Obsessive-compulsive disorder (or OCD), as categorized by the DSM-IV, is an
anxiety disorder. It is characterised by the obsessive need to perform some
task. These tasks are often known as rituals. Note that the DSM-IV Axis II Obsessive-compulsive
personality disorder is considerably different from Obsessive-compulsive disorder,
and is often what people mean when they refer to somebody as "obsessive-compulsive".
Today it is well-accepted that OCD is much more common than was thought previously.
Typically 2–3 % of the general population is believed to have OCD or OCD-like
symptoms.
In many cases the task that an OCD sufferer does may seem simple to the layperson,
but the sufferer feels that they must perform it in some particular way for
fear of dire consequences. Examples might include checking that one has locked
one's car many times over before leaving it parked, or turning the lights on
and off a set number of times every time one leaves a room. Such a person, when
addicted to cigarettes, may argue that they can only quit smoking on the 13th
or 27th of each month, and only when they possess four cigarettes at noon. Some
people who have OCD may be completely aware that such obsessions are not rational,
but feel bound to comply with them because otherwise they suffer from panic
or irrational dread.
Obsessions are ideas that the person cannot stop thinking about. These are
often fears about getting a disease, getting hurt, or causing harm to someone.
The main features of obsessions are that they are automatic, frequent, upsetting
or distressing, and difficult to control or get rid of. Compulsions refer to
actions that the person performs, usually repeatedly, in an attempt to make
the obsession go away. These are often cleansing or avoidance actions. Common
compulsions include excessive washing and cleaning, checking, repetitive actions
such as touching, counting, arranging and ordering, hoarding, ritualistic behaviours
that lessen the chances of provoking an obsession. Compulsions can be observable
actions, for example washing, but they can also be mental rituals such as, repeating
words or phrases, counting, or saying a prayer.
Causes and related disorders
Recent research has revealed a possible genetic mutation that could be the cause
of OCD. Researchers funded by the National Institutes of Health have found a
mutation in the human serotonin transporter gene, hSERT, in unrelated families
with OCD.
Violence is rare among OCD sufferers, but the disorder is often debilitating
to the quality of life. Also, the psychological self-awareness of the irrationality
of the disorder can be painful. For people with severe OCD, it may take several
hours a day to carry out the compulsive acts. More often, they avoid certain
situations or places altogether.
Some people with OCD also suffer from other conditions such as Tourette syndrome,
attention deficit disorder, trichotillomania, hypochondria or Pure Obsessional
OCD (rumination).
Treatment
OCD can be treated with a variety of anti-depressants, such as Anafranil, or
selective serotonin reuptake inhibitors such as Paxil, Zoloft, Prozac, Luvox,
and Anafranil. Some medications like Gabapentin have also been found to be useful
in the treatement of OCD. Symptoms tend to return, however, once the drugs are
discontinued. There are claims that long-term remission of symptoms has been
achieved without medications through cognitive-behavioral therapy making use
of the principles of extinction and habituation.
