Obsessive-compulsive disorder (OCD) is a psychiatric condition affecting the way people think and behave. Troublesome thoughts called obsessions come constantly. The thoughts may be about violence, fear of something bad happening, or worry about forgetting something. People may feel the need to repeat something. These behaviors, called compulsions, are done because of the thoughts. For example, wondering whether the door is locked may lead to checking the lock several times.
OCD usually begins in the late teens to early 20s. Symptoms may sometimes improve but never really go away.
The cause is unknown.
Common obsessions include aggressive thoughts, such as seeing violent images or having fears of harming others or oneself, of doing something embarrassing, of acting on impulses, of feeling responsible for things going wrong, and of something terrible happening. People with contamination obsessions are excessively focused on body waste, dirt, or germs; are overly concerned with contaminants; and are worried about becoming sick to a degree beyond reasonable expectations. Other obsessions are sexual, hoarding or collecting, and religious. Obsessions involve socially unacceptable behaviors, so people feel guilty and anxious.
The many compulsions include repeating rituals and cleaning or hand washing, counting, checking, and ordering or arranging compulsions. For example, people may get up several times during the night to make sure that appliances were turned off, doors were locked, and windows were closed. Or people must have clothes, shoes, or dishes in a certain order or pointing in a certain direction to get relief from anxiety. People may not want to do these behaviors but often cannot control them. These compulsive behaviors can take up a large part the day and make it hard to complete other more productive activities.
The health care provider usually bases the diagnosis of OCD on symptoms: feelings of distress plus the problem behaviors. Symptoms usually get worse during stress. People who feel that obsessions and compulsions take up most of their time and are disturbed by this need treatment. Family members or co-workers may point out the symptoms.
Treatment goals are to reduce the symptoms and minimize their interference in life. Behavior therapy reduces the compulsions, such as frequent hand washing. People may need a combination of medicines and behavioral treatment. Medicines called selective serotonin reuptake inhibitors (SSRIs), such as fluvoxamine, sertraline, and fluoxetine, are often used.
Contact the following sources: