What is obsessive compulsive disorder?

Obsessive compulsive disorder, commonly known as OCD is characterized by obsessive thoughts and compulsive behaviors that impair day to day functioning. The person (or the patient) becomes so obsessive with some thoughts and actions that other activities become less important to him/her.

Some of the common examples of obsessive compulsive disorder are, frequent (may be several times within an hour) washing of hands for the fear of contamination and germs and checking and rechecking of the door again and again if it is locked, especially at night time.

How serious is obsessive compulsive disorder?

The degree of severity of the obsessive compulsive disorder vary from person to person, but in general if a person is suffering from obsessive compulsive disorder, it (obsessive-compulsive activities) generally take more than 1 hour (>1 hour) per day. These obsessive-compulsive activities are undertaken to relieve the anxiety that is triggered by the core fear. Patients frequently conceal their symptoms (obsessive-compulsive activities), because they are embarrassed by the content of their thoughts as well as by the nature of their actions.

How common is obsessive compulsive disorder?

Incidence or prevalence of obsessive compulsive disorder is about 2% to 3% of the population throughout the world. This is approximately same in all regions, races and cultures.

How obsessive compulsive disorders starts?

The onset of obsessive compulsive disorder is usually gradual, which begins in early adulthood, but childhood onset is not uncommon. The disorder usually has a waxing and waning course (improves and deteriorates alternatively), but some cases may show a steady deterioration in psychosocial functioning.

How obsessive compulsive disorder is diagnosed?

The symptoms are diagnostic in case of obsessive compulsive disorders. Specific questions regarding recurrent thoughts and behaviors, particularly if physical clues such as chafed and reddened hands or patchy hair loss (which is generally due to repetitive hair pulling, known as trichotillomania) should be asked. Co-morbid conditions are commonly seen in case of obsessive compulsive disorders and the most frequent are depression and other anxiety disorders, eating disorders, and tics (habit of eating earth or soil).

Etiology & Pathophysiology of obsessive compulsive disorders:

Twin studies suggest a genetic contribution to OCD (obsessive compulsive disorders). Family studies show incidence of OCD is more common in males and in first-born children.

The location of obsessive-compulsive disorder is thought to be the orbital frontal cortex, caudate nucleus, and globus pallidus. The caudate nucleus is involved in the acquisition and maintenance of habit and skill learning, and interventions in this can be successful in reducing obsessive-compulsive behaviors.

Treatment of obsessive compulsive disorders?

FDA (Food & Drug Administration of United States) has approved use of fluoxetine, fluvoxamine, sertraline and clomipramine for treatment of obsessive compulsive disorders. Fluoxetine (5–60 mg/day), fluvoxamine (25–300 mg/day), and sertraline (50–150 mg/day) are effective and have a more benign (less serious) side effect profile in compare to clomipramine (a tri-cyclic antidepressant) and has anticholinergic and sedative side effects at the therapeutic doses required to treat obsessive-compulsive disorder (25–250 mg/day) and as a result is tolerated poorly. The efficacy of clomipramine is not related to its antidepressant property.

But unfortunately only about 50% to 60% of the patients with obsessive compulsive disorders show significant improvement with pharmacotherapy (with drugs) alone and augmentation with other serotonergic agents, like buspirone, or with a neuroleptic or benzodiazepine may be beneficial, especially in treatment resistant cases.

In many patients with obsessive compulsive disorders, especially those who have time-consuming compulsions, behavior therapy will result in as much improvement as that afforded by medication. The techniques which are used successfully are gradual increase in exposure to stressful situations, maintenance of a diary to identify and clarify stressful situations that induce compulsions, and homework assignments that substitute new activities for compulsive behaviors of obsessive compulsive disorders.