GPS: OCD Information

Obsessive-Compulsive Disorder (OCD)
(last updated September, 2003)

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What This Page Contains:

What are the Symptoms of OCD?

What is OCD?

Is OCD Serious?

What Causes OCD?

What Treatment is Available for OCD?

About 2% of the U.S. population has OCD in a given year.

OCD typically begins during adolescence or early childhood but at least one-third of the cases of adult OCD began in childhood.

OCD affects men and women equally.

I. What are the Symptoms of Obsessive-Compulsive Disorder?

upsetting and reoccuring thoughts or images
unstoppable images or thoughts
unstoppable repetition of actions such as
- counting
- checking on things
- washing hands
- re-arranging objects
- doing things until it feels right
- collecting useless objects
worries about terrible consequences unless certain actions are performed
unwanted urges to hurt someone, but knowledge that they could never be carried out

II. What is OCD?

Obsessive-compulsive disorder is characterized by anxious thoughts or rituals you feel you can't control. If you have OCD, you may be plagued by persistent, unwelcome thoughts or images, or by the urgent need to engage in certain rituals.

The disturbing thoughts or images are called obsessions, and the rituals that are performed to try to prevent or dispel them are called compulsions. There is no pleasure in carrying out the rituals you are drawn to, only temporary relief from the discomfort caused by the obsession.

A lot of healthy people can identify with having some of the symptoms of OCD, such as checking the stove several times before leaving the house. But the disorder is diagnosed only when such activities consume at least an hour a day, are very distressing, and interfere with daily life.

Most adults with this condition recognize that what they're doing is senseless, but they can't stop it. Some people, though, particularly children with OCD, may not realize that their behavior is out of the ordinary.

OCD strikes men and women in approximately equal numbers and afflicts roughly 1 in 50 people. It can appear in childhood, adolescence, or adulthood, but on the average it first shows up in the teens or early adulthood. A third of adults with OCD experienced their first symptoms as children. The course of the disease is variable--symptoms may come and go, they may ease over time, or they can grow progressively worse. Evidence suggests that OCD might run in families.

Depression or other anxiety disorders may accompany OCD. Some people with OCD have eating disorders. In addition, they may avoid situations in which they might have to confront their obsessions. Or they may try unsuccessfully to use alcohol or drugs to calm themselves. If OCD grows severe enough, it can keep someone from holding down a job or from carrying out normal responsibilities at home, but more often it doesn't develop to those extremes.

III. Is OCD Serious?

People with obsessive-compulsive disorder (OCD) suffer intensely from recurrent, unwanted thoughts (obsessions) or rituals (compulsions), which they feel they cannot control. Rituals such as handwashing, counting, checking, or cleaning are often performed in hope of preventing obsessive thoughts or making them go away. Performing these rituals, however, provides only temporary relief, and not performing them markedly increases anxiety. Left untreated, obsessions and the need to perform rituals can take over a person's life. OCD is often a chronic, relapsing illness.

OCD is sometimes accompanied by depression, eating disorders, substance abuse, attention deficit hyperactivity disorder, or other anxiety disorders. When a person also has other disorders, OCD is often more difficult to diagnose and treat. Symptoms of OCD can also coexist and may even be part of a spectrum of neurological disorders, such as Tourette's syndrome. Appropriate diagnosis and treatment of other disorders are important to successful treatment of OCD.

IV. What Causes OCD?

There is growing evidence that OCD has a neurobiological basis. OCD is no longer attributed to family problems or to attitudes learned in childhood - for example, an inordinate emphasis on cleanliness, or a belief that certain thoughts are dangerous or unacceptable. Instead, the search for causes now focuses on the interaction of neurobiological factors and environmental influences. Brain imaging studies using a technique called positron emission tomography (PET) have compared people with and without OCD. Those with OCD have patterns of brain activity that differ from people with other mental illnesses or people with no mental illness at all. In addition, PET scans show that in patients with OCD, both behavioral therapy and medication produce changes in the caudate nucleus, a part of the brain. This is graphic evidence that both psychotherapy and medication affect the brain

V. What Treatment is Available for OCD?

A combination of pharmacotherapy and behavioural treatments is often helpful for most OCD patients. Some individuals respond best to one therapy, some to another. Medications that have been found effective in treating OCD are fluvoxamine, paroxetine, sertraline, clomipramine and fluoxetine. Others are showing promise and may soon be available.

Behavioural therapy, specifically a type called exposure and response prevention, has also proven useful for treating OCD. It involves deliberately and voluntarily exposing the person to whatever triggers the problem and then helping him or her forego the usual ritual--for instance, having the patient touch something dirty and then not wash his hands. Studies of behaviour therapy for OCD have found it produces long-lasting benefits. To achieve the best results, a combination of factors is necessary: The client must be highly motivated; and the client's family must be cooperative. In addition to visits to the therapist, the cliient must be faithful in fulfilling "homework assignments". For those who complete the course of treatment, the improvements can be significant, though results have been less favourable in some people who have both OCD and depression.