Obsessive Compulsive Personality Disorder Definition, Symptoms

Write short note on obsessive compulsive disorder.

Answer. Obsessive­compulsive disorder (OCD) is an anxiety disorder characterized by intrusive thoughts that produce uneasiness, apprehension, fear, or worry; by repetitive behaviors aimed at reducing the associated anxiety; or by a combination of such obsessions and compulsions.

Obsessive Compulsive Disorder Etiology

• Genetic: Obsessive compulsive disorder is widely accepted to result from genetic vulnerability and/or chemical changes in some areas of the brain.
  The precise pathogenesis is not completely understood.
  Twin studies show concordance rates as high as 87% in monozygous twins compared with 47% in dizygous pairs.
• Neurobiology: In OCD patients have shown abnormalities in orbitofrontal cortex, cingulate cortex and caudate nucleus.
  In some children and adolescents, OCD develops after β hemolytic streptococcal infection, an autoimmune reaction similar to that of rheumatic fever.
• Psychological theories: In cognitive behavioral theory,obsessions are considered anxiogenic. OCD patients cannot escape this anxiety and therefore develop compulsion in an attmpt to reduce or prevent the feared consequences.
  Reduction of anxiety reinforces the compulsive behavior.

Read And Learn More: General Medicine Question And Answers

Obsessive Compulsive Disorder Symptoms And Signs

Common obsessive thoughts in obsessive­compulsive disorder (OCD) include:

• Fear of being contaminated by germs or dirt or contaminating others.
• Fear of causing harm to yourself or others.
• Intrusive sexually explicit or violent thoughts and images.
• Excessive focus on religious or moral ideas.
• Fear of losing or not having things you might need.
• Order and symmetry: the idea that everything must line up “just right.”
• Superstitions; excessive attntion to something considered lucky or unlucky.

Common compulsive behaviors in obsessive­compulsive disorder (OCD) include:

• Excessive double­checking of things, such as locks,appliances, and switches.
• Repeatedly checking in on loved ones to make sure they’re safe.
• Counting, tapping, repeating certain words, or doing other senseless things to reduce anxiety.
• Spending a lot of time washing or cleaning.
• Ordering or arranging things “just so.”
• Praying excessively or engaging in rituals triggered by religious fear.
• Accumulating “junk” such as old newspapers or empty food containers.

Obsessive Compulsive Disorder Diagnostic Criteria

• Obsessional thoughts, compulsive acts or both should be present on most days for at least two weeks.
• They are recognized by patients as their own
• Patients have tried to resist unsuccessfully at least one obsessive thought or compulsive act.
• The thoughts or act are not pleasurable.
• The thoughts, images, impulses and acts are unpleasantly repetitive.

Obsessive Compulsive Disorder Management

Obsessive Compulsive Disorder Behavioral therapy

The specifi technique used in BT/CBT is called exposure and ritual prevention (also known as “exposure and response prevention”) or ERP; this involves gradually learning to tolerate the anxiety associated with not performing the ritual behavior.
Exposure ritual/response prevention (ERP) has a strong evidence base.
It is considered the most effctive treatment for OCD.
However, this claim has been doubted by some researchers criticizing the quality of many studies.

More recent behavioral work has focused on associative splittng.

Obsessive Compulsive Disorder Medication

• Medications as treatment include selective serotonin reuptake inhibitors (SSRIs) such as paroxetine (60 mg/day),sertraline, floxetine, escitalopram and flvoxamine and the tricyclic antidepressants, in particular clomipramine (150–300 mg/day).
  SSRIs prevent excess serotonin from being pumped back into the original neuron that released it.
  Over a period of several weeks, the increased levels of serotonin downregulate the receptors, making them less responsive to 5­HT.
  This downregulation is concurrent with the onset of any therapeutic benefis from SSRIS, from 2–3 weeks.
• The atypical antipsychotics olanzapine, quetiapine, and risperidone have also been found to be useful as adjuncts to an SSRI in treatment­resistant OCD.
  However, these drugs are often poorly tolerated, and have signifiant metabolic side effcts that limit their use.

Cognitive Behavior therapy

Main approach in OCD is graded exposure and self imposed response prevention.
This require patient’s to face their feared absessions without undoing them with their compulsions.
Exposure should be of suffient duration to be effctive. An effctive method known as thought stopping may also be used.

Combined Therapy

Combination of cognitive behavior therapy and medication can be more effctive than either alone.

Obsessive Compulsive Disorder Psychosurgery

For some, medication, support groups and psychological treatments fail to alleviate obsessive­compulsive symptoms.

These patients may choose to undergo psychosurgery as a last resort.

In this procedure, a surgical lesion is made in an area of the brain (the cingulate cortex).