxiety if they are not done
  • These compulsions are often a way for the person to handle their obsessions
• There is a cycle in OCD involving:

  1. Obsessions
  2. Anxiety
  3. Compulsion
  4. Temporary relief
• Epidemiology:

  • Average age of diagnosis 20 years
  • Equal distribution between men and women
• Diagnosis is based on criteria from either:

  • Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
  • International Classification of Diseases (ICD-11)

   

  The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) can be used to assess the severity of symptoms.
• Management:

  • Mild OCD may be managed with education and self help resources
  • More significant OCD may require:
  • CBT and exposure and response prevention
  • SSRIs (first line)
  • Clomipramine - tricyclic antidepressant