Obsessive-Compulsive Disorder (OCD)

What is obsessive-compulsive disorder?

Obsessive-compulsive disorder (OCD) is characterized by recurrent and persistent thoughts (obsessions) and actions (compulsions). Most adults with this disorder recognize that their behavior is irrational, but others do not. Children with OCD are usually unaware of their behavior being unreasonable.

OCD may be associated with other anxiety, depressive or eating disorders. Many people with OCD also suffer from nervous tics.

OCD is thought to affect around 1-3 persons per 100 adults and one person per 200 children, and is found equally in men and women. It usually begins in adolescence or early adulthood but may develop in childhood. There are generally two age ranges when OCD first appears: (1) between ages 8 and 12 or (2) between the late teens and early adulthood. There is some evidence that OCD may run in families.


What are the symptoms of OCD?

The obsessions are irrational and are unrelated to worries about real life such as financial or work problems. If not treated, OCD may progress until the obsessions take up all of a sufferer's waking time. One of the most common obsessions is worry about contamination, in which the person fears they might be contaminated by germs from ordinary objects or from shaking another person's hand. The compulsive behavior, which develops in order to relieve this anxiety, is hand washing, which may become so excessive that the person's skin becomes raw as a result.

Others may worry that a task, such as locking a door or turning off the stove, has not been completed. The sufferer may be driven to checking every few minutes that the door is locked or repeatedly checking that the stove is off. There may be a need to do things in a certain order or to repeat them a certain number of times. In some cases items must be placed in a certain position and the sufferer may become greatly distressed if they become disordered. The resulting compulsions are all excessive and unrealistic.


What causes OCD?

The exact reason OCD occurs is not known, although it often begins during episodes of increased stress. It is also thought that some people may be genetically predisposed to the condition.  Experts believe that OCD is caused by a chemical imbalance in the brain; it has been proposed that serotonin, a chemical messenger in the brain, may be involved.


How is OCD treated?

There are medicines available that may help some people with OCD. These medicines belong to a group known as selective serotonin reuptake inhibitors (SSRIs). They are thought to act in OCD by blocking the reuptake of serotonin  in the brain, thereby increasing the amount available in certain areas. The drugs available include: escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox CR), clomipramine, paroxetine (Paxil) or sertraline (Zoloft). Other treatment may involve cognitive therapy (a form of psychotherapy) or behavioral therapy.