• Obsessive Compulsive Disorder (OCD)

    by  • 05/12/2013 • Psychiatry

    Definition

    Obsessive-compulsive disorder (OCD) may be characterised by the presence of obsessions or compulsions, but commonly both, despite conscious resistance.

    It is equally common in males and females.

     

    Obsessions are unwanted intrusive thoughts, images or urges that the person feels driven to perform. Attempts to resist them are usually unsuccessful.

     

    Compulsions are the irresistible urge to perform tasks or rituals that are stereotyped behaviours from which the patient derives no pleasure. They may appear to have the purpose of preventing harm but are objectively useless (and recognized as such by the patient).

    They may be overt (observable by others) e.g. checking a door is locked/ taps are turned off, or covert e.g. a mental act that cannot be observed such as repeating a certain phrase in one’s mind.

    The compulsions may have been initiated by a certain event- e.g. a needle stick injury led a nurse to compulsively wash her hands.

     

    Associations

    OCD is associated with simultaneous anxiety.

    OCD can occur in depressive disorders, generlised anxiety disorder (GAD), and anorexia nervosa.

    Puerpural psychosis (aka postpartum psychosis) may also occur.

     

    Management

    Psychological therapies include response prevention (leaning how to cope with tension), mass practice (where the patient is forced to repeat their rituals), and thought-stopping (blocking the undesired thoughts).

    Antidepressants (SSRIs and Tricyclics) are very effective at high doses.

    Benzodiazepines reduce short term anxiety.

    Psychosurgery (cingulotomy) used in sever, intractable cases with major life disruption. 

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