Obsessive-Compulsive Disorder (OCD) Psychology

Obsessive-Compulsive Disorder (OCD)

• Characterized by ego dystonic, time-consuming obsessions and compulsions that interfere with daily life
• Patients recognize their thoughts as excessive and usually try to resist them, but unsuccessfully

Theories of OCD

• Psychoanalytic theory: obsessions prevent undesirable ideas from entering consciousness, e.g. unconscious conflicts (sexual and aggressive)
• Behavioural theory: compulsions decrease anxiety, leading to reinforcement of the condition
• Biological theory:
  • 50% positive family history
  • 5-HT abnormalities
  • Frontal cortex and basal ganglia abnormalities
  • Anankastic premorbid personality traits in 70% of patients

Comorbidity and Prevalence

• 30% of OCD patients have comorbid depression
• Symptoms are exacerbated by depression
• Lifetime prevalence: 2-3%
• Male:Female ratio: 1:1
• Age of onset: usually by early twenties

Symptoms

• Obsessions: persistent thoughts, images, doubts, or impulses that are worrying, blasphemous, obscene, or socially unacceptable
• Content may involve dirt/contamination, sex, aggression, religion, or orderliness
• Compulsions: stereotyped acts, recognized as excessive, unreasonable, or exaggerated, often involving cleaning, repeating, checking, orderliness, or hoarding
• Mental rituals to decrease anxiety, e.g. counting

Differential Diagnosis

• Anankastic personality disorder
• Depression
• Psychosis (e.g. schizophrenia)
• Anorexia Nervosa
• Phobic disorders
• Gilles de la Tourette's syndrome/tic disorders

Treatment

• Treat comorbid medical and psychiatric conditions
• (More information needed to complete this section)