OCD(OBSSESSIVE CUMPULSIVE DISORDER)
Obsessive-compulsive disorder (OCD) is a disorder in which people have recurring, unwanted thoughts, ideas or
sensations (obsessions). To get rid of the thoughts, they feel driven to do something repetitively (compulsions).
The repetitive behaviours, such as hand washing/cleaning, checking on things, and mental acts like (counting) or
other activities, can significantly interfere with a person’s daily activities and social interactions.
• reduce the anxiety completely created by the obsession.
• obsessive = pre- occupied thoughts. Any bad thought consistently going on in your mind & that is creating some
anxiety.
• compulsive = continuing of some action.
• rituals after obsession.
1- majority of people have an insight about the OCD
2- ICD says OCD can be studied in 3 ways -
a) just obsession
b) just compulsion
c) mixed episodes: both obsession & compulsions
OCD Types
1- Washers :
dirt,germs (obsession )
washing again & again ( compulsions )
2- Checkers
checking doors - locks & things ( compulsions )
3- Ritualistic Pattern
In a particular pattern
Treatment
Diagnosis of OCD requires the presence of obsessional thoughts and/or compulsions that are time-
consuming (more than one hour a day), cause significant distress, and impair work or social
functioning. OCD affects 2-3% of people in the United States, and among adults, slightly more women
than men are affected. OCD often begins in childhood, adolescence, or early adulthood. Some people
may have some symptoms of OCD but do not meet full criteria for this disorder.
Examples of obsessional thoughts:
Fear of contamination by people or the environment
Disturbing sexual thoughts or images
Religious, often blasphemous, thoughts or fears
Fear of perpetrating aggression or being harmed (self or loved ones)
Extreme worry something is not complete
Extreme concern with order, symmetry, or precision
Fear of losing or discarding something important
Can also be seemingly meaningless thoughts, images, sounds, words or music
Psychotherapy
1. Psychoanalytic psychotherapy is used in certain selected patients, who are psychologically ori- ented.
2. Supportive psychotherapy is an important adjunct to other modes of treatment. Supportive psychotherapy is
also needed by the family members.
3. Behaviour Therapy and Cognitive Behaviour Therapy-
One effective treatment is a type of cognitive-behavioral therapy (CBT) known as exposure and response
prevention (ERP). During treatment sessions, patients are exposed to feared situations or images that focus on
their obsessions
Behaviour modification is an effective mode of therapy, with a success rate as high as 80%, especially for the
compulsive acts. It is customary these days to combine CBT with BT at most centres.
The techniques used are:
i. Thought-stopping (and its modifications).
ii. Response prevention.
iii. Systematic desensitisation.
iv. Modelling.
4. Drug Treatment
Serotonergic antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and
clomipramine, are the established pharmacologic first-line treatment of OCD. Medium to large dosages
and acute treatment for at least 3 months are recommended until efficacy is assessed.
5. Electroconvulsive Therapy
Electroconvulsive therapy (ECT) is not currently used as a first-line treatment for obsessive-compulsive
disorder (OCD). However, several related case reports have demonstrated that ECT seems to be
effective for severe OCD, especially when first-line therapies have failed.
6. Psychosurgery
Cognitive behavioral therapy (CBT), a type of psychotherapy, is effective for many people with OCD.
Exposure and response prevention (ERP), a component of CBT therapy, involves gradually exposing
you to a feared object or obsession, such as dirt, and having you learn ways to resist the urge to do
your compulsive rituals. ERP takes effort and practice, but you may enjoy a better quality of life once
you learn to manage your obsessions and compulsions.
Maintaining a healthy lifestyle can help in coping with OCD. Getting enough good quality sleep, eating healthy
food, exercising, and spending time with others can help with overall mental health. Also, using basic relaxation
techniques (when not doing exposure exercises) such as meditation, yoga, visualization, and massage can help
ease the stress and anxiety.