about obsessive compulsive disorder

Introduction
Once regarded as a rare psychiatric disorder unresponsive to treatment, obsessive compulsive disorder (OCD) is now recognised to be a common problem affecting some 2 – 3 % of the general population. Based on these figures, it is estimated that there are over 100 million sufferers of OCD worldwide. OCD is now thought to be one of the most frequent disorders in psychiatry. Recent research has shown that patients with OCD respond to a particular group of drugs and this finding has changed the outlook for this disorder. As a result, the emphasis has moved from a psychological cause to brain chemistry. Indeed, OCD can be considered as a common and now treatable disorder.

What is OCD?
At times, most people get a thought stuck in their head or they check a couple of times to make sure they have turned off the stove or locked the door. But if they have OCD, they become so preoccupied with a thought or so compelled to check and recheck that they cannot continue the normal routine of a day. In other words, OCD is a chronic, debilitating medical condition characterised by recurrent, intrusive, unwanted thoughts (obsessions), which cause anxiety and/or irrational, ritualistic, repetitive behaviour, which people feel compelled to perform (compulsions). Symptoms usually involve obsessions about contamination, doubt, or possible harm. The most common compulsions include excessive checking, washing, counting, ordering, arranging or hoarding. Most people with OCD present with multiple obsessive compulsive symptoms. Obsessive compulsive symptoms are usually egodystonic – that is, the person recognises them as senseless or exaggerated, and they are, therefore, ashamed. This awareness often creates a sense of fear that other people will think them ‘mad’ and consequently makes them secretive about their symptoms. This in turn contributes to their reluctance to seek treatment. Even though our understanding and recognition of OCD has improved over the last decade, it can only be recognised if the sufferer discusses fully and openly with his or her doctor their obsessive thoughts and / or compulsions.

Who gets OCD?
OCD affects both males and females of all ages and all ethnic groups, and commonly starts in adolescence or early adulthood. It usually lasts for many years during which time the patient’s symptoms may vary in severity and focus. In the early stages the patient may be able to keep their symptoms under control. However, sometimes the obsessions and/or compulsive rituals become so time consuming that they take over and interfere with the person’s life in a significant and totally debilitating way. In some cases, the person might learn to adapt better to their symptoms, yet they will be significantly bothered by them.

What causes OCD?
Recent studies have demonstrated that people with OCD have different patterns of brain activity from normal individuals and those with other psychiatric disorders. In this way more evidence is added to the theory of a biological cause for OCD. Recent research findings have also shown that patients with OCD respond to a particular group of drugs. The neurotransmitter, serotonin, a naturally occurring compound in the brain involved in the transmission of nerve impulses, is thought to be a key factor in this disorder.

OCD and depression
About 70 to 80 % of people with OCD will develop depression. Many of them will seek treatment for depression or other secondary phenomena of OCD and will not reveal the source of their problems unless they are asked specifically.

OCD and personality
Positive ‘exactness’, which relates to high standards of performance in work or recreation, should not be confused with the obsessive perfectionism of some OCD sufferers. A person with perfectionistic personality traits believes that everyone should conform to his or her high standards while the OCD sufferer realises that his or her obsessions and/or compulsions are senseless and exaggerated and would like to get rid of them.