Obsessive-compulsive disorder (OCD) is an anxiety disorder. The person suffers from unwanted repetitive thoughts and behaviors. These obsessive thoughts and compulsive behaviors are very difficult to overcome. If severe and untreated, OCD can destroy the ability to function at work, school, or home.
The cause is unknown. OCD might be due to neurobiological, environmental, genetic, and psychological factors. An imbalance of serotonin (a brain chemical) may play a major role.
OCD is linked to other neurological disorders, including:
A risk factor is something that increases your chance of getting a disease or condition. Risk factors include:
Symptoms:
People with OCD may know that their thoughts and behaviors do not make sense. And they would like to avoid or stop them. But they are often unable to block their obsessive thoughts or compulsions.
Common obsessions:
Common compulsions:
OCD is usually diagnosed through a psychiatric assessment. OCD is diagnosed when obsessions and/or compulsions either:
Treatment reduces OCD thoughts and behaviors. But treatment does not completely eliminate them. Most commonly, treatment is a combination of medication and cognitive behavioral therapy.
Treatments include:
Selective serotonin reuptake inhibitors (SSRIs) reduce OCD symptoms by affecting the neurotransmitter serotonin. This function is independent of their antidepressant effects. SSRIs include:
***Please note FDA Public Health Advisory for Antidepressants:
The FDA advises that people taking antidepressants should be closely observed. For some, the medications have been linked to worsening symptoms and suicidal thoughts. These adverse effects are most common in young adults. The effects tend to occur at the beginning of treatment or when there is an increase or decrease in the dose. Although the warning is for all antidepressants, of most concern are the SSRI class such as:
Other medications used include clomipramine (Anafranil) and clonazepam (Klonopin) . Clomipramine is a tricyclic antidepressant drug that alters serotonin levels. Clonzepam is a benzodiazepine that relieves anxiety.
Behavioral therapy addresses the actions associated with OCD; cognitive behavioral therapy (CBT) addresses both the thought processes and the actions associated with OCD.
Examples of therapies used to treat OCD include:
An implantable brain device has received limited FDA approval to treat severe cases of OCD. Often called a brain pacemaker, the device delivers mild electrical impulses to the brain to interrupt OCD symptoms.
RESOURCES:
Anxiety Disorders Association of America
http://www.adaa.org/
National Institute of Mental Health
National Institutes of Health
http://www.nimh.nih.gov/
Obsessive-Compulsive Foundation
http://ocfoundation.org/
CANADIAN RESOURCES:
Canadian Mental Health Association
http://www.cmha.ca/
Canadian Psychological Association
http://www.cpa.ca/
References:
Fauci AS, Braunwald E, Isselbacher KJ, et al. Harrison's Principles of Internal Medicine . 14th ed. New York, NY: The McGraw-Hill Companies; 2000.
Obsessive-compulsive disorder (OCD). National Institute of Mental Health, National Institutes of Health website. Available at: http://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml . Accessed June 8, 2008.
OCD risk higher when several variations in gene occur together. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/science-news/2008/ocd-risk-higher-when-several-variations-in-gene-occur-together.shtml . Accessed April 1, 2009.
Professional Guide to Diseases , 9th ed. Ambler, PA: Lippincott Williams & Wilkins; 2009.
Questions and answers about obsessive compulsive disorders. Obsessive Compulsive Foundation website. Available at: http://www.ocfoundation.org/UserFiles/File/Questions-Answers-About-OCD.pdf . Accessed April 1, 2009.
Reclaim DBS therapy for obsessive compulsive disorder. Medtronics website. Available at: http://www.medtronic.com/ocd/ . Accessed April 1, 2009.
*¹4/16/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Simpson HB, Foa EB, Liebowitz MR, et al. A randomized, controlled trial of cognitive-behavioral therapy for augmenting pharmacotherapy in obsessive-compulsive disorder. Am J Psychiatry. 2008;165:621-630. Epub 2008 Mar 3.
Last reviewed April 2009 by Rosalyn Carson-DeWitt, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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