Obsessive-Compulsive Disorder (OCD)

Obsessive-Compulsive Disorder is a psychological disorder characterised by the presence of obsessions and compulsions. Obsessions are repetitive and persistent thoughts, images, or urges. Importantly, obsessions are not pleasurable or experienced as voluntary: they are intrusive and unwanted and cause marked distress or anxiety in most individuals. On the other hand, compulsions are typically performed in response to an obsession. The aim is to reduce the distress triggered by obsessions or to prevent a feared event.

While the specific content of obsessions and compulsions varies among individuals, certain symptom dimensions are common in OCD, including those of cleaning (contamination obsessions and cleaning compulsions); symmetry (symmetry obsessions and repeating, ordering, and counting compulsions); forbidden or taboo thoughts (e.g., aggressive, sexual, and religious obsessions and related compulsions); and harm (e.g., fears of harm to oneself or others and related checking compulsions).

Physical and sexual abuse in childhood and other stressful or traumatic events have been associated with an increased risk for developing OCD(Grisham et al. 2011). Some children may develop the sudden onset of obsessive-compulsive symptoms, which has been associated with different environmental factors, including various infectious agents and a post-infectious autoimmune syndrome(Singer et al. 2012; Swedo et al. 2004).

Individuals with OCD may notice these symptoms:

  1. persistent thoughts (e.g. of contamination, mistakes)
  2. repetitive images (e.g. of violent or horrific scenes)
  3. persistent urges (e.g. arranging things in symmetry)
  4. unwelcomed compulsion (e.g. excessive washing, repeating of a ritual until it feels “just right”, checking something many times)
  5. persistent thoughts to prevent a feared event (e.g. becoming ill, loved ones being hurt)

It is important to note that as many as about half of individuals with OCD experience suicidal thoughts. Suicide attempts are also reported in up to one-quarter of individuals with OCD. There are treatments for individuals who experience OCD. If you suspect you may have OCD, please mention this to your therapist and we can assess your symptoms and present treatment options to address your concerns.

Works Cited
American Psychiatric Association. (2013). Obsessive-Compulsive and Related Disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC. https://doi.org/10.1176/appi.books.9780890425596.dsm06

Grisham JR , Fullana MA , Mataiz-Cols D , et al: Risk factors prospectively associated with adult obsessive-compulsive symptom dimensions and obsessive-compulsive disorder. Psychol Med, June 15, 2011 (Epub ahead of print)

Singer HS , Gilbert DL , Wolf DS , et al: Moving from PANDAS to CANS. J Pediatr 160(5):725–731, 2012

Swedo SE , Leonard HL , Rapaport JL : The pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) subgroup: separating fact from fiction. Pediatrics 113(4):907–911, 2004

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