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Published on: Jun 28, 2006
Last modification: Jun 28, 2006
What is OCD?
by SirGan
 OCD or Obsessive-compulsive disorder is one specific psychiatric disorder, which is most commonly characterized by a subject's obsessive thoughts and related compulsions which attempt to neutralize the obsessions. To be more precise- it is a form of anxiety disorder! It is important to distinguish OCD from other types of anxiety, including the routine tension and stress that appear throughout life. It is proven that in many cases- sufferers are generally of above-average intelligence. This is because the very nature of the disorder necessitates complicated thinking patterns. Children and adolescents often feel shame and embarrassment about their OCD. Many fear it means they're crazy and are hesitant to talk about their thoughts and behaviors. What exactly are obsessions and compulsions?
Obsessions are defined by:
With OCD, someone may have obsessions about:
Compulsions are defined by:
Examples of some common OCD compulsions:
History of the conditionThe fact is that, regarding the psychological aspect of obsessions and compulsions, the definitive cause of OCD is still unknown!
During the 14th and 15th century – it was believed that that those who experienced obsessive thoughts were possessed by the devil.
In the early 1900s, Freud attributed obsessive-compulsive behavior to unconscious conflicts which manifested as symptoms. He linked OCD to stressors or traumas that occurred during childhood. However there are still not enough evidences to support this theory!
Possible causes of OCDThere are many different theories about the cause of obsessive-compulsive disorder.
Some research has discovered a type of size abnormality in different brain structures. The experts are claiming that there is some type of abnormality in the neurotransmitter serotonin. What should be known about this neurotransmitter? Well, it is discovered that serotonin has a role in regulating anxiety, though it is also thought to be involved in sleep and memory function. In order to do his function- serotonin must bind to the receptor sites and that’s why- experts believe that OCD sufferers may have blocked or damaged receptor sites. Of course, this is preventing serotonin from functioning to its full potential. Because of this – it is proven that OCD patients benefit from the use of Selective Serotonin Reuptake Inhibitors- a class of antidepressant medications.
Several researches done in the past have came to this possibility of genetic mutation that could be the cause of OCD. Researchers found a mutation in the human serotonin transporter gene in unrelated families with OCD. In addition, it is proven that environmental factors also play a role in how these anxiety symptoms are expressed.
Using some brain imaging techniques such as positron emission tomography (PET scans), it has been shown that those with OCD tend to have brain activity that differs from those who do not have this disorder. That’s why some experts claim that OCD is caused by the part of the brain that is responsible for translating complex intentions into fundamental actions. This part of the brain is failing to correctly communicate with other structures in the brain.
Although nothing of this has been proven yet- some cases are thought to be caused at least in part by childhood streptococcal infections. This is because it is found that the streptococcal antibodies may become involved in an autoimmune process. Good thing about all this is that, if OCD is caused by bacteria, this provides hope that antibiotics may eventually be utilized to treat or prevent it. Some experts are also saying that OCD in men at least may be partially caused by low estrogen levels.
Several studies have also been done that show nutrition deficiencies may also be a probable cause for OCD and other mental disorders. That’s why- certain vitamin and mineral supplements may aid in such disorders and provide the nutrients necessary for proper mental functioning.
Neuropsychiatric explanationsIt is proven that OCD primarily involves the brain regions of the striatum and the cingulate cortex. It involves several different receptors, mostly H2, M4, nk1, NMDA, and non-NMDA glutamate receptors. Those correlations are as follows:
Activity positively correlated to severity:
Activity negatively correlated to severity:
Differential diagnosisPeople with OCD may be diagnosed with other conditions, such as Tourette syndrome, compulsive skin picking, body dysmorphic disorder and trichotillomania but the differentiating between obsessive-compulsive disorder and a depressive disorder may be the most difficult. This is because these two types of symptoms so frequently occur together. Although obsessional thoughts and compulsive acts commonly coexist in several other conditions- it is useful to be able to specify the characteristic set of symptoms as predominant, since they may respond to different treatments.
OCD, depression and drug abuseThe fact is that there is some researches which tried to demonstrate a link between drug addiction and obsessive compulsive disorder. Therefore- it is proven that there is a higher risk of drug addiction among those with any anxiety disorder. There is only one problem- experts don’t know does the drug addiction among OCD patients may serve as a type of compulsive behavior or just as a coping mechanism.
Depression is also extremely prevalent among sufferers of OCD. People with OCD may feel depressed because of the fact that they get out of control.
OCD and other disordersDisorders that frequently occur with OCD include:
· other anxiety disorders,
· depression,
· disruptive behavior disorders
· attention deficit hyperactivity disorder,
· learning disorders,
· trichotillomania
· habit disorders such as nail biting or skin picking
Treatment of OCDOCD can be treated with Behavioral therapy (BT), Cognitive therapy (CT), or a combination of both known as Cognitive-Behavioral therapy (CBT), as well as with a variety of medications.
The specific technique used in this therapy is called Exposure and Ritual Prevention and it involves gradually learning to tolerate the anxiety associated with not performing the ritual behavior.
The exposure
Patient might touch something only very mildly contaminated. The person quickly habituates to the anxiety-producing situation and discovers that the anxiety level has dropped significantly! Then they can then progress to touching something more contaminated without performing the ritual behavior of washing or checking. It is very simple!
Pharmacologic treatments include:
· selective serotonin reuptake inhibitors (SSRIs) such as paroxetine (Paxil, Aropax), sertraline (Zoloft), fluoxetine (Prozac), and fluvoxamine (Luvox)
SSRIs help about 60% of OCD patients, but relapses are common once the medication is no longer taken · Tricyclic antidepressants, in particular clomipramine (Anafranil).
· Other medications like gabapentin (Neurontin), lamotrigine (Lamictal), antipsychotics olanzapine (Zyprexa) and risperidone (Risperdal)
· The naturally occurring sugar Inositol may be an effective treatment for OCD
Unfortunately - for some, medications, support groups or psychological treatments aren’t helpful in relieving the symptoms of obsessive-compulsive disorder.
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