Obsessive Compulsive Disorder

About Obsessive Compulsive Disorder

Obsessive compulsive disorder is characterized by obsessions, which are intrusive, unwanted thoughts, images or urges that cause marked anxiety or distress, and compulsions, which are repetitive behaviors or mental acts a person feels driven to perform to reduce that distress or prevent a feared outcome. Common themes include contamination, doubt about whether something was done, fear of harming others, taboo sexual or religious thoughts, and a need for symmetry, while common compulsions include washing, checking, counting, arranging and mental rituals such as repeating phrases. Insight varies, but many people recognize their obsessions as excessive. OCD usually begins in childhood, adolescence or early adulthood and is one of the more common chronic psychiatric conditions. DSM-5 moved it out of the anxiety disorders into a new chapter of obsessive compulsive and related disorders. Severity is often measured with the Yale Brown Obsessive Compulsive Scale. Brain imaging research implicates circuits linking the cortex, striatum and thalamus. Exposure and response prevention, a form of cognitive behavioral therapy in which people gradually face feared situations while refraining from compulsions, is a first line treatment with strong evidence. SSRIs and the older antidepressant clomipramine are among the medications used. For severe cases that have not responded to other treatments, deep brain stimulation is used in specialized centers.