Obsessive-compulsive disorder (OCD) is a mental disorder that involves cyclic occurrences of fanatical and impulsive behavior. According to the American Psychiatric Association (15), this psychiatric illness is depicted in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) as a disease that is characterized by continuous ideas, visions or urges that result in striking distress and is generally considered as pointless and disturbing. Compulsions are described as recurring mental or physical activities that are performed as a response to a particular obsession to decrease an individual’s level of distress or to avoid the occurrence of an anticipated frightful consequence. An individual suffering from obsessive-compulsive disorder typically acknowledges the associated symptoms of this mental health as strange but due to his dread of being humiliated, the individual will express these symptoms to his physician as problems with his physical or intuitive condition. Currently, there are two schools of thought with regards to the precise etiology of obsessive-compulsive disorder. One school of thought considers that obsessive-compulsive behavior is a psychological disorder. Another school of thought acknowledges that this behavior is the result of brain dysfunction. Most of the current scientists regard obsessive-compulsive disorder as a biological issue that is caused by a specific abnormality in the brain (Conrad 907).
Criteria for the Diagnosis of Obsessive-Compulsive Disorder
Obsessive-compulsive disorder has been reported to occur in 2 to 3% of the population (Black 57). This mental illness has been generally described to be chronic, yet there are cases wherein the disorder is cured and does not recur. The average age of onset of obsessive-compulsive disorder is 20 years and approximately 80% of the patients experience this behavior by 18 years of age (Nachshoni 173). Gender-related issues with obsessive-compulsive disorder indicate that males tend to acquire this mental illness at a younger age. In addition, males diagnosed with obsessive-compulsive disorder are usually diagnosed with another mental illness. Among adult patients, no gender-related bias with regards to the prevalence of the obsessive-compulsive disorder has been reported. The clinical evaluation shows that stressful living conditions are strongly correlated with the onset and aggravation of obsessive-compulsive disorder (Grisham 108). The symptoms of obsessive-compulsive disorder may be manifested in women during and after pregnancy (Wilcox 33).
Obsessive-compulsive disorder is presented in different ways. The most common indication of obsession is the fear of contamination from diseases and any other negative features that may be present in the patient’s immediate surroundings (Sulkowski 1339). Another indication of the obsessive component of this mental disorder is the fear of accidentally triggering harm to other people. Other forms of obsession may include violence and aggression, as well as extreme sexual acts. Most obsessive patients show extreme forms of doubt that are often medically deemed pathologic. Obsessive-compulsive disorder is also associated with repetitive actions such as multiple checking of doors, keys, wallets, and any other personal items that the patient deals with every day. An obsessive individual will also frequently wash his hands, face, and even his entire body, with the idea that washing cleanses himself of his guilt and possibly, his fear of contamination. The patient presents with the behavior of repeating whatever he sees or hears several times than is necessary to repeat a word or statement. This individual is also fixated on counting anything that comes across him and his mind, even if there is no need to count. An example is portrayed when a patient routinely counts the number of steps he takes when going up the stairs or even constantly counting the number of keys that are attached to his keychain. In case of an obsessive individual making a particular request, this individual will keep on repeating the request to fulfill his urge to get reassurance from the person he requested a service from (APA 35).
In combination with obsessive behaviors, and obsessive-compulsive patients will also show symptoms of impulsive behavior. One simple example of compulsive behavior is to deny offering his hand out to another person to engage in a handshake. The individual’s refusal to shake another person’s hand is based on the notion that his hands will be contaminated if it touches another person’s hand. It should be noted though, that obsessive and compulsive behaviors also exist in the general population. However, individuals positively diagnosed with obsessive-compulsive disorder are distinguished from the general population by the fact that these people show significant distress over this mental disorder’s symptoms, which in turn affects their normal functioning and time management. The social relationships of the patient with other people are also negatively affected (APA 22).
A patient diagnosed with obsessive-compulsive disorder is generally aware of his repetitive and extreme behavior as compared to the general population and is concerned about this. Some patients are aware of their obsessive and compulsive behaviors yet they do not show the slightest concern for it. Some patients are also aware that the fears they carry have little to no chance of occurring yet they still perform these obsessive and compulsive activities just for the sake of pacifying themselves that they have done something (Szechtman 113). Clinical analysis of obsessive-compulsive patients shows that their anxiety levels decrease or even disappear once they have completed or performed their respective repetitive actions (Reuven-Magril 336). Their feeling of anxiety returns after some time and this dictates to the patients that they have to perform their ritual actions and behaviors again to discard their emotions of distress. The repetitive nature of performing specific rituals by these patients results in a very strong learned behavior. It is unfortunate but the lives of obsessive-compulsive patients tend to be controlled by their repetitive actions and any other associated psychiatric issues.
Obsessive-compulsive disorder is strongly linked with co-morbidity or the occurrence of another mental health illness together with obsessive-compulsive disorder. More than half of patients with the obsessive-compulsive disorder also suffer from major depression. The development of major depression is mainly due to the patient’s awareness that he is suffering from obsessive-compulsive disorder and in response, is saddened by the diagnosis and thus succumbs to major depression. Another mental disorder that occurs in co-morbidity with obsessive-compulsive disorder is an illness categorized under the anxiety spectrum of disorders. These mental illnesses that are classified under this spectrum include phobia, separation anxiety, panic disorder, and generalized anxiety disorder. Obsessive-compulsive patients also tend to abuse substances such as drugs or alcohol to medicate or numb themselves to the anxiety they are experiencing (Bandelow 250). Another mental health disorder that occurs in co-morbidity with obsessive-compulsive disorder is attention deficit-hyperactivity disorder.
Obsessive-compulsive disorder is often confused with an obsessive-compulsive personality disorder because both mental illnesses present with the same symptoms and behavioral spectra. However, a patient diagnosed with an obsessive-compulsive personality disorder is less troubled and cautious about the associated symptoms (Cormer 1684). The repetitive thoughts and actions that are performed by an individual with obsessive-compulsive personality disorder are considered by the patient as less controlling and not perceived as ridiculous as what is perceived by an individual with obsessive-compulsive disorder. Hence the symptoms experienced by individuals with obsessive-compulsive disorder are considered more routine than the symptoms associated with an obsessive-compulsive personality disorder.
Obsessive-compulsive disorder (OCD) is a mental disorder that involves cyclic occurrences of fanatical and impulsive behavior. This psychiatric illness is depicted in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) as a disease that is characterized by continuous ideas, visions or urges that result in striking distress and is generally considered pointless and disturbing. OCD has been reported to occur in 2 to 3% of the population. This mental illness has been generally described to be chronic, yet there are cases wherein the disorder is cured and does not recur. The average age of onset of obsessive-compulsive disorder is 20 years and approximately 80% of the patients experience this behavior by 18 years of age. The most effective treatment of OCD is the administration of serotonin reuptake inhibitors (SRIs) singly or in combination with anti-psychotics.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington: The Association, 1994.
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