Question

how does someone with OCD beheves ?

1. What are the common findings of this disorder?
2. What is the treatment plan for this disorder? (Name 3)
3. How prevalent is this disorder?

Answer 1

Definition of OCD ( Obsessive compulsive disorder)

According to ICD 9, Obsessive -compulsive dissorder is a state in which " the outstanding symotome is is feeling of sujective compulsion -which must be resisted -to carry out some action,to dwell on an idea ,to recall an experiance or ruminate on an abstract topic. Unwanted thoughts ,which include the insistencyof words or ideas are percieved by the patient to inapprropriate or non sentional. The obsessionsl idea or urge is recognised as alien to the personality,but as coming from with in the self.Obsessional rituals are designed to relieve anxiety. eg;- Washing the hands to deal with contamination . Attempts to dispel the unwelcome thoughts or urges may lead to severe inner struggle, which intense anxiety."

How does patient behave

Most people with OCD fall in to one of the following catagories

• Washers; are afraid of contamination.They usually have cleaning or hand washing compulsions
• Checkers; repeatedly check things(oven turned off,door locked etc) that they associate with harm or danger
• Doubters and sinners are afraid that if everything is not perfect or done just right something terrible will happen ,or they will be punished
• Counters arrangers are obsessed with order and symmetry. They may have supersitions about certain numbers colours or arrangements
• Hoarders fear that something bad will happenif they throw anything away/They compulsively hoard things that they don't need or use.They may suffer from other disorders such as,depression, PTSD,compulsive buying,kleptomania,ADHD, skin picking,ot tic disorders .

COMMON FINDINGS

• Obsessional thoughts; These are word ,idesd,and beliefs that intrude forcibly in to the partners mind . They are usually unpleasent and shocking. for the patient and may be obscene or blashfemous
• Obsessional images;  They are vividlly imagined scenes,often of a violent or disguesting kind involving abnormal sexual partners.
• Obsessional ruminations ; these involve internal debates inwhich arguments for and against even the simplest everyday actions are reviewed ensdlessly.
• Obsessional doubts ; These may concern action that may not have been completed adequately.The obsession often implies some danger such as turn off the stove or not locking the door.
• Obsessional impulses; They arev urges to perform acts usually of violent embarrassing kind ,such as injuring a child,shouting in church etc
• Obsessional rituals; These may include both mental activity such as counting repeatedly in aspecial way or repeating certain form of words,repeated senseless behavior such as washing hands20 or more times a day .

TREATMENT PLAN

1. Pharmacological therapy

• antidepressants- fluoxamine,setraline etc
• Anxiolytics-benzodiazepine

2.Behavior therapy

• Exposure and response prevention
• Thought stoppage
• Desensitization
• Aversive conditioning

​​​​​​​3.ECT - For patients refractory to other forms of treatment

PREVALANCE

World wide prvalavce of OCD is approximately2% of the general population

• estimates that about 1 in 100 adults or between 2 to 3 million adults in US currently have OCD