Obsessive-Csompulsive Disorder (25/9/2013)

Elham aljammas

Obsessive-Compulsive Disorder affects 3% of world’s population Start from preschool to adulthood

Typically (20-24) cause still unknown Better :diagnosed early

:

Definition Specific criteria to be clinically diagnosed Anxiety disorder with presence of obsessions

or compulsions ego dystonic – realize thoughts and actions

are irrational or excessive Must take up more than 1 hour a day Must disrupt daily routine Symptoms can’t result from effects of other

medical conditions or substances

Obsessions

repetitive and constants thoughts, images, or impulses that cause anxiety or distress

thoughts, images, or impulses not about real-life problems

Try to ignore or counter act thoughts, images, or impulses

thoughts, images, or impulses “recognized as a product of one’s own mind and not imposed from without”

Compulsions Repetitive behaviors or mental acts

person does in reaction to obsessions behaviors or mental acts done to avoid

or decrease distress behaviors or mental acts are clearly

excessive or not realistic

compulsion

TheoriesPsychological disorderAbnormalities in the brain

Causes Serotonin is involved in regulating anxiety Abnormality in the neurotransmitter serotonin

In order to send chemical messages serotonin must bind to the receptor sites located on the neighboring nerve cells

OCD suffers may have blocked or damaged receptor sites preventing serotonin from functioning to full potential

Possible genetic mutation Some people suffering have mutation in the

human serotonin transporter gene

OCD and the Brain PET scans show people with OCD have

different brain activity from others Another theory: miscommunication between

the orbital frontal cortex, the caudate nucleus, and the thalamus Caudate nucleus doesn’t function properly

and causes thalamus to become hyperactive and sends “never-ending” worry signals between OFC and thalamus OFC responds by increasing anxiety

Comorbidity

Has excessive comorbidity with other diseases Common diseases: Depression, Schizophrenia,

Tourette Syndrome Depression is the most common

Many people with OCD suffered from depression first 2/3 of OCD patients develop depression makes

OCD symptoms worse and more difficult to treat

Treatment Only completely curable in rare cases Most people have some symptom relief with

treatment Treatment choices depend on the problem

and patients preferences Most common treatments:

Behavioral Therapy Cognitive Therapy Medication

Cognitive-Behavioral Therapy Cognitive: change the way they think to deal with

their fears Behavioral: change the way they react to “anxiety-

provoking” situations Exposure and Response Prevention

Slowly learning to tolerate anxiety associated with not performing ritual behavior

Psychotherapy Talking with therapist to discover what causes the

anxiety and how to deal with symptoms Systematic Desensitization

Learning cognitive strategies to deal with anxiety then gradual exposure to feared object

Cognitive-Behavioral Therapy Should be done when people are ready for it Must be customized for each person’s specific form

of OCD and their needs No side affects except increased anxiety with

exposure to fear Often lasts about 12 weeks Positive effects off CBT last longer than those of

medication If OCD returns can successfully treat again with

same therapy Best treatment approach for most is CBT combined

with medication

Medication Anxiolytic benzodiazepine such as chloradiazepoxide or

diazepam give temporary relief from anxiety but not really effective on obsessions and compulsions

Antidepressants because of common depression Selective Serotonin Reuptake Inhibitors (SSRIs): alter the

levels of neurotransmitter serotonin in the brain which helps brain cells communicate with one another Prevents excess serotonin from being pumped back into

original neuron that released it Then can bind to receptor sites of nearby neurons and send

chemical message that can help regulate anxiety and obsessive compulsive thoughts

Most effective drug treatment helping about 60% of patients Ex: Prozac, Zoloft, Lexapro, Paxil

Conclusion

OCD is a complicated issue Most cases are incurable Best form of treatment is CBT in combination

with medication Most important thing that can be done to

discover more about OCD and its treatments is to research the brain