OBSESSIVE COMPULSIVE DISORDER

Obsessive-Compulsive Disorder (OCD) is a chronic and often disabling mental health disorder characterized by the presence of obsessions, compulsions, or both. It is classified under anxiety and related disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

  • Obsessions are intrusive, unwanted, and recurrent thoughts, urges, or images that cause significant anxiety or distress (e.g., fear of contamination, fear of harming others, or intrusive taboo thoughts).

  • Compulsions are repetitive behaviors or mental acts (e.g., handwashing, checking, counting, praying) that an individual feels driven to perform in response to an obsession or according to rigid rules. These behaviors are intended to reduce distress or prevent a feared outcome, but are often excessive or not connected in a realistic way to the perceived threat.

To meet diagnostic criteria, these symptoms must:

  • Be time-consuming (e.g., taking more than one hour per day),

  • Cause significant distress or impairment in social, occupational, or other important areas of functioning,

  • Not be better explained by another mental disorder or the effects of substances or medical conditions.

Etiology and Risk Factors:

OCD is believed to result from a combination of genetic, neurobiological, and environmental factors:

  • Dysregulation in the cortico-striato-thalamo-cortical (CSTC) circuitry in the brain

  • Imbalances in neurotransmitters, particularly serotonin

  • Genetic predisposition and family history of OCD or anxiety disorders

  • Childhood trauma or stressful life events as potential triggers

OCD typically begins in adolescence or early adulthood, though it can emerge in childhood. It often follows a chronic and fluctuating course, with symptoms worsening during times of stress. Left untreated, OCD can severely impair daily functioning and quality of life.

Evidence-based treatments for OCD include:

  • Cognitive Behavioral Therapy (CBT), particularly Exposure and Response Prevention (ERP), which is considered the gold standard.

  • Pharmacotherapy, typically selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, sertraline, or fluvoxamine; higher doses and longer durations are often required compared to treatment for depression.

  • Deep Brain Stimulation (DBS) or Transcranial Magnetic Stimulation (TMS) for severe, treatment-resistant cases.

Effective treatment can lead to significant symptom reduction, though many individuals continue to manage residual symptoms throughout their lives.