OBSESSIVE-COMPULSIVE DISORDER
What is Obsessive-Compulsive Disorder?
People with obsessive-compulsive disorder (OCD) suffer intensely
from recurrent, unwanted thoughts (obsessions) or rituals (compulsions),
which they feel they cannot control. Rituals such as handwashing,
counting, checking, or cleaning are often performed with the
hope of preventing obsessive thoughts or making them go away.
Performing these rituals, however, provides only temporary relief,
and not performing them markedly increases anxiety. Left untreated,
obsessions and the need to perform rituals can take over a person's
life.
How Common is Obsessive-Compulsive Disorder?
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About 2.3% of the U.S. population ages 18 to 54 - approximately 3.3
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million Americans - has OCD in a given year.
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OCD affects men and women equally.
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OCD typically begins during adolescence or early childhood; at least one-third of the cases of adult OCD began in childhood.
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OCD cost the US $8.4 billion in 1990 in social and economic losses, nearly 6% of the total mental health bill of $148 billion.
What Causes Obsessive-Compulsive Disorder?
There is growing evidence that OCD represents abnormal functioning of brain circuitry, probably involving a part of the brain called the striatum. OCD is not caused by family problems or attitudes learned in childhood, such as an inordinate emphasis on cleanliness, or a belief that certain thoughts are dangerous or unacceptable. Brain imaging studies using a technique called positron emission tomography (PET) have compared people with and without OCD. Those with OCD have patterns of brain activity that differ from people with other mental illnesses or people with no mental illness at all. In addition, PET scans show that in patients with OCD, both behavioral therapy and medication produce changes in the striatum. This is graphic evidence that both psychotherapy and medication affect the brain.
What Treatments are Available for Obsessive Compulsive Disorder?
Treatments for OCD have been developed through research supported by the NIMH and other research institutions. These treatments, which combine medications and behavioral therapy (a specific type of psychotherapy), are often effective. Several medications have been proven effective in helping people with OCD: clomipramine, fluoxetine, fluvoxamine, sertraline, and paroxetine. If one drug is not effective, others should be tried. A number of other medications are currently being studied. A type of behavioral therapy known as "exposure and response prevention" is very useful for treating OCD. In this approach, a person is deliberately and voluntarily exposed to whatever triggers the obsessive thoughts, and then is taught techniques to avoid performing the compulsive rituals and to deal with the anxiety.
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