Anxiety Disorders
Obsessive-Compulsive
Disorder
People
with obsessive-compulsive disorder (OCD) suffer intensely from
recurrent unwanted thoughts (obsessions) or rituals (compulsions),
which they feel they cannot control. Rituals such as handwashing,
counting, checking,
or cleaning are often performed in hope of preventing, obsessive
thoughts or making them go away. Performing these rituals, however,
provides only temporary relief, and not performing them markedly
increases anxiety. Left untreated obsessions and the need to perform
rituals can take over a person's life. OCD is often a chronic,
relapsing illness.
Fortunately, through research supported
by the National Institute of Mental Health (NIMH), effective treatments
have been developed to help people with OCD.
How Common Is OCD?
- About 2.3% of the U.S. population
(3.3 million Americans) experiences OCD in a given year.
- OCD affects men and women equally.
- OCD typically begins during
adolescence or early childhood; at least one-third of the cases of
adult OCD began in childhood.
- OCD cost the U.S. $8.4 billion in
1990 in social and economic losses, nearly 6% of the total mental
health bill of $148 billion.
What Causes OCD?
There is growing evidence that OCD has a
neurobiological basis. OCD is no longer attributed to family problems
or to attitudes learned in childhood - for example, an inordinate
emphasis on cleanliness, or a belief' that certain thoughts are
dangerous or unacceptable. Instead, the search for causes now focuses
on the interaction neurobiological factors and environmental
influences. Brain imaging studies using a technique called positron
emission tomography (PET) have compared
people with and without OCD. Those with OCD have patterns of brain
activity that differ from people with other mental illnesses or people
with no mental illness at all. In addition, PET scans show that in
patients with OCD, both behavioral therapy and medication produce
changes in the caudate nucleus, a part of the brain. This is graphic
evidence that both psychotherapy and medication affect the brain.
What Treatments Are Available for OCD?
Treatments for OCD have been developed
through research supported by the NIMH and other research institutions.
These treatments, which combine medications and behavioral therapy (a
specific type of psychotherapy), are often effective.
Several medications have been proven
effective in helping people with OCD: clomipramine, fluoxetine,
fluvoxamine and paroxetine.
If one drug is not effective, others should be tried. A number of other
medications are currently being studied.
A type of behavioral therapy known as
"exposure and response prevention" is very useful for treating OCD. In
this approach, a person's deliberately and voluntarily exposed to
whatever triggers the obsessive thoughts and then, is taught techniques
to avoid performing, the compulsive rituals and to deal with the
anxiety.
Can People With OCD Also Have Other
Physical or Emotional Illnesses?
OCD is sometimes accompanied by
depression, eating disorders, substance abuse, attention deficit
hyperactivity disorder, or other anxiety disorders. When a person also
has other disorders, OCD is often more difficult to diagnose and treat.
Symptoms of OCD can also coexist and may even be part of a spectrum of
neurological disorders, such as Tourette's syndrome. Appropriate
diagnosis and treatment of other disorders are important to successful
treatment of OCD.
The content of this fact sheet
was adapted from material
published by the
National Institute of Mental Health.
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