Obsessive Compulsive Disorder

Introduction to Obsessive Compulsive Disorder (OCD)

Obsessive Compulsive Disorder includes both obsessions and compulsions. Obsessions are defined as recurrent, persistent ideas, images or impulses. Compulsions are an attempt to reduce the anxiety caused by the obsession. Compulsive behaviour may be physical or mental acts that are repetitive and purposeful, and performed in response to an obsession.

Signs and Symptoms

Common obsessions include:

Irrational fears of contamination from dirt or germs
Fear of hurting someone
Distressing sexual or religious thoughts
Desire to hoard or a need for symmetry and exactness

Common compulsions include:

Checking
Cleaning and washing
Counting
Hoarding
Mental ruminations

What Are The Causes

Biological

The causes of OCD are probably multifactorial, with genetic and biological influences, as well as environmental influences. Having parents or other family members with the disorder can increase your risk of developing OCD.

Environment

Certain life experiences or stressful events may also trigger intrusive thoughts, rituals and emotional distress characteristic of OCD.

How It Is Treated

If you think you or someone you know may have OCD, you may consult a mental health professional such as a General Practitioner or a Polyclinic Doctor.

Treatment comes in two main forms:

Medication: Medication may be prescribed before or during behaviour therapy if there is indication of severe depression. Drug treatment after behaviour therapy may be prescribed if the therapy has been only moderately effective despite good cooperation. The use of antidepressants has proven to be effective in the treatment of OCD.

Cognitive Behavioural Therapy (CBT): The mainstay of psychological treatment is CBT, where the individual is deliberately exposed to obsessional cues, and then prevented from engaging in the associated repetitive behaviour. With repeated and prolonged exposure to triggers, habituation eventually takes place. Exposure tasks are arranged hierarchically, with treatment commencing with the least anxiety-provoking situation and progressing rapidly through the hierarchy. Ruminations are more difficult to treat. Aversion conditioning such as thought-stopping may be helpful. In addition, it is also useful to teach the individual ways of coping with the anxiety, anger and stress. He will be encouraged to set other targets in life so as to develop a healthier lifestyle.

The combination of CBT and medication increases treatment efficacy. It is important to involve the family in the management of individuals with OCD. Family members are often ignorant about the disorder and may be drawn into the patient’s rituals.