OCD
Obsessive Compulsive Disorder (OCD) still unknown completely of their pathology however, with the use of imaging, OCD has shown activation in the prefrontal cortex; associated with memories and sequences or behavioral responses, basal ganglia; associated with motor and behavioral responses and the thalamus. OCD is commonly characterized by what is called compulsions or obsession that include intruding thoughts or unwanted reoccurring manifestations of events that are known to be bothersome.
Obsessive-Compulsive and Related Disorders:
Recurrent and persistent thoughts, urges or images that are experienced, at some time during the disturbance, as intrusive, unwanted, and that in most individuals cause marked anxiety or distress.
Obsessions: persistent ideas, thoughts, impulses, or images that are experienced as inappropriate or intrusive and that cause anxiety and distress. The content of the obsession is often perceived as alien and not under the person's control.
Compulsions: repetitive behaviors or mental acts that are carried out to reduce or prevent anxiety or distress and are perceived to prevent a dreaded event or situation.
Some individuals with OCD also have a tic disorder. Motor tics are sudden, brief, repetitive movements, such as eye blinking and other eye movements, facial grimacing, shoulder shrugging, and head or shoulder jerking. Common vocal tics include repetitive throat-clearing, sniffing, or grunting sounds.
Genetics:
Twin and family studies have shown that people with first-degree relatives (such as a parent, sibling, or child) who have OCD are at a higher risk for developing OCD themselves. The risk is higher if the first-degree relative developed OCD as a child or teen. Ongoing research continues to explore the connection between genetics and OCD and may help improve OCD diagnosis and treatment.
Age at Onset:
OCD usually begins before age 25 years and often in childhood or adolescence. In individuals seeking treatment, the mean age of onset appears to be somewhat earlier in men than women. According to Swedo et al.'s report in 1989, in a series of 70 children and adolescents seen at the National Institute of Mental Health, the mean age of onset was 9.6 years for boys and 11.0 for girls. In a series of 263 adult and child patients, Lensi et al. in 1996 reported that the mean age at onset was 21 years for men and 24 years for women. Still, in another series reported by Rasmussen and Eisen in 1992, the means were 21 years for men and 22 years for women -- in this series, major symptoms began before age 15 years in about one-third, before age 25 in about two-thirds, and after age 35 in less than 15%.
Treatment:
OCD is typically treated with medication, psychotherapy, or a combination of the two. Although most patients with OCD respond to treatment, some patients continue to experience symptoms.
Sometimes people with OCD also have other mental disorders, such as anxiety, depression, and body dysmorphic disorder, a disorder in which someone mistakenly believes that a part of their body is abnormal. It is important to consider these other disorders when making decisions about treatment.
Medication:
Serotonin reuptake inhibitors (SRIs), which include selective serotonin reuptake inhibitors (SSRIs) are used to help reduce OCD symptoms.
SRIs often require higher daily doses in the treatment of OCD than of depression and may take 8 to 12 weeks to start working, but some patients experience more rapid improvement.
If symptoms do not improve with these types of medications, research shows that some patients may respond well to an antipsychotic medication. Although research shows that an antipsychotic medication may help manage symptoms for people who have both OCD and a tic disorder, research on the effectiveness of antipsychotics to treat OCD is mixed.
Exposure and Response Prevention, a form of CBT is the recommended approach to treating an individual with OCD. Essentially it utilizes that ability of repetitive exposure to the stimulating event with the response of not performing the compulsion. This is a behavioral technique that is used to show an individual that a consequence is not associated with the compulsion. This is typically combined with the use of a systematic desensitization hierarchy that allows the individual to rank their level of interference with objectives.
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