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Obsessive-compulsive disorder

Neelam Maurya

Obsessive-compulsive disorder

INTRODUCTION:

  • Area of brain involved in OCD is Basal ganglia
  • They experience obsessions and compulsions
  • Obsessions –
  • Intrusive, distressing thoughts and mental images which repeat over and over
  • ego-dystonic (experienced as unpleasant)(undoing)

Common obsessions:

  • Dirt and contamination
  • Superstitious fears 
  • Aggressive content
  • Sexual content (blasphemous religious thoughts.)
  • Hoarding
  • Need for symmetry
  • Pathological doubt
  • Compulsions – are behaviours or acts that are carried out to reduce the anxiety   
Common compulsions:
  • Mental rituals (prayers, counting etc.)
  • Checking
  • Hoarding
  • Arranging until things are “just right”
  • Cleaning and washing

CLINICAL FEATURES & SYMPTOMS:

  • Contamination – the most common obsession , obsession of contamination followed by compulsive avoiding of contaminated objects , excessive cleaning , inability to leave there homes because of fear of germs , shame and disgust from feces , urine , dust and germs .
  • Pathological doubt – 2nd most common, obsession of doubt, followed buy compulsive checking, most danger of violence, forgetting to turn off the stove, or not locking the door, some patient can travel back home several times. Obsession of self-doubt, feeling guilty about issues
  • Intrusive thoughts – 3rd most common, intrusive obsessional thoughts without compulsion, such as repetitive sexual or aggressive acts, patients obsessed of there thoughts, may think that they suppose to report them to the police or to make a confession to the priest .
  • Symmetry – 4th most common, the need for symmetry of precision, which lead them to compulsion of slowness, patient can take an hour to eat a meal or shave their faces
  • Religious obsession and compulsive hoarding .
  • ½ of the people with OCD later develop sever depressive episode.
  • Trichitillomnia – compulsive hair pulling and nail biting .
  • Masturbation can be an compulsive pattern , in many way to relief specific obsessive anxiety 
  • Repression,Undoing,Denial  & Displacement are Defence mechanism in OCD
  • Shows perfectionism 
  • Rigidity and Stubbornne
  • OCD usually has a gradual onset, beginning in early adulthood
  • OCD has a prevalence of 2-3% worldwide..
  • ALL cases of OCD take up greater than 1 hour
  • Group A streptococcal infections are associated with OCD. 
  • Childhood onset is not rare and the disorder has a waxing and wanning course.
Exam Question
 
  • Obsession to Dirt and contamination  is a common finding of OCD 
  • ½ of the people with OCD later develop sever depressive episode.
  • Obsessive Compulsive Disorder is associated with intrusive thoughts (obsessions) and unusual rituals and activities (compulsions).
  • Ego’s defence mechanism “Undoing” is typically seen in OCD
  • Perfectionism interfering with performance, Compulsive checking behaviour ,Preoccupation with rule are find in OCD
  • Irritational thought,Resisting the idea, Persistence of idea are find in OCD
  • Abnormal thought possession is found in OCD
  • Repression,Undoing,Denial  & Displacement are Defence mechanism in OCD
  • Patient is conscious about the disorder in OCD
  • Irresistible desire to do a thing repeatedly is seen in OCD
  • Area of brain involved in OCD is Basal ganglia
  • Compulsive hair pulling that produces bald spots is called Trichotillomania
Don’t Forget to Solve all the previous Year Question asked on Obsessive-compulsive disorder
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