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Alternative Names Return to topObsessive-compulsive neurosis; OCD
Definition Return to top
Obsessive-compulsive disorder is an anxiety disorder in which people have thoughts, feelings, ideas, sensations (obsessions), or behaviors that make them feel driven to do something (compulsions). A person may have both obsessions and compulsions.
Causes Return to top
Obsessive-compulsive disorder (OCD) is more common than was once thought. Most people who develop it show symptoms by age 30.
There are several theories about the cause of OCD, but none have been confirmed. Some reports have linked OCD to head injury and infections. Several studies have shown that there are brain abnormalities in patients with OCD, but more research is needed.
About 20% of people with OCD have tics, which suggests the condition may be related to Tourette syndrome. However, this link is not clear.
Symptoms Return to top
An example of obsessive-compulsive disorder is excessive, repeated handwashing to ward off infection.
The person usually recognizes that the behavior is excessive or unreasonable.
Exams and Tests Return to top
Your own description of the behavior can help diagnose the disorder. A physical exam can rule out physical causes, and a psychiatric evaluation can rule out other mental disorders.
Questionnaires, such as the Yale-Brown Obsessive Compulsive Scale, can help diagnose OCD and track the progress of treatment.
Treatment Return to top
OCD is treated using medications and therapy.
The first medication usually considered is a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI). These drugs include:
If an SSRI does not work, the doctor may prescribe an older antidepressant called clomipramine. Clomipramine is the oldest medication for OCD. It works better than SSRI antidepressants in treating the condition, but it has unpleasant side effects, including:
In some cases, an SSRI and clomipramine may be combined. Other medications such as benzodiazepines may offer some relief from anxiety, but they are generally used only with the more reliable treatments.
Psychotherapy is used to:
Behavioral therapies may include:
Outlook (Prognosis) Return to top
OCD is a long-term (chronic) illness with periods of severe symptoms followed by times of improvement. However, a completely symptom-free period is unusual. Most people improve with treatment.
Possible Complications Return to top
Long-term complications of OCD have to do with the type of obsessions or compulsions. For example, constant handwashing can cause skin breakdown. However, OCD does not usually progress into another disease.
When to Contact a Medical Professional Return to top
Call for an appointment with your health care provider if your symptoms interfere with daily life, work, or relationships.
Prevention Return to top
There is no known prevention for this disorder.
References Return to top
Moore DP, Jefferson JW. Handbook of Medical Psychiatry. 2nd ed. St. Louis, Mo: Mosby; 2004:167-170.
Rakel RE, ed. Textbook of Family Practice. 6th ed. Philadelphia, Pa: WB Saunders; 2005:1348-1350.
Koran LM, Hanna GL, Hollander E, Nestadt G, Simpson HB, et al. Practice guideline for the treatment of patients with obsessive-compulsive disorder. Am J Psychiatry. 2007;164:5-53.
Denys D. Pharmacotherapy of obsessive-compulsive disorder and obsessive-compulsive spectrum disorders. Psychiatr Clin North Am. 2006;29:553-584.Update Date: 2/6/2008 Updated by: Christos Ballas, MD, Attending Psychiatrist, Hospital of the University of Pennsylvania, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.