Obsessive-compulsive disorder (OCD) is a widespread mental condition that involves suffering from obsessive thoughts and compulsive behaviors. OCD can happen to anyone. A few people start having symptoms very soon, around puberty, but it usually starts early adulthood.

OCD behavior can be distressing and majorly interferes with a person's everyday activities, but treatment and medications can help to keep it under control.So, OCD is a mental anxiety disorder that produces repeated thoughts or images such as fear of germs, dirt, acts of violence, hurting loved ones, sexual thoughts and being overly tidy with things and oneself. It is more prevalent in developing countries than developed countries. OCD is a disorder that has a neurobiological basis.It equally affects men, women, and children of all races, ethnicities and socioeconomic backgrounds.  In the United States, about 1 in 40 adults and 1 in 100 children have OCD.  And according to the World Health Organization, OCD is one of the top 20 causes of illness-related disability, worldwide, for individuals between 15 and 44 years of age. Some disorders that coexist with OCD are-

• Anxiety Disorders
• Major Depressive Disorder
• Bipolar Disorders
• Attention-Deficit/Hyperactivity Disorder (AD/HD)
• Feeding/Eating Disorders
• Autism Spectrum Disorder (ASD)
• Tic Disorders/Tourette Syndrome (TS)

 OCD Symptoms-

A person with OCD usually experiences persistent obsessive thoughts and compulsive behaviors.

• Obsessive thought is an undesired and bothersome thought, vision, or urge that repeatedly begins in the mind, generating anxiety, disgust, or uneasy feelings.
• Compulsive behavior is a repetitious pattern or mental performance that makes an individual do temporary activities to relieve the unpleasant feelings brought on by the obsessive thought.
• OCD can come in many forms, some common symptoms fall into four categories-checking, contamination, symmetry and ordering and finally ruminations and intrusive thoughts.

Risk factors for OCD- 

• Parent/ sibling with OCD 
• Physical differences in certain parts of your brain
• Trauma experiences
• Physical abuse as child
• Depression
• Anxiety
• Sexual abuse as child 
• Post-streptococcal infection 

NOTE- PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders associated with Streptococcal Infections) is an illness in children. It causes OCD and/or a tic disorder. This type of OCD gets worse or is related to strep. throat. 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.

Diagnosis of OCD-

• Physical examination
• Blood tests do not help much
• Doctor may talk to the patient to know his thoughts, feelings and habits.

No laboratory test exists that can identify OCD.  Mental health professionals frequently use diagnostic interviews to determine the presence of OCD as well as other tools that measure the severity of obsessions and compulsions, the most common of which is the Yale-Brown Obsessive Compulsive Scale (Y-BOCS).

Although not a substitute for a formal evaluation and diagnosis provided by a qualified mental health professional, there is a self-screening test you can take to determine if you have symptoms similar to those associated with OCD and could benefit from professional help.

 OCD Treatment-

There are some effective treatments for OCD that can help reduce the impact on life. The major treatments are:

• Psychological therapy – usually cognitive behavioral therapy (CBT), which helps a person face their fears and obsessive thoughts 
• Medication – normally, a type of antidepressant medication called selective serotonin reuptake inhibitors (SSRIs) is induced, which can help by altering the balance of chemicals in the brain

CBT will usually have an effect almost immediately. However, it can take several months for the effects of SSRIs to appear, though more beneficial for people.

If these treatments do not help, an alternative SSRI or a combination of an SSRI and CBT may be given. Some individuals may be referred to a specialist for further medication. However not all modes of treatment are totally effective. That’s why it is said that OCD is a vicious cycle.

To be noted is, the main differential diagnosis is depression and many patients with OCD have comorbid depressive symptoms. Other differentials include phobic disorders, anorexia nervosa, obsessive or anankastic personality and occasionally schizophrenia.

Medications-

• Clomipramine (Anafranil) for adults and children 10 years and older.
• Fluoxetine (Prozac) for adults and children 7 years and older.
• Fluvoxamine for adults and children 8 years and older.
• Paroxetine (Paxil, Pexeva) for adults only.
• Sertraline (Zoloft) for adults and children 6 years and older.

 

Fact Check-

• OCD affects 1-3 percent of the Indian population.
• 1.3% of the US population suffers from OCD.
• 1 in every 200 children have OCD.
• OCD includes some obsessions and compulsions in patients. 
• Obsessions include- contamination, losing control, harming someone and losing important items.
• Compulsions include- washing, cleaning, orderliness, double checking, following a strict routine.
• OCPD or Obsessive compulsive personality disorder is an illness in which someone wants to be in control, believes too much in perfectionism and its traits are persistent all the time. 
• Some warning signs of OCD include depression, being isolated, seeking reassurance, intrusive thoughts and compulsive behavior. 
• All patients of OCD go through a phase called OCD cycle. 

 

• Some OCD examples are- Fear of being contaminated by germs or dirt or contaminating others. Fear of losing control and harming yourself or others. Intrusive sexually explicit or violent thoughts and images. Excessive focus on religious or moral ideas.
• OCD is totally non-preventable and can be reduced by early diagnosis and treatment. 
• OCD is common in both sexes, starting in childhood carried till adulthood.
• There is more risk of OCD in adolescence.
• Stress can make OCD symptoms worse.
• Rates of OCD are higher in women as compared to men.
• OCD impacts the whole family, not just the sufferer. 
• Sometime people with OCD also suffer parallel from bipolar disorder.

PGC Resolution-

Identifying and supporting people with OCD by diagnosing and referring them to therapies, medication, and treatment. Providing information and creating awareness of this disorder among Indians.