| Obsessive–compulsive disorder | |
|---|---|
 | |
| Frequent, excessive hand washing occurs in some people with OCD | |
| Specialty | Psychiatry |
| Symptoms | Feel the need to check things repeatedly, perform certain routines repeatedly, have certain thoughts repeatedly[1] |
| Complications | Tics, anxiety disorder, suicide[2][3] |
| Usual onset | Before 35 years[1][2] |
| Causes | Unknown[1] |
| Risk factors | Child abuse, stress[2] |
| Diagnostic method | Based on the symptoms[2] |
| Differential diagnosis | Anxiety disorder, major depressive disorder, eating disorders, obsessive–compulsive personality disorder[2] |
| Treatment | Counseling, selective serotonin reuptake inhibitors, clomipramine[4][5] |
| Frequency | 2.3%[6] |
Obsessive–compulsive disorder (OCD) is a mental disorder in which a person feels the need to perform certain routines repeatedly (called "compulsions"), or has certain thoughts repeatedly (called "obsessions").[1] The person is unable to control either the thoughts or activities for more than a short period of time.[1] Common compulsions include hand washing, counting of things, and checking to see if a door is locked.[1] Some may have difficulty throwing things out.[1] These activities occur to such a degree that the person's daily life is negatively affected,[1] often taking up more than an hour a day.[2] Most adults realize that the behaviors do not make sense.[1] The condition is associated with tics, anxiety disorder, and an increased risk of suicide.[2][3]
The cause is unknown.[1] There appear to be some genetic components, with both identical twins more often affected than both non-identical twins.[2] Risk factors include a history of child abuse or other stress-inducing event.[2] Some cases have been documented to occur following infections.[2] The diagnosis is based on the symptoms and requires ruling out other drug-related or medical causes.[2] Rating scales such as the Yale–Brown Obsessive Compulsive Scale (Y-BOCS) can be used to assess the severity.[7] Other disorders with similar symptoms include anxiety disorder, major depressive disorder, eating disorders, tic disorders, and obsessive–compulsive personality disorder.[2]
Treatment involves counseling, such as cognitive behavioral therapy (CBT), and sometimes antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) or clomipramine.[4][5] CBT for OCD involves increasing exposure to what causes the problems while not allowing the repetitive behavior to occur.[4] While clomipramine appears to work as well as SSRIs, it has greater side effects and thus is typically reserved as a second-line treatment.[4] Atypical antipsychotics may be useful when used in addition to an SSRI in treatment-resistant cases but are also associated with an increased risk of side effects.[5][8] Without treatment, the condition often lasts decades.[2]
Obsessive–compulsive disorder affects about 2.3% of people at some point in their lives.[6] Rates during a given year are about 1.2%, and it occurs worldwide.[2] It is unusual for symptoms to begin after the age of 35, and half of people develop problems before 20.[1][2] Males and females are affected about equally.[1] The phrase obsessive–compulsive is sometimes used in an informal manner unrelated to OCD to describe someone as being excessively meticulous, perfectionistic, absorbed, or otherwise fixated.[9]
References edit
- ^ a b c d e f g h i j k l The National Institute of Mental Health (NIMH) (January 2016). "What is Obsessive-Compulsive Disorder (OCD)?". U.S. National Institutes of Health (NIH). Archived from the original on 23 July 2016. Retrieved 24 July 2016.
- ^ a b c d e f g h i j k l m n o Diagnostic and statistical manual of mental disorders : DSM-5 (5 ed.). Washington: American Psychiatric Publishing. 2013. pp. 237–242. ISBN 978-0-89042-555-8.
- ^ a b Angelakis, I; Gooding, P; Tarrier, N; Panagioti, M (25 March 2015). "Suicidality in obsessive compulsive disorder (OCD): A systematic review and meta-analysis". Clinical Psychology Review. 39. Oxford, England: Pergamon Press: 1–15. doi:10.1016/j.cpr.2015.03.002. PMID 25875222.
- ^ a b c d Grant JE (14 August 2014). "Clinical practice: Obsessive-compulsive disorder". The New England Journal of Medicine. 371 (7): 646–53. doi:10.1056/NEJMcp1402176. PMID 25119610.
- ^ a b c Veale, D; Miles, S; Smallcombe, N; Ghezai, H; Goldacre, B; Hodsoll, J (29 November 2014). "Atypical antipsychotic augmentation in SSRI treatment refractory obsessive-compulsive disorder: a systematic review and meta-analysis". BMC Psychiatry. 14: 317. doi:10.1186/s12888-014-0317-5. PMC 4262998. PMID 25432131.
{{cite journal}}: CS1 maint: unflagged free DOI (link) - ^ a b Goodman, WK; Grice, DE; Lapidus, KA; Coffey, BJ (September 2014). "Obsessive-compulsive disorder". The Psychiatric Clinics of North America. 37 (3): 257–67. doi:10.1016/j.psc.2014.06.004. PMID 25150561.
- ^ Fenske JN, Schwenk TL (August 2009). "Obsessive compulsive disorder: diagnosis and management". American Family Physician. 80 (3): 239–45. PMID 19621834. Archived from the original on 12 May 2014.
- ^ Decloedt EH, Stein DJ (2010). "Current trends in drug treatment of obsessive-compulsive disorder". Neuropsychiatr Dis Treat. 6: 233–42. doi:10.2147/NDT.S3149. PMC 2877605. PMID 20520787.
{{cite journal}}: CS1 maint: unflagged free DOI (link) - ^ Bynum, W.F.; Porter, Roy; Shepherd, Michael (1985). "Obsessional Disorders: A Conceptual History. Terminological and Classificatory Issues.". The anatomy of madness: essays in the history of psychiatry. London: Routledge. pp. 166–187. ISBN 978-0-415-32382-6.