Obsessive-Compulsive
Disorder
Jennie Kelly
Geneva College
What is it?
Overview
Who has it?
- For US adults aged 18 and up, 1.2% reported having OCD in any given year
- Rates of OCD were found to be higher with women (1.8%) than men (0.5%)
- The lifetime prevalence of OCD among U.S. adults was 2.3%
- Over 50% of adults with OCD reported serious impairment
(Obsessive-Compulsive Disorder (OCD) 2017)
Symptoms
Symptoms
A. Presence of obsessions, compulsions, or both
B. The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
C. The obsessive-compulsive symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
D. The disturbance is not better explained by the symptoms of another mental disorder
(American Psychiatric Association, 2013)
Assessment
- Obsessive–compulsive symptoms can be difficult to assess, given that they are often manifested internally, and individuals with OCD may not be inclined to recognize and report symptoms (ie, limited insight).
- free-form clinical interviews are the most common method for determining an OCD diagnosis in clinical practice
- Semi-structured interviews, such as the ADIS and SCID are also effective.
- Some cross cutting self-report measures may be helpful for initial investigation.
Assessment
https://www.psychiatry.org/psychiatrists/practice/dsm/educational-resources/assessment-measures
(Rapp et al, 2016)
Nature or Nurture?
Etiology
- Like many mental health disorders, the causes of OCD are unclear, However there are both biological and environmental roots.
- Those with relatives who have been diagnosed are twice as likely to also develop symptoms
- Those with relatives who had onset of OCD symptoms in childhood or adolescence are ten times as likely to also develop symptoms
- Additional risk factors include trauma and abuse and certain temperaments in childhood.
(American Psychiatric Association, 2013)
Biology and Neurology
- A mistake is detected in the orbital frontal cortex
- The orbital frontal cortex sends this message to the cingulate gyrus, which causes a physiological reaction of dread in the heart and gut
- the caudate nucleus becomes "sticky" causing the brain to sit with current thoughts rather than moving on to the next
Biology
(Doidge, 2017)
Comorbidity
- 76% have an axiety disorder
- 63% have a mood disorder
- 41% major depressive disorder
- 23-32 % personality disorder
- 12%of those with Schizoprenia or schizoaffective disorder
- 30% lifetime tic disorder
- 14% attempt suicide
Comorbidity
(American Psychiatric Association, 2013)
What kind of therapy can help?
Treatment
- The best practice of therapy across all symptoms of OCD is Cognitive behavioral therapy, specifically exposure and response prevention.
- ERP is conducted by creating a heirarchy of he anxiety, then gradual exposing the client to each anxiety producing stimulus, allowing them to soothe their anxiety and habituate to the stimulus before moving on.
- Other techniques include externalizing the anxiety producing thoughts and replacing worrysome thoughts with pleasurable activities.
(chase et al, 2015) (International OCD Foundation, 2019)
types of Treatment and prognosis
- Traditional Outpatient
- Intensive Outpatient
- Day Program
- Partial Hospitalization
- Residential
- Inpatient
Continuum of Care
(International OCD Foundation, 2019)
Medication
Medication
- Luvox
- Zoloft
- Celexa
- Lexpro
- Prozac
- Paxil
- Anafranil
- Effexor
Serotonin Reuptake inhibitors are effective in diminishing symptoms of OCD. However, continued research must be conducted in order to demonstrate why SRI's are effective.
(International OCD Foundation, 2019)
OCD Presentation
Other Concerns
(Northpoint Recovery Staff, 2019)
References
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
- Chase, T., Wetterneck, C. T., Bartsch, R. A., Leonard, R. C., & Riemann, B. C. (2015). Investigating treatment outcomes across OCD symptom dimensions in a clinical sample of OCD patients. Cognitive Behaviour Therapy, 44(5), 365–376. https://doi-org.proxy-geneva.klnpa.org/10.1080/16506073.2015.1015162
- Doidge, N. (2017). Brain Lock Unlocked. In The brain that changes itself: Stories of personal triumph from the frontiers of brain science (pp. 164-176). Strawberry Hills, NSW: ReadHowYouWant.
- Obsessive-Compulsive Disorder (OCD). (2017, November). Retrieved November 03, 2020, from https://www.nimh.nih.gov/health/statistics/obsessive-compulsive-disorder-ocd.shtml
- Rapp, A. M., Bergman, R. L., Piacentini, J., & McGuire, J. F. (2016). Evidence-Based Assessment of Obsessive-Compulsive Disorder. Journal of central nervous system disease, 8, 13–29. https://doi.org/10.4137/JCNSD.S38359