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Obsessive-Compulsive Disorder (OCD)

Obsessive-compulsive disorder (OCD) is an anxiety disorder defined by upsetting, intrusive ideas which may be accompanied by compulsive rituals which reduce the discomfort of the obsessions.

The rituals are irrational and excessive, and the sufferer realizes this. They also are time-consuming, stressful, and may impair social and occupational functioning.

Theories

Some theorists believe that the disorder is caused by learning: Because the rituals bring immediate relief they are "reinforced" temporarily. This leads to a learning phenomenon caused "generalization" in that over a period of time fears of an increasingly greater number of stimuli and ritualistic behaviors accrue. Theorists from this school favor behavioral interventions, emphasizing a "relearning" approach to feared stimuli, as the primary form of therapy for OCD.

Since there is evidence that familial, genetic, neurological, and even streptococcal infection influence the origin of OCD, a number of clinician recommend biological therapies such as antidepressants.

Treatment

Behavioral therapy (BT), Cognitive Behavioral Therapy, medications, or any combination of these are first-line treatments for OCD. Psychodynamic psychotherapy does not appear to be helpful for this disorder.

Behavior Therapy, among many other things, helps the patient obtain prolonged exposure with feared objects or stimuli without allowing rituals to occur. Of all interventions available, BT is considered to be the most effective by several experts who have reviewed the psychological and psychiatric literature.

Medications usually begin with serotonin reuptake inhibitors (SSRIs) such as Paxil, Zoloft, Prozac, and Luvox. Antidepressants may take 2-3 months to show an effect, but often the effect is significant. Combined with behavior therapy, medications can often provide long-term improvement.