Obsessive Compulsive Disorder and Related Disorders
What is it?
Obsessive Compulsive Disorder and Related Disorders include obsessive compulsive disorder, body dysmorphic disorder, hoarding disorder, trichotillomania, excoriation, substance/medication-induced obsessive compulsive disorder and related disorder, obsessive compulsive and related disorder due to another medical condition, and other specified obsessive compulsive and related disorder and unspecified obsessive compulsive and related disorder.
It is a prevalent and persistent condition characterised by uncontrollable and recurring thoughts (referred to as “obsessions”) and behaviours (known as “compulsions”) that individuals feel compelled to repeat excessively.
Causes
Researchers don’t know what exactly causes OCD. But they think several factors contribute to its development, including :
- Genetics: Studies show that people who have a first-degree relative (biological parent or sibling) with OCD are at a higher risk for developing the condition. The risk increases if the relative developed OCD as a child or teen.
- Brain changes: Imaging studies have shown differences in the frontal cortex and subcortical structures of the brain in people who have OCD. OCD is also associated with other neurological conditions that affect similar areas of your brain, including Parkinson’s disease, Tourette’s syndrome and epilepsy.
- PANDAS syndrome: PANDAS is short for “paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections.” It describes a group of conditions that can affect children who have had strep infections, such as strep throat or scarlet fever. OCD is one of these conditions.
- Childhood trauma: Some studies show an association between childhood trauma, such as abuse or neglect, and the development of OCD.
Symptoms
Obsessive Compulsive Disorder can be defined as a disorder in which a person has frequent unwanted thoughts (obsessions) that causes the person to perform repetitive behaviours (compulsions). This can significantly interfere with social interactions and performing daily tasks. It can affect anyone, the average age of onset is 19 years. About 50% of people with OCD begin to have symptoms in childhood and adolescence.
Obsessions can be unwanted thoughts or images related to sex, need for order, neatness, symmetry or perfection, need for constant reassurance, fear of making a mistake, fear of coming into contact with perceived contaminated substances, such as germs or dirt, etc. Compulsions are arranging things in a very specific way, bathing, cleaning or washing hands over and over again, saying certain prayers or words, collecting or hoarding items that have no personal or financial value, etc.
Body dysmorphic disorder is characterised by preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear only slight to others, and by repetitive behaviours or mental acts in response to the appearance concerns.
Hoarding disorder is characterised by persistent difficulty discarding or parting with possessions, regardless of their actual value, as a result of strong perceived need to save the items and to distress associated with discarding them.
Trichotillomania (hair-pulling disorder) is characterised by recurrent pulling out of one’s hair resulting in hair loss, and repeated attempts to decrease or stop hair pulling.
Excoriation disorder (skin-picking) is characterised by recurrent picking of one’s skin resulting in skin lesions and repeated attempts to decrease or stop skin picking.
Substance/medication induced obsessive compulsive and related disorder consists of symptoms that are due to substance intoxication or withdrawal or to a medication.
Obsessive compulsive and related disorder due to another medical condition involves symptoms characteristic of obsessive compulsive and related disorders that are the direct pathophysiological consequences of a medical disorder.
Treatment
Medicine and several types of psychotherapy can be helpful in treating the disorder. The most common and effective forms for treating include :
- Cognitive behavioural therapy (CBT) : During CBT, a therapist will help you examine and understand your thoughts and emotions. It aims to help the individual identify and change unhealthy emotions, thoughts and behaviours.
- The individual works with a mental health professional, such as a psychologist. Over several sessions, CBT can help alter harmful thoughts and stop negative habits, perhaps replacing them with healthier ways to cope.
- Exposure and response prevention (ERP) : ERP is a type of CBT. During ERP, a therapist exposes you to your feared situations or images and has you resist the urge to perform a compulsion. For example, your therapist may ask you to touch dirty objects but then stop you from washing your hands.
- By staying in a feared situation without anything negative happening, you learn that your anxious thoughts are just thoughts and not necessarily reality.
- Acceptance and commitment therapy (ACT) : ACT helps you learn to accept obsessive thoughts as just thoughts, taking the power away from them. An ACT therapist will help you learn to live a meaningful life despite your OCD symptoms.
- Mindfulness techniques such as meditation and relaxation can also help with symptoms.
