Obsessive-compulsive disorder (OCD) is a common psychiatric disorder that affects all ages and where a person has an obsession and/or compulsion or both.
Obsessions are recurrent, persistent & unwanted intrusive thoughts, images, or urges/impulses that produce escalating anxiety despite a person’s effort to avoid/exclude them.
Compulsions are repetitive stereotypes behaviors in response to the obsessions that transiently reduce anxiety but time-consuming.
The rates of OCD are fairly consistent, with a lifetime prevalence in the general population estimated at 2% to 3%.
Among adults, men and women are equally likely to be affected, but among adolescents, boys are more commonly affected than girls.
The mean age of onset is about 20 years, although men have a slightly earlier age of onset (mean about 19 years) than women (mean about 22 years).
The presentation of obsessions and compulsions is heterogeneous in adults and in children and adolescents. The symptoms of an individual patient can overlap and change with time.
Four major obsessions- contamination (45%), pathological doubt (42%), intrusive thoughts (sexual, aggression), symmetry (31%). Other obsessions are a religious obsession, obsessive phobia, etc.
Common compulsions are – checking (63%), washing (50%), counting, symmetry or precision, hoarding, need to ask or confess.
OCD is diagnosed by the presence of obsessions, compulsions, or both which is time-consuming (take more than 1 hour per day) and causes clinically significant distress or impairment in personal, family, social or occupational life.
Co-morbidity:
Persons with OCD are commonly affected by other mental disorders. The lifetime prevalence for major depressive disorder in persons with OCD is about 67% and for social phobia, about 25%. Other common comorbid psychiatric diagnoses in patients with OCD include alcohol use disorders, generalized anxiety disorder, specific phobia, panic disorder, eating disorders, and personality disorders.
Etiology
Exact cause is unknown but there are some plausible hypothesis.
- Genetic factors 2) Biological Factors – Neurotransmitters (Serotonin) 3) Immunological factors 4) Psychological factors 5) Behavioral factors
