Full description of Obsessive-Compulsive Disorder, OCD. Definition, signs, symptoms, causes of Obsessive-Compulsive Disorder.
Description of Obsessive-Compulsive Disorder (OCD)
Obsessive-Compulsive Disorder is one of the anxiety disorders. It affects 2-3% of the population, usually begins in adolescence or young adulthood and occurs in men and women equally.
OCD is characterized by recurrent intense unwanted and obtrusive obsessions and/or compulsions that cause severe discomfort and interfere with day-to-day functioning. Obsessions are recurrent and persistent thoughts, impulses, or images (concerns about contamination, doubts that something that needs to be done hasn't been done, fear of loss, fear of hurting someone) that are unwanted and cause marked anxiety or distress. Frequently, they are unrealistic or irrational and may even seem silly, weird, nasty, or horrible to the person experiencing them. They are not simply excessive worries about real-life problems or preoccupations. Compulsions are repetitive behaviors or rituals (like hand washing, hoarding, keeping things in order, checking something over and over) or mental acts (like counting, repeating words silently, avoiding). In OCD, the obsessions or compulsions cause significant anxiety or distress, or they interfere with the person's normal routine, academic functioning, social activities, or relationships.
Most people with OCD are aware that their obsessive thoughts do not reflect actual risks and that their compulsive behaviors are ineffective. Obsessive-compulsive disorder, therefore, differs from psychotic disorders, in which people lose contact with reality. Obsessive-compulsive disorder also differs from obsessive-compulsive personality disorder in which specific personality traits are defined (for example, being a perfectionist).
People with obsessive-compulsive disorder are aware that their compulsive behaviors are excessive to the point of being bizarre, and they are afraid they will be embarrassed, shamed or stigmatized. Thus, they often perform their rituals secretly, even though the rituals may occupy several hours each day.
Many with OCD also suffer from depression.
Obsessions as defined by (1), (2), (3), and (4):
1. recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress
2. the thoughts, impulses, or images are not simply excessive worries about real-life problems
3. the person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action
4. the person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind (not imposed from without as in thought insertion)
Compulsions as defined by (1) and (2):
1. repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly
2. the behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive
At some point during the course of the disorder, the person has recognized that the obsessions or compulsions are excessive or unreasonable. Note: This does not apply to children.
The obsessions or compulsions cause marked distress, are time consuming (take more than 1 hour a day), or significantly interfere with the person's normal routine, occupational (or academic) functioning, or usual social activities or relationships.
If the individual has an additional disorder, the content of the obsessions or compulsions is not restricted to it.
The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.
Causes of Obsessive-Compulsive Disorder (OCD)
There has been a lot of research into the causes of OCD and as with many psychiatric disorders, genetics, brain chemistry, environment and biology probably play a significant role in the development of obsessive-compulsive disorder.
Generally accepted theories regarding the cause of OCD include:
- Serotonin deficiency
- Learned behaviors over time
- Change in the body's own chemistry
- OCD is a brain disorder and tends to run in families
Several controversial studies suggest that some children develop OCD after having strep throat. Some research suggests that an antibody against strep throat bacteria sometimes mistakenly acts like a brain enzyme. This disrupts communication between neurons in the brain and may trigger OCD.
Sources: 1. American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC: American Psychiatric Association. 2. Merck Manual, Home Edition for Patients and Caregivers, last revised 2006. 3. Mayo Clinic website, OCD Causes.
Last Updated: 29 March 2017
Reviewed by Harry Croft, MD