Treatment For Obsessive Compulsive Disorder - OCD

What is obsessive compulsive disorder (OCD)?

Obsessive compulsive disorder (OCD) is a mental illness in the DSM-IV is categorized as anxiety disorder. The old name of the condition is compulsion. In DSM-5, however, the disorder is classified into a separate chapter on obsessive-compulsive and related disorders.

General

Not all OCD sufferers experience anxiety. Sometimes fear is a consequence, and not so much the cause of a compulsion or obsession. OCD comes in different forms, but the most common feature is an obsessive compulsion to perform certain operations, which are called rituals. The OCD patient performs these acts (compulsions) in response to obsessive thoughts (obsessions). For others, these acts seem superfluous, and they have no eye for the details, but for the patient, these actions are vital and they should be carried out according to a certain pattern to prevent alleged adverse effects. Examples are very often check a door is closed or the excessively frequent washing of hands (not to be confused with the specific fear of contamination or mysofobie). The action or thought can be a result of a strong sense of responsibility, such as the fear of something vulnerable like a child to do something bad to. OCD affects both children, adolescents and adults, and many OCD adults also had in their youth obsessive compulsive disorder symptoms.

Obsessive compulsive disorder causes

Psychiatric diseases are complex and, therefore, is the designation of a specific cause is usually not possible. For a long time in psychiatry psychoanalytic conception dominant that usually causes should be sought in early childhood and particularly caused by (repressed) ambivalent thoughts and feelings, often about sexuality. This view has lost its influence, however sharply in recent decades. Nowadays there is, in general, assume that the interaction of genetic and environmental factors cause the susceptibility to the development of OCD.

• Psychological factors

Had repeated from the standpoint of evolutionary psychology or stereotypical behavior ever a function to protect against intruders, natural disasters, unsanitary conditions and lack of food (hoarding). It is in other words a primitive drive that is still present deep in the human genes.

• Genetic factors

From twin studies show that genetic factors play a role as one half of identical twins has OCD, then the probability that the other half is also greater than in fraternal twins. It is also true that the chance of developing OCD is also greater for persons with a child or parent with OCD, compared with the general population.

• Brain Damage

-In rare cases, brain damage is the cause of OCD.
-Encephalitis
-Streptococcal infection in children
-Various types of brain damage, immediately prior to the occurrence of OCD

• Neurological disorders

There is evidence that neurological abnormalities are the basis for the development of OCD. Patients with OCD were more gray matter and less white matter in their brains compared to normal controls.

More recent research shows that the brain activity of OCD patients is different from that of healthy individuals. Thus exhibit OCD patients in MRI scans increased activity in the prefrontal cortex of the brains and caudate nucleus. The latter is an important area switching motor in the basal ganglia that has many links with the front regions of the brains. There may in OCD patients have a hyper-connectivity (too many interconnections) between the caudate nucleus with those anterior brain regions. There then occurs a disturbance in the communication between the parts in the frontal brains which cognitive processes and rewarding to arrange if the taking of decisions and in the basal ganglia structures involved in the selection of actions.

• Neurotransmitters

Recently, also found evidence from animal and human studies that OCD symptoms associated with dysfunction of neurotransmitter systems. Chief candidates are a) a deficiency or under production of serotonin in the basal ganglia and b) increased levels of dopamine in the prefrontal cortex. In particular, dopamine D2 receptors might play a role. It is probably here two mutually interacting systems. Therefore, would be possible (SSRI) (selective serotonin reuptake inhibitors) are not always effective in the treatment of obsessive compulsive disorder symptoms.

Miscellaneous

Most OCD sufferers are well aware that their behavior is not rational, but they continue to perform their compulsions to avoid being anxious or tense. Other patients see their behavior as exceptional and it also unconvincing. In that case, their OCD related to a personality, and it has another name, namely dwangmatige- or obsessive-compulsive personality disorder (OCPs) and should not be confused with OCD. There is a third group who are not compulsive acts performed. In their case, the disease is confined to obsessions. In the latter group, it happens that will eventually develop rituals (compulsions) to neutralize the obsessions.

Obsessive The term is also used in other contexts, often in order to indicate that someone highly concentrated or perfectionist with his tasks is in progress. In this case there is, of course, not always talk of a disorder. This is only the case if the obsessive or compulsive behavior function normally stands in the way. It is also important to distinguish OCD, and other types of stress or anxiety, including the tension and stress that may occur in daily life.

Diagnostic criteria

The DSM-IV (American Psychological Association, 1994) gives the following criteria for obsessive-compulsive disorder:

• A. The presence of obsessive thoughts (obsessions) or compulsive behaviors (compulsions)

Criteria for obsessions:

1. Returning and cause persistent thoughts, impulses, or images that are experienced as forced or meaningless and anxiety or tension.
2. The thoughts, impulses, or more than an exaggerated concern about problems in daily life.
3. The person tries the thoughts, impulses, or to ignore or suppress, or neutralize them with some other thought or action.
4. The person recognizes that the obsessional thoughts, impulses or images are a product of his or her own mind (not imposed by thought insertion).

Criteria for compulsions:

1. Repeated behavior (eg. Handwashing (hosophobia), ordering, checking) or mental acts (eg., Praying, counting, repeating words lightly) who is carrying in response to an obsession or carried out according to strict rules.
2. The behaviors or mental acts are aimed at preventing or reducing stress or the occurrence of a feared situation. However, these behaviors or mental acts depend unrealistic with the event should be reduced or avoided or are clearly excessive.

• B. At some point during the disease sees the person that the obsessions or compulsions are excessive and unnecessary.
• C. The obsessions or compulsions cause marked stress, cost a lot of time (more than one hour per day) or seriously infringe on daily activities, work (or study) or social activities and relationships.
• D. If another Axis I disorder is found out, the content of the obsessions or compulsions is not restricted thereto (eg. Preoccupation with food at an eating disorder, hair pulling in Trichotillomania, concern with appearance in a body dysmorphic disorder, preoccupation with drugs at an addiction disorder, preoccupation with a serious illness in hypochondria, preoccupation with sexual urges or fantasies in paraphilia or guilt in clinical depression).
• E. The disturbance is not due to the ingestion of a substance (e.g., drugs or medication) or a general medical condition.

OCD / Obsessive compulsive disorder treatment

• Behavioral therapy

OCD is usually treated through some form of behavioral therapy or cognitive behavioral therapy. Sometimes normalizes after treatment with behavioral therapy, mindfulness exercises initially abnormal behavior and abnormal brain activity.
For most patients, is that a combination of behavioral, and the use of certain drugs (predominantly SSRIs) are the most effective. In OCD, there appears to be strong talk of experiential avoidance. Recently it was shown that Acceptance and Commitment Therapy, which focuses, among other these experiential avoidance, is effective for OCD.

• Deep brain stimulation

It has been found that, in the severe and persistent cases, application of deep brain stimulation in an area next to the amygdala may have a beneficial therapeutic effect on the disease. The latter suggests that OCD may be associated with an imbalance of specific circuits in the limbic system of the brains that are involved in regulation of basic emotions. Currently, research is being done into the opportunities offered by stimulation of the amygdala.