Obsessive Compulsive Disorder

OBSESSIVE COMPULSIVE DISORDER

FEATURES AND ASSESSMENT OF OBSESSIVE COMPULSIVE DISORDER

• It is an anxiety disorder, characterised by recurrent obsessions or compulsions which cause marked distress and functional impairment.
• It is a disorder of thought content.
• In this, patients have insight about the illness but are unable to resist their actions.
• Features of OCD are Ego-Alien(Ego Dystonic),Insight ,Failure to resist,Irrationale Thought,Persistence of idea.
• Defence mechanism in OCD includes Repression,undoing and displacement
• The range and severity of OCD symptoms is assessed by the Yale-Brown Obsessive Compulsive Scale.

CAUSE OF OBSESSIVE COMPULSIVE DISORDER

• Abnormalities in serotonin (5-HT) neurotransmission in the brain are meaningfully involved in this disorder.
• Area of brain involved in OCD is Basal Ganglia.

MANAGEMENT OF OBSESSIVE COMPULSIVE DISORDER

• Combination of behaviour & drug therapy is the treatment of choice.
• Behavioural Therapy includes particular forms of Cognitive behavior therapy (exposure and response prevention) .
• First-line medicines for OCD are selective serotonin reuptake inhibitors (SSRIs; (fluoxetine, fluvoxamine, sertraline, paroxetine, citalopram, escitalopram) and clomipramine , a tricyclic antidepressant.
• SSRIs are generally preferred over clomipramine, as their adverse effect profiles are less prominent.
• In OCD treatment is based on Serotonergic receptor.
• SSRIs help the condition by increasing the seratonin levels.
• Clomipramine has the most specific seratoninergic effects among the Tricyclic Antidepressants (TCAs).
• Other secondary medicines used are Carbamazepine,Lithim,etc .
•  Drug of choice for OCD is SSRIs.
• Selective serotonin reuptake inhibitors (SSRIs) are US-FDA approved drugs of first choice (line) for major Depression, Obscessive – compulsive disorder (OCD), Premenstrual dysphoric disorder, Post traumatic stress disorder (PTSD), Panic disorder, Eating disorder (bulimia nervosa), and Social phobia (social anxiety disorder).
• Psychoanalytic psychotherapy is also used as a treatment modality in OCD.
• Neurosurgery (anterior capsulotomy/cingulotomy, or deep brain stimulation), in extremely refractory cases.