OCD

• Obsessive-Compulsive Disorder (OCD)


  Previously classified as an anxiety disorder due to the sometimes extreme anxiety that people experience
• Obsessive-Compulsive Spectrum


  • Certain disorders characterized by repetitive thoughts and/or behaviors, such as OCD
• Repetitive behaviors in the obsessive-compulsive spectrum


  • Self-soothing behaviors (Trichotillomania, Dermatillomania, onychophagia)
  • Reward-seeking behaviors (Hoarding, Kleptomania, Pyromania, Oniomania)
  • Disorders of body appearance or function (body dysmorphic disorder)
• Obsessions


  Recurrent, persistent, intrusive, and unwanted thoughts, images, or impulses that cause marked anxiety and interfere with interpersonal, social, or occupational function
• Compulsions


  Ritualistic or repetitive behaviors or mental acts that a person carries out continuously in an attempt to neutralize anxiety
• Common compulsions


  • Checking rituals
  • Counting rituals
  • Washing and scrubbing
  • Praying or chanting
  • Touching, rubbing, or tapping
  • Ordering
  • Exhibiting rigid performance
  • Having aggressive urges
• OCD is diagnosed only when these thoughts, images, and impulses consume the person or he or she is compelled to act out the behaviors to a point at which they interfere with personal, social, and occupational functions
• Early-onset OCD


  • More likely to affect males
  • More severe symptoms
  • More comorbid diagnoses
  • Greater likelihood of a family history of OCD
• Late-onset OCD


  • Average age of 23
• Cognitive model of OCD


  • Believing one's thoughts are overly important and therefore having a need to control those thoughts
  • Perfectionism and the intolerance of uncertainty
  • Inflated personal responsibility
  • Overestimation of the threat posed by one's thoughts
• Environmental influences are not solely responsible for the development of OCD
• Population-based studies have confirmed substantial heritability in OCD
• Genome-wide and candidate gene association studies support the idea that a complex network of several genes may contribute to the genetic risk for OCD
• Manifestations of Obsessive-Compulsive Disorder


  • Repetitive, meaningless, and difficult behaviors to conquer
  • The person understands that these rituals are unusual and unreasonable but feels forced to perform them to alleviate anxiety or to prevent terrible thoughts
• Diagnostic criteria for OCD


  • Presence of obsessions or compulsions or both
  • The obsessions or compulsions are time-consuming or cause clinically significant distress or impairment
  • The symptoms are not attributable to physiological effects or another mental disorder
• Excoriation disorder (skin-picking)


  Self-soothing behavior that can cause significant distress and medical complications
• Trichotillomania


  Chronic repetitive hair-pulling, a self-soothing behavior that can cause distress and functional impairment
• Body dysmorphic disorder


  Preoccupation with an imagined or slight defect in physical appearance that causes significant distress and interferes with functioning
• Hoarding disorder


  Excessive acquisition of animals or apparently useless things, cluttered living spaces that become uninhabitable, and significant distress or impairment
• Onychophagia


  Chronic nail-biting which is a self-soothing behavior
• Kleptomania


  Compulsive stealing, a reward-seeking behavior
• Oniomania


  Compulsive buying, a reward-seeking behavior
• Body identity integrity disorder (BIID)


  Feeling "overcomplete" or alienated from a part of the body and desiring amputation
• Treatment for OCD


  Combination of medication (SSRI antidepressants, second-generation antipsychotics) and behavioral therapy (exposure, response prevention, deep breathing, relaxation)