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==Overview==
==Overview==


'''Obsessive-compulsive disorder''' ('''OCD''') is a [[psychiatric]] [[anxiety disorder]] most commonly characterized by a subject's obsessive, [[distress]]ing, [[intrusive thoughts]] and related compulsions (tasks or "rituals") which attempt to neutralize the obsessions. It is listed by the [[World Health Organization]] as one of the top 10 most disabling illnesses in terms of a diminished quality of life.<ref>Kohn, R. et al. "The treatment gap in mental health care". The World Health Organization, 2004. <http://www.who.int/bulletin/volumes/82/11/en/858.pdf>. Accessed June 28, 2007.</ref>
Obsessive Compulsive disorder is a [[psychiatric condition]] characterized by recurrent undesirable thoughts or sensations (obsessions) that cause patients to do something repetitively (compulsions). WHO listed this disorder among one of the top 10 psychiatric disorders that can affect the [[quality of life]].


The phrase "obsessive-compulsive" has worked its way into the wider English lexicon, and is often used in an offhand manner to describe someone who is meticulous or absorbed in a cause (see also "[[Anal retentive|anal-retentive]]"). Such casual references should not be confused with obsessive-compulsive disorder; see [[clinomorphism]]. It is also important to '''distinguish''' OCD from other types of [[anxiety]], including the routine [[tension]] and [[Stress (medicine)|stress]] that appear throughout life. Although these signs are often present in OCD, a person who shows signs of infatuation or [[fixation]] with a subject/object, or displays traits such as [[Perfectionism (psychology)|perfectionism]], does not necessarily have OCD, a specific and well-defined condition.
==Historical Perspective==


To be diagnosed with obsessive-compulsive disorder, one must have either obsessions or compulsions alone, or obsessions and compulsions, according to the [[Diagnostic and Statistical Manual of Mental Disorders|DSM-IV-TR]] diagnostic criteria. The Quick Reference to the diagnostic criteria from DSM-IV-TR (2000) describes these obsessions and compulsions:<ref name="Quick">''Quick Reference to the Diagnostic Criteria from DSM-IV-TR''. Arlington, VA: American Psychiatric Association, 2000.</ref>
==Classification==
Obsessive compulsive disorder is classified in the [[Diagnostic and Statistical Manual of Mental Disorders]], Fourth Edition, Text Revision (DSM-IV-TR) as an [[anxiety]] [[disorder]]. According to the American Psychiatric Association there will be change in the classification of OCD and associated conditions into DSM-5 once the the fifth edition of the DSM scheduled for release in May 2013 comes out.


'''Obsessions are defined by:'''
==Pathophysiology==
# Recurrent and persistent thoughts, impulses, or images that are experienced at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress.
Different [[biological]] and [[psychological]] explanations have been put forward to understand the pathophysiology of obsessive-compulsive disorder. It is generally agreed that [[neurotransmitters]] play an important role in the pathophysiology of obsessive–compulsive disorder.
# The thoughts, impulses, or images are not simply excessive worries about real-life problems.
==Causes==
# The person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action.
It is generally agreed that [[neurotransmitters]], [[biological]], [[psychological]], and environmental factors all play a probable role in causing obsessive–compulsive disorder.
# The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind, and are not based in reality.
# The tendency to haggle over small details that the viewer is unable to fix or change in any way. This begins a mental pre-occupation with that which is inevitable.


'''Compulsions are defined by:'''
==Differentiating Obsessive Compulsive Disorder from other Diseases==
# Repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly.
The differential diagnosis of obsessive-compulsive disorder (OCD) includes [[tic]]s, [[mood]] and [[anxiety]] disorders, and other [[compulsive]] behaviors, such as [[trichotillomania]] or [[neurodermatitis]].
# The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive.


In addition to these criteria, at some point during the course of the disorder, the sufferer must realize that his/her obsessions or compulsions are unreasonable or excessive. Moreover, the obsessions or compulsions must be time-consuming (taking up more than one hour per day), cause distress, or cause [[impairment]] in social, occupational, or school functioning.<ref name="Quick"> </ref> OCD often causes feelings similar to those of [[Depression (mood)|depression]].
==Epidemiology and Demographics==
Once believed to be rare, OCD was found to have a lifetime prevalence of 2,300 per 100,000 (2.3%) of the overall population. The twelve month prevalence of OCD is 1,200 per 100,000 (1.2%) of the overall population. Discovery of effective treatments and education of patients and health care providers have significantly increased the identification of individuals with OCD. International studies have shown a similar incidence and prevalence of OCD worldwide.
 
==Risk Factors==
Risk factors for obsessive compulsive disorder include [[genetic predisposition]], a variety of [[genetic]] factors, environmental factors, and [[brain]] structure and function.
 
==Screening==
This screening test for obsessive-compulsive disorder is designed as a guide to find out whether one shows [[symptoms]] similar to those of obsessive-compulsive disorder (OCD). The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is considered as a gold standard to screen for the symptoms and severity of obsessive compulsive disorder.
 
==Natural History, Complication and Prognosis==
The course of obsessive compulsive disorder is difficult to predict, and minimal research has been done on it. However, it is known that [[stress]] exacerbates the [[symptoms]] of OCD, and if left untreated, OCD often develops into a [[chronic]] condition that presents varying complications and results in an overall poor [[quality of life]].
 
==Diagnosis==
===History and Symptoms===
Obsessive-compulsive disorder (OCD) is a [[psychiatric]] [[anxiety]] [[disorder]] most commonly characterized by a subject's obsessive, [[distress]]ing, [[intrusive thoughts]] and related compulsions (tasks or "rituals") which attempt to neutralize the obsessions.
 
===Physical Examination===
Although obsessive-compulsive disorder is a [[mental health]] problem, certain physical examinations are done to pin point the diagnosis for OCD.
 
===Laboratory Findings===
The laboratory tests for obsessive compulsive disorder may include a [[complete blood count]] ([[CBC]]), screening for alcohol and drugs, and a check of the [[thyroid]] function.
 
===Electrocardiogram===
 
===X-ray===
 
===Echocardiography and Ultrasound===
 
===CT scan===
 
===MRI===
===Other Imaging Findings===
 
===Other Diagnostic Studies===
 
==Treatment==
===Medical Therapy===
According to the Expert Consensus Guidelines for the Treatment of obsessive-compulsive disorder, [[behavioral therapy]] (BT), [[cognitive therapy]] (CT), [[Psychiatric medication|medications]], or any combination of the three are first-line treatments for OCD. [[Psychodynamic psychotherapy]] may help in managing some aspects of the disorder, but there are no controlled studies that demonstrate effectiveness of [[psychoanalysis]] or dynamic [[psychotherapy]] in OCD. Though there is no known treatment for full [[remission]] of OCD yet, there are a number of successful treatment options available to promote significant improvement.
 
===Interventions===
 
===Surgery===
 
===Primary Prevention===
 
===Secondary Prevention===


==References==
==References==


{{Reflist|2}}
{{Reflist|2}}
[[Category:Psychiatry]]
{{WH}}
{{WH}}


{{WS}}
{{WS}}
[[Category:Psychiatry]]
[[Category:Disease]]

Latest revision as of 07:53, 9 June 2021

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Priyanka Kumari, M.B.B.S[2] Sonya Gelfand

Overview

Obsessive Compulsive disorder is a psychiatric condition characterized by recurrent undesirable thoughts or sensations (obsessions) that cause patients to do something repetitively (compulsions). WHO listed this disorder among one of the top 10 psychiatric disorders that can affect the quality of life.

Historical Perspective

Classification

Obsessive compulsive disorder is classified in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) as an anxiety disorder. According to the American Psychiatric Association there will be change in the classification of OCD and associated conditions into DSM-5 once the the fifth edition of the DSM scheduled for release in May 2013 comes out.

Pathophysiology

Different biological and psychological explanations have been put forward to understand the pathophysiology of obsessive-compulsive disorder. It is generally agreed that neurotransmitters play an important role in the pathophysiology of obsessive–compulsive disorder.

Causes

It is generally agreed that neurotransmitters, biological, psychological, and environmental factors all play a probable role in causing obsessive–compulsive disorder.

Differentiating Obsessive Compulsive Disorder from other Diseases

The differential diagnosis of obsessive-compulsive disorder (OCD) includes tics, mood and anxiety disorders, and other compulsive behaviors, such as trichotillomania or neurodermatitis.

Epidemiology and Demographics

Once believed to be rare, OCD was found to have a lifetime prevalence of 2,300 per 100,000 (2.3%) of the overall population. The twelve month prevalence of OCD is 1,200 per 100,000 (1.2%) of the overall population. Discovery of effective treatments and education of patients and health care providers have significantly increased the identification of individuals with OCD. International studies have shown a similar incidence and prevalence of OCD worldwide.

Risk Factors

Risk factors for obsessive compulsive disorder include genetic predisposition, a variety of genetic factors, environmental factors, and brain structure and function.

Screening

This screening test for obsessive-compulsive disorder is designed as a guide to find out whether one shows symptoms similar to those of obsessive-compulsive disorder (OCD). The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is considered as a gold standard to screen for the symptoms and severity of obsessive compulsive disorder.

Natural History, Complication and Prognosis

The course of obsessive compulsive disorder is difficult to predict, and minimal research has been done on it. However, it is known that stress exacerbates the symptoms of OCD, and if left untreated, OCD often develops into a chronic condition that presents varying complications and results in an overall poor quality of life.

Diagnosis

History and Symptoms

Obsessive-compulsive disorder (OCD) is a psychiatric anxiety disorder most commonly characterized by a subject's obsessive, distressing, intrusive thoughts and related compulsions (tasks or "rituals") which attempt to neutralize the obsessions.

Physical Examination

Although obsessive-compulsive disorder is a mental health problem, certain physical examinations are done to pin point the diagnosis for OCD.

Laboratory Findings

The laboratory tests for obsessive compulsive disorder may include a complete blood count (CBC), screening for alcohol and drugs, and a check of the thyroid function.

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

According to the Expert Consensus Guidelines for the Treatment of obsessive-compulsive disorder, behavioral therapy (BT), cognitive therapy (CT), medications, or any combination of the three are first-line treatments for OCD. Psychodynamic psychotherapy may help in managing some aspects of the disorder, but there are no controlled studies that demonstrate effectiveness of psychoanalysis or dynamic psychotherapy in OCD. Though there is no known treatment for full remission of OCD yet, there are a number of successful treatment options available to promote significant improvement.

Interventions

Surgery

Primary Prevention

Secondary Prevention

References

Template:WH

Template:WS