In an effort to identify specific biological factors that may be important in the onset or persistence of OCD, NIMH-supported investigators have used a device called the positron emission tomography (PET) scanner to study the brains of patients with OCD. Several groups of investigators have obtained findings from PET scans suggesting that OCD patients have patterns of brain activity that differ from those of people without mental illness or with some other mental illness. Brain-imaging studies of OCD showing abnormal neurochemical activity in regions known to play a role in certain neurological disorders suggest that these areas may be crucial in the origins of OCD. There is also evidence that treatment with medications or behavior therapy induce changes in the brain coincident with clinical improvement.

Recent preliminary studies of the brain using magnetic resonance imaging showed that the subjects with obsessive-compulsive disorder had significantly less white matter than did normal control subjects, suggesting a widely distributed brain abnormality in OCD. Understanding the significance of this finding will be further explored by functional neuroimaging and neuropsychological studies (Jenike et al, 1996).

Symptoms of OCD are seen in association with some other neurological disorders. There is an increased rate of OCD in people with Tourette's syndrome, an illness characterized by involuntary movements and vocalizations. Investigators are currently studying the hypothesis that a genetic relationship exists between OCD and the tic disorders.

Other illnesses that may be linked to OCD are trichotillomania (the repeated urge to pull out scalp hair, eyelashes, eyebrows or other body hair), body dysmorphic disorder (excessive preoccupation with imaginary or exaggerated defects in appearance), and hypochondriasis (the fear of having--despite medical evaluation and reassurance--a serious disease). Genetic studies of OCD and other related conditions may enable scientists to pinpoint the molecular basis of these disorders.

Other theories about the causes of OCD focus on the interaction between behavior and the environment and on beliefs and attitudes, as well as how information is processed. These behavioral and cognitive theories are not incompatible with biological explanations.

WHAT THE FAMILY CAN DO TO HELP

OCD affects not only the sufferer but the whole family. The family often has a difficult time accepting the fact that the person with OCD cannot stop the distressing behavior. Family members may show their anger and resentment, resulting in an increase in the OCD behavior. Or, to keep the peace, they may assist in the rituals or give constant reassurance.

Education about OCD is important for the family. Families can learn specific ways to encourage the person with OCD to adhere fully to behavior therapy and/or pharmacotherapy programs. Self-help books are often a good source of information. Some families seek the help of a family therapist who is trained in the field. Also, in the past few years, many families have joined one of the educational support groups that have been organized throughout the country.

IF YOU HAVE SPECIAL NEEDS

Individuals with OCD are protected under the Americans with Disabilities Act (ADA). Among organizations that offer information related to the ADA are the ADA Information Line at the U.S. Department of Justice, (202) 514-0301, and the Job Accommodation Network (JAN), part of the President's Committee on the Employment of People with Disabilities in the U.S. Department of Labor. JAN is located at West Virginia University, 809 Allen Hall, P.O. Box 6122, Morgantown, WV 26506, telephone (800) 526-7234 (voice or TDD), (800) 526-4698 (in West Virginia).

The Pharmaceutical Research and Manufacturers Association publishes a directory of indigent programs for those who cannot afford medications. Physicians can request a copy of the guide by calling 800-762-4636 (800-PMA-INFO).

next: Take our OCD Screening Test or Where to Get Help for OCD

FOR FURTHER INFORMATION

For further information on OCD, its treatment, and how to get help, you may wish to contact the following organizations:

Anxiety Disorders Association of America
11900 Parklawn Drive, Suite 100
Rockville, MD 20852
Telephone 301-231-9350

Makes referrals to professional members and to support groups. Has a catalog of available brochures, books, and audiovisuals.

Association for Advancement of Behavior Therapy
305 Seventh Ave.
New York, NY 10001
Telephone 212-647-1890

Membership listing of mental health professionals focusing on behavior therapy.

Obsessive Compulsive Information Center
Madison Institute of Medicine
7617 Mineral Point Road, Suite 300
Madison, WI 53717
Telephone 608-827-2470
Website: http://www.miminc.org/aboutocic.html

Computer data base of over 4,000 references updated daily. Computer searches done for nominal fee. No charge for quick reference questions. Maintains physician referral and support group lists.

Freedom From Fear
308 Seaview Ave.
Staten Island, NY 10305
Telephone: 718-351-1717
http://www.freedomfromfear.org

Offers a free newsletter on anxiety disorders and a referral list of treatment specialists.

Obsessive-Compulsive Foundation
P.O. Box 70
Milford, CT 06460-0070
Telephone: 203-878-5669
Fax: 203-874-2826
InfoLine: 203-874-3843
e-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Offers free or at minimal cost brochures for individuals with the disorder and their families. In addition, videotapes and books are available. A bimonthly newsletter goes to members who pay an annual membership fee of $30.00. Has over 250 support groups nationwide. Can refer to mental health professionals in your area with experience in treating OCD.

Tourette Syndrome Association, Inc.
42-40 Bell Boulevard
New York, NY 11361-2874
Telephone 718-224-2999

Publications, videotapes, and films available at minimal cost. Newsletter goes to members who pay an annual fee of $35.00.

Trichotillomania Learning Center
1215 Mission Street, Suite 2
Santa Cruz, CA 95060-3558
Telephone: 408-457-1004
E-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Membership fee of $35.00 includes information packet and bimonthly newsletter.

For information on other mental disorders, contact:

Information Resources and Inquiries Branch
National Institute of Mental Health
5600 Fishers Lane, Room 7C-02, MSC 8030
Bethesda, MD 20892
Telephone: 301-443-4513
e-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Books Suggested for Further Reading

Baer L. Getting Control. Overcoming Your Obsessions and Compulsions. Boston: Little, Brown & Co., 1991.

DeSilva P and Rachman S. Obsessive-compulsive Disorder: that Facts. Oxford: Oxford University Press, 1992.

Foa EB and Wilson R. Stop Obsessing! How to Overcome Your Obsessions and Compulsions. New York: Bantam Books, 1991.

Foster CH. Polly's Magic Games: A Child's View of Obsessive-Compulsive Disorder. Ellsworth, ME: Dilligaf Publishing, 1994.

Greist JH. Obsessive Compulsive Disorder: A Guide. Madison, WI: Obsessive Compulsive Disorder Information Center. rev. ed., 1992. (Thorough discussion of pharmacotherapy and behavior therapy)

Jenike MA. Drug Treatment of OCD in Adults. Milford, CT: OC Foundation, 1996. (Answers frequently asked questions about OCD and drug treatments)

Johnston HF. Obsessive Compulsive Disorder in Children and Adolescents: A Guide. Madison, WI: Child Psychopharmacology Information Center, 1993.

Matisik EN. The Americans with Disabilities Act and the Rehabilitation Act of 1973: Reasonable Accommodation for Employees with OCD. Milford, CT
OC Foundation, 1996.

Neziroglu F. and Yaryura-Tobias JA. Over and Over Again: Understanding Obsessive-compulsive Disorder. Lexington, MA: DC Health, 1991.

Rapoport JL. The Boy Who Couldn't Stop Washing: The Experience and Treatment of Obsessive-Compulsive Disorder. New York: E.P. Dutton, 1989.

Steketee GS and White K. When Once Is Not Enough: Help for Obsessive Compulsives. Oakland, CA: New Harbinger, 1990.

VanNoppen BL, Pato MT, and Rasmussen S. Learning to Live with OCD. Milford, CT: OC Foundation, 1993.

Videotape

The Touching Tree. Jim Callner, writer/director, Awareness films. Distributed by the O.C. Foundation, Inc., Milford, CT. (about a child with OCD)

REFERENCES

DuPont RL, Rice DP, Shiraki S, and Rowland C. Economic costs of obsessive-compulsive disorder. Unpublished, 1994.

Foa EB and KoZak MJ. Obsessive-compulsive disorder: long-term outcome of psychological treatment. In Mavissakalian & Prien (Eds.), Long-term Treatments of Anxiety Disorders. Washington, DC: American Psychiatric Press, 1996, 285-309.

Hiss H, Foa EB, and Kozak MJ. Relapse prevention program for treatment of obsessive-compulsive disorder. Journal of Consulting and Clinical Psychology 62:4:801-808, 1994.

Jenike MA. Obsessive-compulsive Disorder: efficacy of specific treatments as assessed by controlled trials. Psychopharmacology Bulletin 29:4:487-499, 1993.

Jenike MA. Managing the patient with treatment-resistant obsessive-compulsive disorder: current strategies. Journal of Clinical Psychiatry 55:3 (suppl):11-17, 1994.

Jenike MA et al. Cerebral structural abnormalities in obsessive-compulsive disorder. Archives of General Psychiatry 53:7:625-632, 1996.

Leonard HL, Swedo SE, Lenane MC, Rettew DC, Hamburger SD, Bartko JJ, and Rapoport JL. A 2- to 7-Year follow-up study of 54 obsessive-compulsive children and adolescents. Archives of General Psychiatry 50:429-439, 1993.

March JS, Mulle K, and Herbel B. Behavioral psychotherapy for children and adolescents with obsessive-compulsive disorder: an open trial of a new protocol-driven treatment package. Journal of the American Academy of Child and Adolescent Psychiatry 33:3:333-341, 1994.

Pato MT, Zohar-Kadouch R, Zohar J, and Murphy DL. Return of symptoms after discontinuation of clomipramine in patients with obsessive-compulsive disorder. American Journal of Psychiatry 145:1521-1525, 1988.

Swedo SE and Leonard HL. Childhood movement disorders and obsessive-compulsive disorder. Journal of Clinical Psychiatry 55:3 (suppl):32-37.

Swedo SE and Leonard HL. Excessively compulsive or obsessive-compulsive disorder? It's Not All in Your Head. New York, NY: HarperCollins, 1996.

next: Take our OCD Screening Test or Where to Get Help for OCD