Obsessive-compulsive disorder (OCD) is a mental disorder that significantly affects a person's life. It, like phobias, refers to obsessive-compulsive disorder neuroses. But, if phobias include only obsessions (obsessive thoughts and fears), then OCD also adds compulsions (actions aimed at overcoming fears). A person who does not perform these actions experiences severe anxiety, which sooner or later will force him to follow the compulsions.

The name of the disease comes from the English words "obsessio", meaning obsession with an idea, and "compulsio" - coercion. It is chosen successfully - capaciously and briefly describes the essence of the disease. People suffering from this disorder are considered incapacitated in some countries, losing their jobs. Even without taking this fact into account, patients tend to waste a lot of time because of compulsions. Obsessions can also be expressed by phobias, obsessive thoughts, memories or fantasies, which also significantly worsens the patient's quality of life.

What it is?

Obsessions are obsessive thoughts, memories and fears that repeat over and over again. People with OCD simply cannot control them. They find these thoughts unpleasant and sometimes frightening, but over time they come to realize that these fears are meaningless.

Often obsessions do not come alone, they are followed by varying degrees of fear, doubt, and disgust. In the case of obsessive-compulsive disorder, obsessions devour time and prevent important tasks from being done. This feature is important for the diagnosis of OCD, it is necessary to distinguish between a person with a mental disorder and just an impressionable person. People with OCD experience obsessions regularly and they cause a lot of anxiety.

Compulsions - "rituals" - are another part of OCD. These are constantly repeated actions that the patient uses to neutralize or counteract obsessions. People suffering from obsessive-compulsive disorder understand that this is not a solution to the problem, but lacking a choice, rely on compulsions to get temporary relief. They also include behavior in which the patient tries to avoid places or situations that can cause obsession.

As with obsessions, not all repeated "rituals" are compulsive. For example, routine hygiene activities, religious practices, and learning new skills involve repetition. the same actions but it's part of daily life. People with OCD, on the other hand, have the feeling that something is forcing them to follow "rituals" even though they don't want to. Compulsive actions are entirely aimed at trying to reduce the anxiety caused by obsession.

Fear of infection
Body fluids. Viruses and bacteria. Dirt. Poisoning with household chemicals. Exposure to radiation.	Frequent and unreasonable washing of hands, taking a shower. Frequent thorough house cleaning. Other actions aimed at eliminating sources of infection.
Fear of losing control
Fear of following an impulse and hurting yourself or someone else. Terrible, full of violence pictures in the imagination. Fear of random obscene expressions. Fear of stealing something.	Constant checking whether the patient has harmed anyone, whether he has made any mistakes.
Fear of hurting someone
Fear of responsibility for some terrible incident. Fear of responsibility for an accidental injury to someone.	Checking if something terrible has happened.
Obsessions related to perfectionism
Concerned about precision or parity. The need for knowledge. Fear of losing important information when you throw something away. Doubts about the need for something. Fear of losing something.	Constant multiple checks of the result of their work. Reassessment of things, the definition of their "need".
Religious Obsessions
Fear of blasphemy or, conversely, the need for it. Excessive concern about the moral side of their actions.	Prayers for forgiveness. performance of religious rites.
unwanted sexual obsessions
Fear of homosexuality. Perverted thoughts and fantasies, sometimes with other people. Sexual fantasies involving children or relatives.
Other obsessions and compulsions
Obsessive thoughts about lucky/unlucky numbers, colors, etc. Fear of illness that does not imply infection (cancer).	Avoiding situations that cause compulsions. Constant asking. The process of putting things in order, and the order can be determined by the patient himself.

Causes

There is no consensus on the origin of the disease. Studies point to 2 causes - brain disease and genetic predisposition. In OCD, there are problems with the exchange of synapses between the frontal lobes of the brain and its internal structures. For transmission nerve impulses a neurotransmitter substance called serotonin is used. Studies have shown that communication is restored when medications that affect serotonin levels (serotonin reuptake inhibitors) are combined with cognitive psychotherapy.

Statistical data has shown that OCD is usually inherited, so genes play a role in the development of the disease. No one knows what factors actually trigger the activity of genes associated with OCD. These can be diseases of the body, ordinary life troubles, use psychoactive substances. Among the biological factors, one should also include the infectious theory - the so-called PANDAS syndrome.

Diagnostics

Diagnosis of OCD can only be made by a psychiatrist who has the appropriate education and work experience. He pays attention to 3 things:

• The person has obsessive obsessions.
• There is compulsive behavior, attempts to get rid of obsessions.
• Obsessions and compulsions are time consuming and interfere with daily activities such as work, study, or going out with friends.

Symptoms, in order to be of medical significance, must be repeated at least 50 percent or more of the days for at least two weeks. For an accurate diagnosis, anancaste personality disorder must be ruled out.

Treatment

There are several methods of treatment, the use of which depends on the form and severity of the disease. In milder forms, cognitive-behavioral psychotherapy is sufficient:

• Method of "exposure and prevention of reactions". The doctor analyzes each obsession with the patient, to find out which of the fears are real and which are imposed by the disease. After that, he, sometimes with the help of a person close to the sick person, explains how a healthy individual would act in his situation.
• Mindfulness-based Cognitive Behavioral Therapy. Mindfulness is about accepting an unpleasant experience as a passing process in the mind, instead of identifying it with oneself.
• Psychotherapy of acceptance and commitment. This method invites the person to focus on accepting the unpleasant psychological experience (anxiety) without using compulsive actions to eliminate it.

Despite the successes, some doctors consider psychotherapy ineffective, preferring drug treatment.

• To eliminate anxiety at the beginning of treatment, tranquilizers are used.
• If the disease is adjacent to depression - selective serotonin reuptake inhibitors.
• If there is no depression, drugs of the class of atypical antipsychotics are prescribed.

The use of these drugs is relatively safe for the patient, they have few contraindications and side effects, but they effectively cope with the disease.

In severe forms of the course of the disease, extreme measures are used: biological therapy in the form of atropinocomatous and electroconvulsive therapy. These types of treatment have many contraindications, so doctors try not to use them, and, believe me, their choice is quite reasonable.

The following videos follow on the topic, in which the therapist examines the origins of the problem and helps to find a solution:

Anxiety, to one degree or another, is common to all people, and many of us sometimes perform rituals varying degrees irrationality designed to insure us from trouble - banging on the table with their fist or putting a lucky T-shirt on an important event. But sometimes this mechanism gets out of control, causing a serious mental disorder. Theories and Practices explains what tormented Howard Hughes, how an obsession differs from schizophrenic delusions, and what magical thinking has to do with it.

Endless Ritual

The hero of Jack Nicholson in the famous film "It doesn't get better" was distinguished not only by a complex character, but also by a whole set of oddities: he constantly washed his hands (and every time with new soap), ate only with his cutlery, avoided other people's touches and tried not to step on cracks on asphalt. All these "eccentricities" - typical signs obsessive-compulsive disorder, a mental illness in which a person is obsessed with obsessive thoughts that cause him to repeat the same actions regularly. OCD is a real find for a screenwriter: this disease is more common in people with high intelligence, it gives the character originality, noticeably interferes with his communication with others, but at the same time is not associated with a threat to society, unlike many other mental disorders. But in reality, the life of a person with obsessive-compulsive disorder cannot be called easy: constant tension and fear are hidden behind innocent and even funny, at first glance, actions.

In the head of such a person, it’s as if a record is stuck: the same unpleasant thoughts regularly come to his mind, which have little rational basis. For example, he imagines that dangerous microbes are everywhere, he is constantly afraid of hurting someone, losing some thing, or leaving the gas on when leaving home. A leaky faucet or an asymmetrical arrangement of objects on a table can drive him crazy.

The flip side of this obsession, that is, obsession, is compulsion, the regular repetition of the same rituals, which should prevent impending danger. A person begins to believe that the day will go well only if, before leaving the house, he reads a children's rhyme three times, that he will protect himself from terrible diseases if he wash his hands several times in a row and use his own cutlery. After the patient performs the ritual, he experiences relief for a while. 75% of patients suffer from both obsessions and compulsions at the same time, but there are cases when people experience only obsessions without performing rituals.

At the same time, obsessive thoughts differ from schizophrenic delusions in that the patient himself perceives them as absurd and illogical. He is not at all happy to wash his hands every half an hour and zip up his fly five times in the morning - but he simply cannot get rid of the obsession in another way. The level of anxiety is too high, and rituals allow the patient to achieve temporary relief from the condition. But at the same time, in itself, the love of rituals, lists or putting things on the shelves, if it does not bring discomfort to a person, does not belong to the disorder. From this point of view, the aesthetes who diligently arrange carrot peels lengthwise in Things Organized Neatly are absolutely healthy.

Obsessions of an aggressive or sexual nature cause the most problems in OCD patients. Some become afraid that they will do something bad to other people, up to sexual abuse and murder. Obsessive thoughts can take the form of individual words, phrases, or even lines of poetry - a good illustration can be an episode from the movie The Shining, where the protagonist, going crazy, starts typing the same phrase “all work and no play makes Jack a dull boy." A person with OCD experiences tremendous stress - he is simultaneously horrified by his thoughts and tormented by guilt for them, tries to resist them, and at the same time tries to make the rituals he performs go unnoticed by others. In all other respects, however, his consciousness functions perfectly normally.

There is an opinion that obsessions and compulsions are closely related to "magical thinking", which arose at the dawn of mankind - a belief in the ability to take control of the world with the help of the right mood and rituals. Magical thinking draws a direct parallel between a mental desire and a real consequence: if you draw a buffalo on the wall of a cave, tuning in to a successful hunt, you will certainly be lucky. Apparently, this way of perceiving the world is born in the deep mechanisms of human thinking: neither scientific and technical progress, neither logical arguments, nor sad personal experience proving the uselessness of magical passes, do not relieve us of the need to look for a relationship between random things. Some scientists believe that it is embedded in our neuropsychology - the automatic search for patterns that simplify the picture of the world helped our ancestors survive, and the most ancient parts of the brain still work according to this principle, especially in stressful situation. Therefore, with an increased level of anxiety, many people begin to be afraid of their own thoughts, fearing that they can become reality, and at the same time believe that a set of some irrational actions will help prevent an undesirable event.

Story

In ancient times, this disorder was often associated with mystical causes: in the Middle Ages, people obsessed with obsessions were immediately sent to exorcists, and in the 17th century the concept was reversed - it was believed that such states arise due to excessive religious zeal.

In 1877, one of the founders of scientific psychiatry, Wilhelm Griesinger, and his student Karl-Friedrich-Otto Westphal found that the basis of "compulsive disorder" is a thought disorder, but it does not affect other aspects of behavior. They used the German term Zwangsvorstellung, which, being variously translated in Britain and the United States (as obsession and compulsion respectively), became modern name illness. And in 1905, the French psychiatrist and neurologist Pierre Maria Felix Janet singled out this neurosis from neurasthenia as a separate disease and called it psychasthenia.

Opinions differed about the cause of the disorder - for example, Freud believed that obsessive-compulsive behavior refers to unconscious conflicts that manifest themselves in the form of symptoms, and his German colleague Emil Kraepelin attributed it to "constitutional mental illness" caused by physical causes.

Famous people also suffered from obsessional disorder - for example, the inventor Nikola Tesla counted steps while walking and the volume of food portions - if he could not do this, the dinner was considered spoiled. And entrepreneur and American aviation pioneer Howard Hughes was terrified of dust and ordered employees to "wash themselves four times, each time using a large amount of lather from a new bar of soap," before visiting him.

Defense mechanism

The exact causes of OCD are not clear even now, but all hypotheses can be divided into three categories: physiological, psychological and genetic. Supporters of the first concept associate the disease either with the functional and anatomical features of the brain, or with metabolic disorders (biologically active substances that transmit electrical impulses between neurons, or from neurons to muscle tissue) - first of all, serotonin and dopamine, as well as norepinephrine and GABA. Some researchers noted that many patients with obsessive-compulsive disorder had birth trauma at birth, which also confirms the physiological causes of OCD.

Supporters psychological theories believe that the disease is associated with personal characteristics, temperament, psychological trauma and improper response to the negative impact of the environment. Sigmund Freud suggested that the occurrence of obsessive-compulsive symptoms is associated with defense mechanisms psyche: isolation, liquidation and reactive formation. Isolation protects a person from anxiety-causing affects and impulses, forcing them into the subconscious, liquidation is aimed at combating repressed impulses that pop up - on which, in fact, the compulsive act is based. And, finally, reactive formation is a manifestation of patterns of behavior and consciously experienced attitudes that are opposite to emerging impulses.

There is also scientific evidence that genetic mutations contribute to OCD. They were found in unrelated families whose members suffered from OCD - in the serotonin transporter gene, hSERT. Studies of identical twins also confirm the existence of a hereditary factor. In addition, people with OCD are more likely to have close relatives with the same disorder than healthy people.

Maxim, 21 years old, suffering from OCD since childhood

It started for me around 7 or 8 years old. The neurologist was the first to report the likelihood of OCD, even then there was a suspicion of obsessive neurosis. I was constantly silent, scrolling through various theories in my head like "mental chewing gum." When I saw something that caused me anxiety, obsessive thoughts about it began, although the reasons were very insignificant in appearance and, perhaps, would never have touched me.

At one time there was an obsessive thought that my mother might die. I turned over the same moment in my head, and it captured me so much that I could not sleep at night. And when I ride in a minibus or in a car, I constantly think about the fact that now we will have an accident, that someone will crash into us or we will fly away from the bridge. A couple of times the thought arose that the balcony under me would fall apart, or someone would throw me out of there, or I myself would slip in the winter and fall.

We never really talked to the doctor, I just took different medications. Now I'm moving from one obsession to another and follow some rituals. I constantly touch something, no matter where I am. I walk from corner to corner throughout the room, adjusting the curtains, wallpaper. Maybe I am different from other people with this disorder, everyone has their own rituals. But it seems to me that those people who accept themselves as they are are more lucky. They are much better than those who want to get rid of it and are very worried about it.

Obsessive-compulsive disorder, also abbreviated (OCD), refers to complexes of symptoms that are combined into a group and are derived from the combined Latin terminology obsessio and compulsio.

Obsession itself, translated from Latin, means siege, imposition, blockade, and compulsions, translated from Latin, means I force.

For obsessive drives, varieties of obsessive phenomena (obsessions) are characterized by unbearable and very irresistible drives that arise in the head in defiance of reason, will and feelings. Very often they are accepted by the patient as unacceptable and act contradictory in relation to his moral and ethical principles and never, compared with impulsive drives, compulsions are realized. All these inclinations are recognized by the patients themselves as wrong and are very hard for them to experience. The very emergence of these drives, by the nature of its incomprehensibility, very often contributes to the emergence of a feeling of fear in the patient.

The very term compulsions is often used to refer to obsessions in the realm of movement, as well as obsessive rituals.

If we turn to domestic psychiatry, we will find that under obsessive states psychopathological phenomena are understood, which are characterized by the appearance in the mind of the patient of phenomena of a certain content, accompanied by a painful feeling of coercion. Obsessive states are characterized by the emergence of involuntary, against the will itself, obsessive desires with a clear awareness. But these obsessions are alien in themselves, superfluous in the psyche of the patient, but the patient himself cannot get rid of them. Seen in the patient close connection with emotionality, as well as depressive reactions and a feeling of unbearable anxiety. When the above symptoms occur, it is found that they do not affect the intellectual activity and in general, are alien to his thinking, and also do not lower his level, but worsen the efficiency and productivity of mental activity itself. For the entire period of illness, a critical attitude is maintained towards the ideas of obsession. Obsessive states are preliminarily subdivided into intellectual-affective obsessions (phobias), as well as motor obsessions (compulsions). In most cases, several types of obsessions are combined in the very structure of the disease of obsessions. The allocation of obsessions that are abstract, or indifferent in their content (affectively indifferent), for example, arrhythmomania, is often unjustified. When analyzing the psychogenesis of neurosis, it is realistic to see at the basis

Obsessive Compulsive Disorder - Causes

The causes of obsessive-compulsive disorder are genetic factors psychasthenic personality, as well as family problems.

With elementary obsessions, in parallel with psychogeny, there are cryptogenic causes, in which the very cause of the occurrence of experiences is hidden. Obsessive states are observed mainly in people with a psychasthenic character, and fears of an obsessive nature are especially important here, as well as these n.s. occur in a period of neurosis-like states at the moment sluggish schizophrenia, epilepsy, after traumatic brain injury and somatic diseases, with hypochondriacal-phobic or nosophobic syndrome. Some researchers believe that mental trauma plays an important role in the clinical picture of the genesis of obsessive-compulsive disorder, as well as conditioned reflex stimuli that have become pathogenic due to their coincidence with other stimuli that previously caused a feeling of fear. Situations that have become psychogenic due to the confrontation of opposing tendencies play an important role as well. But it should be noted that these same experts note that obsessive states occur in the presence of various character traits, but still more often in psychasthenic personalities.

To date, all these obsessive states have been described and included in International Classification Diseases under the names of "obsessive-compulsive disorder."

OCD is very common with a high percentage of morbidity and needs urgent involvement of psychiatrists in the problem. Currently, the understanding of the etiology of the disease has expanded. And it is very important that the treatment of obsessive-compulsive disorder is directed towards serotonergic neurotransmission. This discovery made it possible in the prospects to be cured by millions around the world who fell ill with obsessive-compulsive disorder. How to replenish the body with Serotonin? Tryptophan, an amino acid that is found in the only source - food, will help with this. And already in the body Tryptophan is converted into Serotonin. With this transformation, mental relaxation occurs, as well as a feeling of emotional well-being. Further, Serotonin acts as a precursor to melatonin, which regulates the biological clock.

This discovery of intense serotonin reuptake inhibition (SSRI) holds the key to the most effective treatment for obsessive-compulsive disorder and was the very first stage of a revolution in clinical research that showed the effectiveness of such selective inhibitors.

Obsessive Compulsive Disorder - History

The obsessive-compulsive disorder clinic has attracted the attention of researchers since the 17th century.

They were first talked about in 1617, and in 1621 E. Barton described an obsessive fear of death. Studies in the field of obsession are described by F. Pinel (1829), and I. Balinsky introduced the term "obsessive ideas", which entered the Russian psychiatric literature. Since 1871, Westphal has introduced the term "agoraphobia", which refers to the fear of being in public places.

In 1875, M. Legrand de Sol, analyzing the features of the dynamics of the course of obsessive-compulsive disorder in the forms of insanity of doubt, along with the delusion of touch, found out that the gradually becoming more complex clinical picture, in which obsessive doubts are replaced by fear of touching objects in the environment, and also join motor rituals to which the life of the sick is subject

Obsessive Compulsive Disorder in Children

But only in the XIX-XX centuries. the researchers were able to more clearly characterize the clinical picture and give an explanation of the syndromes of obsessive-compulsive disorders. Obsessive-compulsive disorder itself in children often falls on adolescence or adolescence. The maximum of clinically identified manifestations of OCD itself stands out in the interval of 10-25 years.

Obsessive Compulsive Disorder - Symptoms

The main features of obsessive-compulsive disorder are repetitive and very intrusive thoughts (obsessive) and compulsive actions (rituals).

Simply put, the core in OCD is the obsession syndrome, which is a combination of thoughts, feelings, fears, memories in the clinical picture, and all this occurs in addition to the desire of the patients, but still with the awareness of all the pain and a very critical attitude. When understanding the unnaturalness and all the illogicality of obsessive states, as well as ideas, patients are very powerless in trying to overcome them on their own. All obsessive urges, as well as ideas, are accepted as alien to the person and as if coming from within. In patients, compulsive actions are the performance of rituals that act as anxiety relief (this may be hand washing, wearing a gauze bandage, frequent change of clothes in order to prevent infection). All attempts to drive away uninvited thoughts, as well as urges, lead to severe internal struggle accompanied by intense anxiety. These obsessive states are included in the group of neurotic disorders.

The prevalence among the population of OCD is very high. Those suffering from obsessive-compulsive disorder make up 1% of patients who are treated in psychiatric hospitals. It is believed that men, like women, get sick to the same extent.

Obsessive-compulsive disorder is characterized by the appearance of thoughts of an obsessive painful nature for independent reasons, but given out to patients as their personal beliefs, ideas, images. These thoughts forcibly penetrate into the consciousness of the patient in a stereotyped form, but at the same time he tries to resist them.

This combination of an internal feeling of compulsive belief, as well as efforts to resist it, indicates the presence of obsessive symptoms. Thoughts of an obsessive nature can also take the form of individual words, lines of poetry, and phrases. For the sufferer himself, they can be indecent, shocking, and also blasphemous.

The obsessional images themselves are very vividly presented scenes, often of a violent nature, as well as disgusting (sexual perversions).

obsessive impulses include urges to act that are usually destructive or dangerous, and that may also bring disgrace. For example, shout out obscene words in society, and also jump out abruptly in front of a moving car.

Obsessional rituals include repetitive activities such as counting, repetition certain words, the repetition of often meaningless acts, such as washing hands up to twenty times, but some may develop obsessive thoughts about the impending infection. Some of the rituals of the sick include constant ordering in the laying out of clothes, taking into account complex system. One part of the patients experiences an irresistible and wild impulse to carry out actions a certain number of times, and if this does not happen, then the sick are forced to repeat everything from the beginning. The patients themselves recognize the illogicality of their rituals and deliberately try to hide this fact. Sufferers experience and consider their symptoms as a sign of incipient madness. All these obsessive thoughts, as well as rituals, contribute to the appearance of problems in everyday life.

obsessive thoughts or simply mental chewing gum, akin to an internal debate in which all the arguments for and against are constantly being revised, including the very simple daily activities. Some obsessive doubts refer to actions that could allegedly be incorrectly performed and also not completed, for example (turning off the gas stove faucet, as well as locking the door); and others refer to actions that could possibly harm other individuals (presumably driving past a cyclist in a car to knock him down.) Very often, doubts are caused by religious prescriptions and rituals, namely remorse.

As for compulsive actions, they are characterized by often repeated stereotyped actions that have acquired the character of protective rituals.

Along with this, obsessive-compulsive disorders distinguish a number of clear symptom complexes, including contrasting obsessions, obsessive doubts, and phobias (obsessive fears).

obsessive thoughts compulsive rituals themselves, as well as compulsive rituals, can intensify in some situations, namely, the nature of obsessive thoughts about harming other people is very often intensified in the kitchen or anywhere else where there are piercing objects. Patients themselves often try to avoid such situations and there may be similarities with an anxiety-phobic disorder. Anxiety itself is significant component with obsessive-compulsive disorder. Some rituals weaken anxiety, and after other rituals it increases.

Obsessions tend to intensify within depression. In some patients, the symptoms resemble a psychologically understandable reaction to obsessive-compulsive symptoms, while others experience recurring episodes of depressive disorders that occur for independent reasons.

obsessive states (obsessions) are divided into sensual or figurative, which are characterized by the development of a painful affect, as well as obsessive states of affectively neutral content.

Obsessive states of the sensual plane include an obsessive feeling of antipathy, actions, doubts, obsessive memories, ideas, desires, fears about habitual actions.

Under obsessive doubts falls uncertainty that has arisen in spite of sound logic, as well as reason. The patient begins to doubt the correctness of the decisions made, as well as the committed and committed actions. The very content of these doubts is different: fears about a locked door, closed taps, closed windows, electricity off, gas off; office doubts about a correctly written document, addresses on business papers whether the numbers are accurate. And despite repeated verification of the perfect action, obsessive doubts do not disappear, but only cause psychological discomfort.

Obsessive memories are stubborn and irresistible sad memories unpleasant, as well as shameful events, which are accompanied by a sense of remorse and shame. These memories prevail in the mind of the patient, and this despite the fact that the patient is trying to distract from them in any way.

obsessive attraction pushed to carry out a tough or very dangerous action. At the same time, the patient experiences a feeling of fear, horror and confusion about the impossibility of getting rid of it. The sick person has a wild desire to throw themselves under the train, as well as push under the train loved one or kill cruel way wife and also a child. At the same time, sick people are very tormented and worried about the implementation of these actions.

Obsessions also appear in various options. In some cases, a vivid vision of the results of the obsessive drives themselves is possible. At this moment, patients vividly present a vision of a cruel act they have committed. In other cases, these obsessive ideas appear as something implausible, even as absurd situations, but the sick people take them for real. For example, the belief and conviction of a sick person that a buried relative was buried while still alive. At the peak of obsessive ideas, the awareness of their absurdity, as well as the improbability itself, disappears and an acute confidence in their reality prevails.

An obsessive feeling of antipathy, this also includes obsessive blasphemous thoughts, as well as antipathy towards loved ones, unworthy thoughts towards respected people, towards saints, as well as ministers of the church.

Obsessive actions are characterized by actions that are committed against the wishes of the sick and despite all the restraining efforts made for them. Some of the obsessive actions are burdensome for the patient himself and this continues until they are realized.

And other obsessions pass by the patient himself. Obsessive actions are most painful when others pay attention to them.

obsessive fear or phobias include fear big streets, fear of heights, confined or open spaces, fear of large crowds, fear of being stepped on sudden death, as well as the fear of getting sick with an incurable disease. And some patients develop phobias with fear of everything (panphobia). And finally, there may be an obsessive fear (phobophobia).

Nosophobia or hypochondriacal phobias are associated with an obsessive fear of any serious illness. Stroke-, cardio-, AIDS-, syphilo-, phobia of malignant tumors are very often noticed. At the very peak of anxiety, patients often lose their critical attitude towards their health and often resort to doctors for examination, as well as treatment of non-existent diseases.

Specific or isolated phobias include obsessive fears caused by a specific situation (fear of heights, thunderstorms, nausea, pets, treatment at the dentist, etc.). For patients experiencing fear, avoidance of these situations is characteristic.

Obsessive fears are often supported by the development of rituals - actions that are involved in magic spells. Rituals are performed because of protection from imaginary misfortune. Rituals may include snapping fingers, repeating certain phrases, singing a melody, and so on. In such cases, the relatives themselves are not at all aware of the existence of such disorders in relatives.

Obsessions bearing an affectively neutral character include obsessive sophistication, as well as obsessive counting or recalling neutral events, formulations, terms, and so on. These obsessions burden the patient and interfere with his intellectual activity.

Contrasting obsessions or aggressive obsessions include blasphemous as well as blasphemous thoughts, obsessions are filled with fear of fear of harm not only to themselves, but also to others.

Patients with contrasting obsessions are disturbed by irresistible desires to shout out cynical words that are contrary to morality, they are able to commit dangerous, as well as ridiculous actions in the form of injuring themselves and their loved ones. Often, obsessions go in combination with object phobias. For example, fear of sharp objects (knives, forks, axes, etc.). This group of contrasting obsessions includes sexual obsessions (the desire for perverted sexual acts with children, animals).

Mysophobia- obsessions of pollution (fear of pollution by earth, urine, dust, feces), small objects (glass fragments, needles, specific types of dust, microorganisms); fear of harmful substances entering the body, as well as toxic substances(fertilizers, cement, toxic waste).

In many cases, the fear of pollution itself can be limited, manifesting itself only, for example, in personal hygiene (very frequent change of linen, repeated washing of hands) or household issues (food handling, frequent washing gender, no pets). Of course, such monophobias do not affect the quality of life, they are perceived by others as personal habits of cleanliness. Clinically recurring variants of these phobias are classified as severe obsessions. They consist in cleaning things, as well as in certain sequence the use of detergents and towels to maintain sterility in the bathroom. Outside the apartment, the sick person initiates protective measures. Appears on the street only in special and maximum covered clothes. In the later stages of the disease, the patients themselves avoid pollution, moreover, they are afraid of going out into the street and do not leave their own apartments.

One of the places in the series of obsessions was occupied by compulsions, as isolated, monosymptomatic movement disorders. In childhood, they include tics. People with tics are able to shake their heads, as if checking if my hat fits well, make hand movements, as if discarding interfering hair, and constantly blink their eyes. Along with obsessive tics, there are actions such as biting lips, spitting, etc.

Obsessive Compulsive Disorder - Treatment

As noted earlier, cases complete recovery are observed relatively rarely, but stabilization of the condition is possible, as well as mitigation of symptoms. Mild forms of obsessive-compulsive disorder are treated favorably on an outpatient basis, and the reverse development of the disease occurs no earlier than 1 year after treatment.

And more severe forms of obsessive-compulsive disorder (phobias of contamination, sharp objects, pollution, contrasting performances, or multiple rituals) become more resistant to treatment.

Obsessive-compulsive disorder is very difficult to distinguish from schizophrenia, as well as Tourette's syndrome.

As well as schizophrenia interfere with the diagnosis of obsessive-compulsive disorder, so to exclude these diseases, you need to contact a psychiatrist.

For effective treatment of obsessive-compulsive disorder, stressful events must be removed, and pharmacological intervention should be directed to serotonergic neurotransmission. Unfortunately, science is powerless to cure this mental illness forever, but many experts use the method to stop thoughts.

Drug therapy is a reliable treatment for OCD. Self-medication should be refrained from, and a visit to a psychiatrist should not be postponed.

Obsessives often involve family members in their rituals. In this situation, relatives should treat the sick person firmly, but also sympathetically, if possible, softening the symptoms.

Drug therapy in the treatment of obsessive-compulsive disorder includes serotonergic antidepressants, anxiolytics, small antipsychotics, MAO inhibitors beta-blockers to stop autonomic manifestations, and triazole benzodiazepines. But the main ones in the treatment regimen for obsessive-compulsive disorder are atypical antipsychotics - quetiapine, risperidone, olanzapine in combination with SSRI antidepressants or antidepressants such as moclobemide, tianeptine, as well as benzodiazepine derivatives (these are alprazolam, bromazepam, clonazepam).

One of the main tasks in the treatment of obsessive-compulsive disorder is the establishment of cooperation with the patient. It is important to inspire the patient to believe in recovery and overcome prejudices against the harm of psychotropic drugs. Required support from relatives in the likelihood of healing the patient

Obsessive Compulsive Disorder - Rehab

Social rehabilitation includes the establishment of intra-family relations, learning how to properly interact with other people, professional education and learning skills for everyday life. Psychotherapy is aimed at gaining faith in one's own strength, self-love, mastering ways to solve everyday problems.

Often, obsessive-compulsive disorder is prone to relapse, and this, in turn, requires longitudinal prophylactic medication.

Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by obsessive-compulsive behaviors associated with symptoms such as anxiety, apprehension, fear or anxiety (obsessive thoughts), pathological cyclical actions aimed at reducing comorbid anxiety (compulsive compulsions), or a combination of obsessive thoughts and compulsive urges. Symptoms of the disorder include: excessive washing and cleaning of various objects, repetitive checking, excessive hoarding, preoccupation with sexuality, violent and religious thoughts related to relationships, obsessions related to relationships, dislike of particular numbers, and nervous reactions such as opening and closing. doors a certain number of times before entering or leaving the room. These symptoms are time consuming, can lead to loss of relationships with others, and often cause emotional and financial distress. The actions of those suffering from OCD are paranoid and potentially psychotic. However, people with OCD in general may be aware of their obsessive thoughts and compulsive urges as irrational and suffer from their implementation later on. Despite irrational behavior, OCD is often seen in patients with mental faculties above average. Many physiological and biological factors may be involved in obsessive-compulsive disorder. Standardized rating scales such as the Yale-Brown Obsessive-Compulsive Scale can be used to assess the severity of symptoms. Other disorders with similar symptoms include: obsessive-compulsive personality disorder, autism spectrum disorder, or disorders in which perseveration (hyperfocus) is a feature of ADHD, PTSD, physical disorders, or just a problematic habit. Treatment for OCD includes the use behavioral therapy and, in some cases, selective serotonin reuptake inhibitors (SSRIs). The type of behavioral therapy used involves increasing the exposure to the factor that is causing the problem until compulsive behavior is observed. Atypical antipsychotics such as quetiapine may be useful when used in addition to SSRIs in treatment-resistant cases, but their use is associated with an increased risk of side effects. Obsessive-compulsive disorder affects children and adolescents, as well as adults. Approximately one-third to one-half of adults with OCD report the onset of the disorder in childhood, suggesting the duration of anxiety disorders throughout life. The term "obsessive-compulsive" comes from the English lexicon and is often used in an informal or caricatured manner to describe someone who is overly pedantic, perfectionist, brooding, or fixated.

Signs and symptoms

obsessive thoughts

Intrusive thoughts are thoughts that repeatedly arise and persist despite efforts to ignore or resist them. People with OCD often perform actions or compulsive urges in an attempt to alleviate the anxiety associated with the compulsive thoughts. Within and among subjects, initial intrusive thoughts, or compulsive thinking, vary in intelligibility and realism. A relatively vague obsession may include general feeling confusion or tension, accompanied by the belief that life cannot continue normally as long as the imbalance persists. A more pronounced obsession is the thought or imagining that someone close is dying, or the imposition associated with "the right relationship." Other obsessions concern the possibility that someone or something other than oneself—such as God, the Devil, or disease—could harm either the person with OCD or the people or things that person cares about. Other subjects with OCD may report feeling invisible rashes on their body, or have the sensation that inanimate objects have come to life. Some people with OCD exhibit obsessions of a sexual nature, which may include obsessive thoughts or images of "kissing, touching, caressing, oral sex, anal sex, intercourse, incest, and rape" with "strangers, acquaintances, parents, children, family members, friends, colleagues, animals, and religious figures" and may also include "heterosexual or homosexual content" with subjects of any age. As with other intrusive, unpleasant thoughts or perceptions, most normal people» people have disturbing thoughts of a sexual nature from time to time, but people with OCD may attach undue importance to thoughts. For example, obsessive fears about sexual orientation can be observed not only in relation to the people with OCD, but also in relation to the people around them, as a crisis of sexual self-determination. Moreover, the doubts that accompany OCD lead to uncertainty about whether unpleasant thoughts can be influenced by causing self-criticism or self-hatred. People with OCD realize that their beliefs do not match reality; however, they feel they must act as if their beliefs are correct. For example, a subject who is prone to pathological hoarding may tend to treat inorganic objects as if they had spiritual life or the rights of living organisms, while at the same time being aware that such behavior is irrational, on a more intellectual level.

primary obsessive state

OCD in some cases manifests itself without pronounced compulsive impulses. Nicknamed "Simple-O" or referred to as Primary Compulsive OCD, OCD without overt compulsive urges can, by one calculation, account for approximately 50 to 60 percent of OCD cases. Primary obsessive OCD has been called one of the most depressing and intractable forms of OCD. People with this form of OCD suffer from depressing and unwanted thoughts that occur frequently, and these thoughts are usually based on the fear that someone might do something that is generally out of character for them, potentially fatal to them or others. The thoughts are likely to be aggressive or sexual in nature. Instead of producing observable compulsive urges, a subject with this subtype may perform more secret, mental actions, or can work out a way to avoid situations that in specific thoughts can be imposed. As a result of this avoidance, people may have difficulty fulfilling social or individual roles, even if they are high in those roles and even if they have performed well in the past. Moreover, avoidance can be misleading to others who are unaware of its origin or intended purpose, as was the case for a man whose wife began to wonder why he did not want to hold their newborn child. Hidden mental rituals can take most subject's time throughout the day.

Compulsive urges

Some people with OCD perform compulsive acts because they inexplicably feel the need to do so, others act compulsively to alleviate anxiety that stems from specific obsessive thoughts. The subject may feel that these actions can to some extent prevent the frightening event or push the event out of his thoughts. In any case, the subject's reasoning is so specific or distorted that it causes significant distress to the subject with OCD and those around them. Excessive skin trauma (ie dermatillomania) or hair pulling (ie trichotillomania) and nail biting (ie onychophagia) are on the obsessive-compulsive spectrum. Subjects with OCD are aware that their thoughts and behaviors are not rational, but they feel that giving in to these thoughts can prevent feelings of panic or fear. Some common compulsive urges include counting certain things (such as steps) in specific ways(for example, in two), as well as performing other repetitive actions, often with an atypical susceptibility to numbers or patterns. People may repeatedly wash their hands or gargle, make sure certain objects are in a straight line, repeatedly check that they have locked a parked car, constantly arrange things in a certain way, turn lights on and off, keep doors closed all the time, touch an object a certain number of times before leaving the room, go the usual way, stepping only on tiles of a certain color, start a certain order in using the stairs, for example, to end the stairs on a certain foot. The compulsive urges of OCD are characterized by tics; movements, as in other movement disorders such as chorea, dystonia, myoclonus; movements seen in stereotypical movement disorder or in some people with autism; movements of convulsive activity. There may be a significant degree of comorbidity between OCD and tic-related disorders. People define compulsive urges as a way to avoid intrusive thoughts; however, they are aware that this avoidance is temporary and that the obsessive thoughts will soon return. Some people use compulsive behaviors to avoid situations that may encourage obsessions. While many people do certain things over and over again, they don't always do things compulsively. For example, getting ready for bed, learning a new skill, religious practices are not compulsive urges. Whether or not a behavior is a compulsive urge or just a habit depends on the context in which the behavior is observed. For example, organizing and arranging DVDs for eight hours a day might be expected from someone who works in a video store, but would look abnormal in other situations. In other words, habits make one's life efficient, while compulsions disrupt it. In addition to the anxiety and fear that typically accompanies OCD, those with the disorder may spend hours performing compulsive activities each day. In such situations, it becomes difficult for the subject to carry out his work and keep family or public roles. In some cases, this behavior can cause secondary physical symptoms. For example, people who compulsively wash their hands with antibacterial soap and hot water may experience reddening of the skin that becomes rough as a result of dermatitis. People with OCD can give rationale for their behavior; however, these logical explanations do not correspond to generally accepted behavior, but are individual for each case. For example, a person who compulsively checks the front door may argue that the time and stress of one extra check of the front door is much less than the time and stress associated with a robbery, and thus checking is the best remedy. In practice, after such a check, a person is still not sure and believes that it is still better to check again, and this explanation can continue indefinitely.

Dominant Ideas

Some OCD sufferers display thoughts known as dominant ideas. In such cases, the person with OCD is genuinely unsure whether the fears that drive them to perform compulsive acts are rational or not. After some argument, it is possible to convince the subject that his fears may be unfounded. It may be more difficult to apply ERP therapy to such patients because they may not be willing to interact, at least at first. There are severe cases in which the sufferer has unshakable confidence in the context of OCD that is difficult to distinguish from psychosis.

Cognitive performance

A 2013 meta-analysis confirmed that OCD patients have mild but widespread cognitive deficits; it relates largely to spatial memory, to a lesser extent to verbal memory, verbal fluency, executive functioning, and processing speed, while auditory attention was not significantly affected. Spatial memory was assessed using the Corsi Block Test, Rey-Osterit's Composite Figure Test of Retrieval from Memory, and the Spatial Short-Term Memory Test among the errors found. Verbal memory was assessed by the Verbal Learning Test of Delayed Memory Reproduction and the Logical Memory Test II. Speech fluency was assessed with a category and letter recognition speed test. Auditory attention was assessed by a number memorization test. The speed of information processing was assessed by Form A of the "leaving traces" test. In fact, people with OCD show impairments in formulating an organizational strategy for information coding, attention shifting, and motor and cognitive inhibition.

Related states

People with OCD may be diagnosed with other conditions alongside or in place of OCD, such as the aforementioned obsessive compulsive personality disorder, clinical depression, bipolar disorder, general anxiety disorder, anorexia nervosa, social phobia, bulimia nervosa, Tourette syndrome, Asperger's Syndrome, Attention Deficit Hyperactivity Disorder, Dermatillomania (compulsive skin injury), Body Dysmorphic Disorder and Trichotillomania (hair pulling). In 2009, it was reported that depression among OCD sufferers is partly a warning, as the risk of suicide is high; more than 50 percent of patients show suicidal tendencies, and 15 percent attempt suicide. Subjects with OCD also experience night owl syndrome to a significantly greater extent than the general population. Moreover, severe OCD symptoms are necessarily accompanied by more restless sleep. A decrease in total sleep time and its effectiveness is observed in patients with OCD, with a delay in the onset and end of sleep, as well as an increase in the prevalence of night owl syndrome. In terms of behavior, some research shows a link between drug addiction and the disorder in equal measure. For example, there is an increased risk of drug addiction among people with an anxiety disorder (perhaps as a way of coping increased level anxiety), but drug addiction among OCD patients may act as a type of compulsive behavior rather than as a coping mechanism for anxiety. Depression is also common among OCD sufferers. One of the explanations increased risk depression among OCD sufferers was made by Meineck, Watson and Clark (1998), who explained that people with OCD (or any other anxiety disorders) can be suppressed due to uncontrolled perception. Some subjects who show signs of OCD do not necessarily have OCD. Behavior that appears (or appears) to be compulsive or compulsive can also be attributed to many other conditions, including obsessive-compulsive personality disorder, autism spectrum disorders, disorders in which perseveration is a possible feature (ADHD, PTSD, physical disorders or habits), or subclinical disorders. Some individuals with OCD exhibit features commonly associated with Tourette syndrome, such as compulsive actions that may resemble motor tics; the terms "tic-related OCD" or "Tourette's OCD" apply to such a disorder.

Causes

Scientists generally agree that both physiological and biological factors play a role in the causation of the disorder, although they differ in degree of severity.

Physiological

The view of evolutionary psychology is that moderate compulsive behaviors may have had evolutionary advantages. Examples would be constant checking of hygiene, hearth or environment regarding enemies. Similarly, hoarding may have evolutionary advantages. From this point of view, OCD may be the last statistical "tail" of such behavior, which is presumably associated with a high number of predisposing genes.

Biological

OCD is associated with pathological disorders of serotonin neurotransmission, although it can be both a cause and a consequence of these disorders. Serotonin is thought to play a role in the regulation of anxiety. To send chemical signals from one neuron to another, serotonin must bind to receptor centers located on a nearby nerve cell. It is hypothesized that serotonin receptors in OCD sufferers may be relatively understimulated. This statement is consistent with the observation that many OCD patients benefit from the use of selective serotonin reuptake inhibitors (SSRIs), a class of antidepressants that make more serotonin immediately available to other nerve cells. A possible genetic mutation may contribute to OCD. The mutation was found in the human serotonin transporter gene, hSERT, in bound friend with a friend of families with OCD. Moreover, data on identical twins support the existence of a "hereditary factor in neurotic anxiety." In addition, subjects with OCD are more likely to have first-order family members with similar disabilities than matched controls. In cases where OCD develops in childhood, there is a stronger family connection with the disorder than in cases in which OCD develops in adulthood. Overall, genetic factors account for 45–65% of symptoms in children diagnosed with the disorder. Environmental factors also play a role in how anxiety symptoms are expressed; various studies on this topic are in progress and the presence of a genetic link has not been definitely established. Individuals with OCD show increased gray matter volumes in the bilateral lenticular nucleus extending into the caudate nucleus, but reduced gray matter volumes in the bilateral posterior medial frontal/frontal cingulate gyrus. These findings conflict with evidence for people with other anxiety disorders, who show reduced (rather than elevated) gray matter volumes in the bilateral lenticular/caudate nucleus, but also reduced gray matter volumes in the bilateral posterior medial frontal/frontal cingulate gyrus. Increased activity the orbifrontal cortex is attenuated in patients who respond positively to SSRI drugs, a result presumably due to increased stimulation of the serotonin 5-HT2A and 5-HT2C receptors. The striatum associated with planning and initiating appropriate actions is also relevant; Mice genetically bred with a striatum disorder exhibit OCD-like behavior, grooming themselves three times more than normal mice. Recent evidence supports the possibility of a genetic predisposition to neurological development contributing to OCD. The rapid onset of OCD in children and adolescents may be caused by group A streptococcal infection syndrome (PANDAS) or immunologic reactions to other pathogens (PANS).

neurotransmitters

Researchers have already pinpointed the cause of OCD, but brain differences, genetic influences, and environmental factors have also been investigated. Images of the brains of people with OCD have shown that they have different brain patterns. brain activity from people without OCD, and that different circuit functioning in a specific area of ​​the brain, the striatum, can cause the disorder. Differences in other regions of the brain and dysregulation of neurotransmitters, especially serotonin and dopamine, can also contribute to OCD. Independent Research similarly found unusual dopamine and serotonin activity in various regions of the brain in subjects with OCD. This can be defined as dopaminergic hyperfunction in the prefrontal cortex (mesocortical dopamine pathway) and serotonergic hypofunction in nucleus basalis. Glutamate dysregulation is also the subject of recent research, although its role in the etiology of the disorder is not clear. Glutamate acts as a dopamine cotransmitter on dopamine pathways that originate from the ventral tegmental area.

Diagnostics

Formal diagnosis can be performed by a psychologist, psychiatrist, clinical social worker, or other licensed mental health professional. To be diagnosed with OCD, a person must exhibit obsessions, compulsions, or both, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM). The Quick Reference Guide to 2000 Variants of the DSM states that certain features characterize clinically significant obsessions and compulsions. Such obsessions, according to the DSM, are recurrent and persistent thoughts, impulses, or representations that are felt to be intrusive and cause marked anxiety and depression. These thoughts, impulses, or representations are of a degree or type that is beyond normal concern about ordinary problems. The person may try to ignore or suppress such intrusive thoughts, or neutralize them with other thoughts or actions, and tends to recognize such thoughts as idiosyncratic or irrational. Compulsive urges become clinically significant when the person seeks to carry them out in response to the urge or in accordance with rules that must be strictly observed, and when the person feels or causes intense distress as a result. For this reason, while many people who do not have OCD can perform activities often associated with OCD (such as arranging things in a closet by height), what makes clinically significant OCD different is the fact that a person with OCD must perform these activities despite being under severe psychological stress. Is this behavior or thought processes aimed at preventing or reducing stress or preventing any frightening event or situation; however, these actions are logically or practically unrelated to the problem, or they are excessive. In addition to this, at some point in the course of the disease, the subject must realize that his obsessions and compulsive urges are unreasonable or excessive. Moreover, obsessions and compulsive urges are time consuming (occupying more than one hour a day) or cause impairments in social, occupational, or academic functioning. It is useful to quantify symptom severity and impairment before and during OCD treatment. In addition to patient-calculated time per day accounting for obsessive-compulsive thoughts and behaviors, Fenske and Schwenk, in "Obsessive-Compulsive Disorder: Diagnosis and Management," argue that more precise tools should be used to determine a patient's condition (2009). .). These may be rating scales such as the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). By means of such indicators a more appropriate psychiatric consultation can be determined, because they are standardized.

Differential Diagnosis

OCD is often confused with the separate obsessive-compulsive personality disorder (OCPD). OCD is egodystonic, which means that the disorder is the opposite of the sufferer's self-image. Since egodystonic disorders are contrary to the patient's self-image, they cause a great deal of depression. OCPD, on the other hand, is ego-synthonic, meaning that the person accepts that the characteristics and behavior are consistent with their self-image, or, in other words, acceptable, correct, and expedient. As a result, people with OCD are often aware that their behavior is wrong, dissatisfied with compulsive urges, but somehow feel compelled to carry them out, and may suffer from anxiety. In contrast, people with OCPD are not aware of the abnormality; they immediately explain that their actions are right, it is usually impossible to convince them otherwise, and they tend to enjoy their obsessions and compulsive urges. OCD is different from behaviors like gambling and overeating. People with these disorders usually show pleasure in their activities; OCD sufferers may be unwilling to perform their compulsive tasks and may not show pleasure in doing them.

Control

Behavioral therapy (BT), cognitive behavioral therapy (CBT), and medications are the first line treatments for OCD. Psychodynamic psychotherapy may help manage some aspects of the disorder. The American Psychiatric Association notes the lack of controllable symptoms and that psychoanalysis or dynamic psychotherapy is effective "at addressing the core symptoms of OCD." The fact that many subjects do not seek treatment may be partly due to prejudice against OCD.

Behavioral Therapy

A specific technique used in behavioral/cognitive behavioral therapy is called action presentation and avoidance (also known as presentation and response avoidance), or ERP; it involves gradually learning how to bear the anxiety associated with not performing ritual actions. First, for example, some can touch something only by getting “dirty” very easily (because the cloth has been in contact with another cloth, touch only with the tip of the finger, for example, a book from a “dirty” place, such as a school.) This "performance". "Action prevention" is not washing your hand. Another example would be leaving home and checking the lock only once (representation) without going back and checking again (action prevention). A person quickly enough gets used to the anxiety-producing situation and realizes that his level of anxiety drops significantly; they may then progress to touching something more "contaminated" or failing to re-check the lock - failing to perform ritual actions such as washing hands or checking. Reaction presentation/prevention (ERP) has a strong evidence base. It is considered the most effective treatment for OCD. However, this claim has been questioned by some researchers who criticize the quality of many of the studies. It is widely accepted that psychotherapy in combination with psychiatric medicines more effective than either agent alone. However, more recent studies have shown no difference in outcomes for those treated with a combination of drugs and CBT compared to CBT alone.

Medicines

Medications as treatment include selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants such as clomipramine. SSRIs are a second-line treatment for adults with obsessive-compulsive disorder (OCD) with mild functional impairment and a first-line treatment for adults with moderate or severe impairment. For children, SSRIs can be considered a second-line treatment for those with moderate to severe impairment, with careful monitoring of psychiatric side effects. SSRIs are effective in treating OCD; patients treated with SSRIs are twice as likely to respond to treatment compared to placebo. Efficacy has been shown in both short-term (6–24 weeks) treatment trials and interrupted trials lasting 28–52 weeks. Atypical antipsychotics such as quetiapine are also useful when used in addition to SSRIs in the treatment of treatment-resistant OCD. However, these drugs are often poorly tolerated and also have metabolic side effects that limit their use. None of the atypical antipsychotics are beneficial when used alone.

Electroshock therapy

Electroconvulsive therapy (ECT) is effective in some severe and difficult to treat cases.

Psychosurgery

As for some medicines, the support group and psychological ways treatments do not relieve obsessive-compulsive symptoms. These patients may choose psychosurgery as a last resort. In this procedure, a surgical injury is applied to a region of the brain (anterior cingulate cortex). In one study, 30% of participants benefited significantly from the procedure. Deep brain stimulation and stimulation cranial nerve are possible surgical means, but do not require damage to the brain tissue. In the United States, the Food and Drug Administration has approved deep brain stimulation for the treatment of OCD in accordance with humanistic guidelines requiring that the procedure be performed exclusively in a medical facility by an appropriately qualified specialist. In the US, psychosurgery for OCD is the last resort and is not performed until the patient responds to drug treatment (full dose) plus many months of intensive cognitive behavioral therapy with ritual/action presentation and avoidance. Similarly, in the UK, psychosurgery cannot be performed until the course of treatment has been completed by an appropriately qualified cognitive behavioral therapist.

Children

Therapeutic treatment may be effective in reducing ritualistic behavior in OCD in children and adolescents. Family involvement, in the form of behavioral observations and reports, is a key component to the success of this treatment. Parental intervention also provides positive reinforcement for children who exhibit appropriate behavior as an alternative to compulsive urges. After one or two years of therapy, during which children learn the nature of their obsessions and learn coping strategies, such children become more wide circle friends, show less shyness and become less self-critical. Although the causes of OCD in childhood groups range from pathological brain disorders to psychological biases, stress from life circumstances, such as frightening and traumatic deaths of family members, can also contribute to the childhood case of OCD, and knowledge of these stressors can be of value in treating the disorder.

Epidemiology

OCD occurs in 1 to 3% of children and adults. It is equally observed in both sexes. In 80% of cases, symptoms appear before the age of 18. A 2000 study by the World Health Organization found some degree of variability in the prevalence and incidence of OCD around the world, with rates Latin America, Africa and Europe are two to three times higher than Asia and Oceania. One Canadian study found that the prevalence of OCD had little correlation with race. However, respondents who single out Judaism as their religion are overrepresented. in large numbers among patients with OCD.

Forecasting

Psychological interventions such as behavioral and cognitive-behavioral therapy, as well as drug treatment, can provide significant relief from the symptoms of OCD in the average patient. However, OCD symptoms may persist at a moderate level even after an adequate course of treatment, and a completely symptom-free period is rare.

Story

From the 14th to the 16th century, it was claimed in Europe that people subject to blasphemous, sexual, or other obsessive thoughts were possessed by the devil. Based on this reason, the treatment involved expelling the "evil" from the "possessed" person through exorcism. In the early 1910s, Sigmund Freud attributed obsessive-compulsive behavior to unconscious conflicts that manifest as symptoms. Freud described the clinical history of a typical case of "touch phobia" that began in early childhood when the person had desire touch objects. In response to this, man developed external prohibition» against this type of touch. However, "this prohibition did not succeed in eliminating" the desire to touch; all he could do was suppress the desire and "make it involuntary."

Society and culture

Movies and television often present an idealized portrayal of disorders such as OCD. These descriptions can lead to increased public awareness, understanding and sympathy for such disorders. In 1997's As Good As It Gets, actor Jack Nicholson portrays a man "with obsessive-compulsive disorder (OCD)". "Throughout the film, [he] exhibits ritualized behaviors (i.e., compulsive acts) that disrupt his interpersonal and professional life", "a cinematic depiction of psychopathology [that] accurately portrays the functional interaction and stress associated with OCD." The 2004 film The Aviator depicts a biography of Howard Hughes starring Leonardo DiCaprio. In the film, "Hughes is subject to OCD symptoms that are intermittently severe and disabling." "Many of Hughes' OCD symptoms are fairly classic, in particular his fears of contagion." The Magnificent Scam (2003), directed by Ridley Scott, portrays a con man named Roy (Nicolas Cage) who suffered from obsessive-compulsive disorder. The film "begins with Roy at home, suffering from numerous compulsive symptoms that take the form of a need for order and cleanliness and a compulsive urge to open and close doors three times while counting loudly before walking through them." British poet, essayist and lexicographer Samuel Johnson is an example of a historical figure with a retrospective diagnosis of OCD. He carefully thought out rituals for crossing the thresholds of doorways and repeatedly walked up and down the stairwells, counting the steps. American aviator and director Howard Hughes suffered from OCD. “About two years after his death, Hughes’ real estate attorney called on the former CEO APA Raymond D. Fowler, PhD, host psychological observation to determine the mental and emotional state of Hughes in Last year life to understand the origin of his mental disorder. Fowler determined that "Hughes' fear of germs continued throughout his life, and he paralleled the development of obsessive-compulsive symptoms while making efforts to protect himself from germs." Hughes' friends also mentioned his compulsive urge to dress less revealingly. English footballer David Beckham has been vocal about his struggles with OCD. He said he counted all his clothes, and his magazines lay in a straight line. Canadian comedian, actor, TV presenter and voice actor Huey Mandel, well known for hosting the game show The Deal, wrote an autobiography, "The Line: Don't Touch Me," describing how OCD and mysophobia (fear of germs) affected his life. American show host Mark Summers wrote Everything in Its Place: My Trials and Victories Over Obsessive-Compulsive Disorder, describing the impact of OCD on his life.

Study

The naturally occurring sugar inositol has been shown to be useful in the treatment of OCD. Nutritional deficiencies can also contribute to OCD and other mental disorders. Vitamin and mineral supplements can help with these disorders and provide the nutrients needed for proper mental functioning. μ-opioids such as hydrocodone and tramadol may relieve symptoms of OCD. Opiates may be contraindicated in subjects concomitantly taking CYP2D6 inhibitors such as paroxetine. Much current research is devoted to the therapeutic potential of agents that affect the release of the neurotransmitter glutamate or its binding to receptors. They include riluzole, memantine, gabapentin, N-acetylcysteine, topiramate, and lamotrigine.

An obsessive-compulsive personality should be distinguished from a person with OCD, i.e. which one obsessive-compulsive disorder(compulsive disorder).

Because in the first, somewhat obsessive and ritualistic thinking and behavior may look like an anxious and suspicious trait of character and temperament, and especially not interfere with himself and those around him, close people.

In the second, overly obsessive OCD symptoms, such as fear of infection and frequent handwashing, can significantly interfere with a person, both in personal and in public life. That, too, can negatively affect the immediate environment.

However, it should be remembered that the first can easily become the second.

obsessive-compulsive personality

The obsessive-compulsive personality type is characterized by the following features:

• Them keywords: "Control" and "Must"
• Perfectionism (striving for perfection)
• Consider themselves responsible for themselves and others
• Others for them are frivolous, irresponsible and incompetent
• Beliefs: “I must manage the situation”, “I must only do everything right”, “I know what is best ....”, “You must do it my way”, “People and yourself need to be criticized to prevent mistakes” ...
• Catastrophic thoughts that the situation will get out of hand
• They control the behavior of others by excessive control, or by disapproval and punishment (up to the use of force and enslavement).
• Prone to regret, disappointment, punishment of themselves and others.
• Often experiencing anxiety, with failures can become depressed

Obsessive Compulsive Disorder - Symptoms

Obsessive Compulsive Personality Disorder (OCD) is characterized by: symptoms:

• Repetitive obsessive thoughts and forced actions that interfere with a normal life
• Repetitive obsessive, ritualistic behavior (or imagination) to relieve anxiety and distress caused by obsessive thoughts
• A person with OCD may or may not be aware of the meaninglessness of their thoughts and behaviors.
• Thoughts and rituals take a lot of time and interfere with normal functioning, causing psychological discomfort, including in the immediate environment
• Impossibility of independent, volitional control and opposition to automatic thoughts and ritual behavior

Related OCD symptoms:
Depressive disorder, anxiety and panic disorder, social phobias, eating disorders (anorexia, bulimia)…

The listed accompanying symptoms may be similar to OCD, therefore, a differential diagnosis is made, distinguishing other personality disorders.

obsessional disorder

Persistent (frequent) obsessive thoughts are ideas, images, beliefs, and ruminations that cause anxiety and distress and constitute obsessive personality disorder.

The most common obsessive thoughts are fear of infection, pollution or poisoning, harm to others, doubts about closing the door, turning off household appliances ... and so on.

Compulsive disorder

Obsessive behavior, or ritual behavior (ritual can be mental) is a stereotyped behavior by which a person with a compulsive disorder tries to relieve anxiety or relieve distress.

The most common ritual behaviors are washing hands and/or objects, counting aloud or to oneself, and checking the correctness of one's actions...etc.

Obsessive Compulsive Disorder - Treatment

For the treatment of obsessive-compulsive disorder, drug therapy and psychotherapy are used, in particular, cognitive behavioral therapy, exposure therapy and psychoanalysis.

Usually, with severe OCD and with little motivation for a person to get rid of it, drug treatment is used, in the form of taking antidepressants and serotonin reuptake inhibitors, non-selective serotonergic drugs and placebo pills. (effect, usually short-lived, besides, pharmacology is not harmless)

For OCD sufferers long time, and usually strongly motivated to cure, the best option would be psychotherapeutic intervention without medication (medication, in some difficult cases, can be used at the beginning of psychotherapy).

However, those wishing to get rid of obsessive-compulsive disorder and its accompanying emotional and psychological problems should be aware that psychotherapeutic intervention is time-consuming, slow and expensive.

But those who have the desire, after a month of intensive psychotherapy, will be able to improve their condition to normal. In the future, to avoid relapses and to consolidate the results, supportive therapeutic meetings may be necessary.