Project Description

OCD Fast Facts

Obsessive-Compulsive Disorder affects an estimated 2.3% of adults in the United States. The rate of diagnosis for women is somewhat higher than that for men.

About one half of the adults diagnosed with Obsessive-Compulsive Disorder have been identified as having serious impairment from the disorder. Approximately 35% are moderately impaired, and about 15% are mildly impaired.

Obsessive-Compulsive Disorder is characterized by consistent, repetitive thoughts or urges (obsessions) that result in anxiety, as well as behaviors (compulsions) that sufferers feel the need to engage in as a result of the obsessive thoughts.

Obsessive-Compulsive Disorder is more common among people who have a first-degree relative (a parent, sibling, or child) who also has the disorder, and the risk of developing the disorder increases if that relative developed the disorder themselves before adulthood.

OCD sufferers very often understand that their obsessive thoughts are not rational, but they remain powerless to stop the obsessions.

What is OCD?

Obsessive-Compulsive Disorder (OCD) is a chronic mental disorder that manifests as obsessive thoughts that cause distress in the sufferer, along with compulsions to perform certain behaviors in an effort to lessen the anxiety caused by the obsessive thoughts. Although obsessions and compulsions are common experiences even for people who don’t have OCD, the thoughts and behaviors in diagnosed cases of OCD rise to a level of severity that is disruptive to the daily life of the sufferer.

People with OCD may experience either obsessions or compulsions, or they may experience both at the same time in an irresistible cycle of behaviors.

Obsessions

The obsessive thoughts experienced by OCD sufferers are more than mere repetitive ideas or notions. They may be full-fledged thoughts, or they may be relatively simple mental images or urges that occur over and over again, and sufferers feel as if they have no control over when the obsessions begin or end.

Obsessions often bring negative feelings with them, including fear, doubt, or disgust, and they may be accompanied by the feeling that only doing things a certain way will make the negative feelings go away. OCD sufferers very often understand that their obsessive thoughts are not rational, but they remain powerless to stop the obsessions. As a result, the obsessions and their effects become disruptive to the person’s daily functioning.

Common Obsessive-Compulsive Disorder obsessions include:

  • Fear of contamination by germs, chemicals, dirt, or other contaminants
  • Unwanted sexual thoughts, often about taboo or prohibited sexual behavior
  • Fear of doing something harmful to yourself or others, or being responsible for harm coming to someone
  • Obsession with doing things perfectly, or a fear of being imperfect
  • Obsession with following religious or moral rules

Compulsions

The compulsions experienced by people with OCD, again, differ from the common ritualistic or habitual behaviors that most people engage in. For OCD sufferers, compulsions are behaviors that provide some relief from the negative feelings brought about from obsessions, and the sufferer indulges in the compulsion to feel better, if only for a short time. Sometimes compulsive behaviors are rituals meant to avoid the situation that produces the obsession in the first place.

As is the case with obsessions, OCD sufferers are typically aware that their compulsive behaviors are not rational, but because they produce some relief from the anxiety produced from obsessions, the compulsions are tolerated. The person with OCD likely would prefer not to be driven by the compulsion, but there seems to be no other way out.

Common Obsessive-Compulsive Disorder compulsions include:

  • Excessive cleanliness, including repeated handwashing, bathing, or housecleaning
  • Repetitive checking to be sure that you haven’t harmed yourself or others
  • Repeating or redoing actions over and over, or repeating actions (such as tapping or touching an object) a particular number of times
  • Mentally constructing thoughts in a particular way (such as counting while doing something) as a ritual that will prevent harm from coming to anyone
  • Arranging or ordering objects obsessively

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

What Causes OCD?

Doctors and researchers have not yet determined exactly what causes Obsessive-Compulsive Disorder (OCD), but they have identified several risk factors that increase the likelihood that an individual will develop the disorder.

  • Genetic Predisposition. Studies of families in which OCD is present, including studies of identical twins, seem to suggest that there may be a genetic component that is a risk factor for the disorder. Having a parent, sibling, or child who has been diagnosed with OCD increases the chance that you will also be diagnosed with the disorder. Researchers have made some progress in identifying the genes that may play a role in the development of OCD, but more research is necessary to determine the precise genetic connections.
  • Neurological Causes. Some brain imaging research has noted differences in parts of the brain structure, including the frontal cortex and subcortical structures, between people who have OCD and those who don’t. How these differences may play a role in the development of the disorder, however, is not yet understood.
  • Environmental Factors. Symptoms of OCD often first occur before adulthood, and they often seem to be triggered by stress. Research has shown a connection between a history of physical or sexual abuse in childhood and the development of OCD, and other childhood traumas may also be a risk factor for the development of the disorder.
  • Bacterial Infections. Some children develop OCD, or symptoms consistent with OCD, after having had a streptococcal infection.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

Is OCD Hereditary?

Researchers have long suspected that Obsessive-Compulsive Disorder (OCD) is primarily caused by biological factors, rather than environmental factors, and studies of families in which the disorder occurs strongly suggest that a genetic component may be responsible.

  • One early study found that among patients who had been diagnosed with OCD, 37% of the parents of the patients and 21% of their siblings were also diagnosed with the disorder.
  • Another study found that participants with OCD had a first-degree relative (a parent, child or sibling) with the disorder, as compared to 1.9% in the case of participants without OCD.
  • Studies have also found that having a first-degree relative who experienced the onset of OCD during childhood or adolescence increases the risk of developing the disorder.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How Is OCD Detected?

Because the onset of Obsessive-Compulsive Disorder (OCD) often occurs in childhood or adolescence, detection of the early signs of the disorder often falls on parents. Pediatric OCD generally develops gradually over time, so spotting the earliest warning signs may be difficult. Eventually, the obsessive and compulsive symptoms will become so severe that they interfere with the child’s functioning, but at first, they may be subtle.

OCD can first manifest at any age, but the most common age ranges for the development of pediatric OCD are in the pre-adolescent years (between the ages of 8 and 12) and the post-adolescent period between the late teens and early 20s.

Potential early signs of Obsessive-Compulsive Disorder (OCD) include:

  • Frequent worries about illness, germs, or death
  • Frequent worries about being imperfect or doing things incorrectly
  • Frequent worries about doing harm to others
  • Unwanted thoughts about sex
  • Excessive washing or cleaning
  • Excessive concerns about safety issues (e.g, whether the door is locked or the oven is turned off)
  • Excessive need for reassurance or approval
  • Repetitive actions or ritualistic behavior
  • Excessive focus on religious or moral rules
  • Excessive focus on “lucky” behaviors, numbers, or rituals

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How Is OCD Diagnosed?

Diagnosis of Obsessive-Compulsive Disorder (OCD) can be tricky, given that the disorder can sometimes appear similar to other physical or mental disorders, and it may be coincident with other disorders in the same patient. Proper diagnosis requires physical and psychiatric assessments, as well as observation and evaluation of current symptoms.

In general, a mental health professional will first determine if the patient is experiencing obsessive thoughts if the obsessive thoughts are coincident with compulsive behaviors and if the combination of obsessions and compulsions are interfering with the patient’s typical daily functioning. If these criteria are met, there is a reason to suspect that OCD is present.

Further diagnostic steps may include:

  • A physical exam. This exam will be aimed at ruling out physical conditions that could be causing the symptoms.
  • Blood tests. These tests will look at the patient’s blood chemistry for issues such as thyroid function. Screenings for drugs and alcohol may also be conducted to rule out symptoms that may be caused by substance abuse.
  • Psychological assessments. These assessments may take the form of questionnaires or talk sessions with a mental health professional to assess the patient’s mood, mental state, and mental health history. Family members or caregivers may also be asked to participate in these assessments.

The results of the psychological assessments will be compared to the diagnostic criteria for Obsessive-Compulsive Disorder (OCD) in the Diagnostic and Statistical Manual of Mental Disorders. Comparison to these criteria will help a psychiatrist to decide whether the symptoms indicate OCD or another psychiatric problem (such as obsessive-compulsive personality disorder, anxiety disorders, depression, and schizophrenia) whose symptoms sometimes look similar to those of OCD.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How Is OCD Treated?

Obsessive-Compulsive Disorder (OCD) currently has no cure, but a combination of medications and psychotherapy has proven to be effective at reducing the severity of symptoms in many patients. In these patients, the impact of symptoms may be reduced to a level that minimizes their detrimental effect on daily functioning. Many sufferers, however, will need to continue treatment for the rest of their lives in order to manage their symptoms, and some patients may not respond to treatment at all.

Medication

Several different medications may be used to treat and manage the symptoms of OCD, and individual medication plans are dependent on the age of the patient, the patient’s responsiveness to treatments, and the severity of their symptoms.

  • Antidepressants. These drugs are usually the medications that doctors try first as part of an overall treatment plan. Clomipramine is often prescribed to treat OCD symptoms in adults and children over the age of 10. Fluoxetine, fluvoxamine, and sertraline are sometimes prescribed for younger children, and paroxetine is typically only prescribed for adults.
  • Antipsychotics. When OCD patients do not respond to treatment with antidepressants, doctors will sometimes prescribe an antipsychotic such as risperidone. The research into the effectiveness of these drugs in treating OCD is not yet conclusive, however.
  • Other Medications. Because OCD sometimes is present alongside other mental disorders, medications to treat those disorders may also be part of a patient’s treatment plan.

Psychotherapy

While medications or psychotherapy are sometimes used alone in treating Obsessive-Compulsive Disorder (OCD), a combination of the two approaches is often most effective at lessening the severity of the symptoms. The most common therapeutic approach is cognitive-behavioral therapy (CBT), an approach that focuses on helping the patient to identify a pattern of harmful thoughts and to construct strategies and solutions for dealing with them that don’t interfere with functionality.

A more involved approach is exposure and response prevention (ERP) therapy. This is a type of CBT that involves gradually, and in a controlled way, exposing the patient to the triggers of their anxieties and compulsive behaviors and teaching them ways to cope with the triggers.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How Does OCD Progress?

The progression of Obsessive-Compulsive Disorder (OCD) from the initial experience of obsessions and compulsions to a fully developed and disruptive manifestation of the disorder is usually a slow process that takes place over months or even years. Research has shown that several factors, such as the time of the initial onset of symptoms and the amount of stress a sufferer experiences during the onset phase, seem to influence how the disorder progresses.

One study found that most participants experienced a slow progression of the disorder, with an average time of five years between the first signs of the disorder and the development of full-blown OCD. A lengthy progression was consistent whether patients developed OCD early or late in life, but those with late-onset OCD tended to experience an even slower progression.

Slower progressions also seemed to be more common in women and in people who experienced compulsions before they experienced obsessions.

In children who develop OCD symptoms in conjunction with a streptococcal infection, the progression may be very rapid.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

How Is OCD Prevented?

Obsessive-Compulsive Disorder (OCD) cannot be prevented, but early diagnosis and a consistent treatment plan can help to manage symptoms and prevent them from becoming as disruptive as they would be if they were left untreated. Faithful adherence to a treatment plan, especially if it’s working well, can also help to prevent a relapse into a state of severe symptoms. It’s important for those diagnosed with OCD to seek a regular evaluation from their mental health providers and to stick to any prescribed plan for medication.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

OCD Caregiver Tips

One of the most important things that caregivers can do in support of an Obsessive-Compulsive Disorder (OCD) sufferer is to educate themselves about the disorder. Education will help the caregiver to identify what is a symptom of the disorder and what isn’t, to understand what the sufferer is going through, and to understand how they can (and can’t) help the sufferer.

Caregivers for someone with OCD should consider these tips in order to help the sufferer and themselves to cope with the disorder:

  • Learn as much as possible about the disorder.
  • Seek out appropriate professional treatment for the sufferer.
  • Do everything possible to support the sufferer in the pursuit of treatment.
  • When a professional says it’s appropriate, disengage with the disorder by refusing to participate in rituals.
  • Find ways to have positive experiences with the sufferer that don’t focus on the disorder.
  • Find a support group for caregivers.
  • Take time away from the sufferer when possible.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

OCD Brain Science

Researchers are currently working on studies with the goals of finding the causes of Obsessive-Compulsive Disorder (OCD) (which could, in turn, lead to a cure), identifying the medications that work best to treat the disorder’s symptoms (and finding new medications that are even more effective), and learning which therapies produce the best results in lessening the impact of symptoms.

Many studies are being directed at what could be the fundamental causes of the disorder on the level of genetics and neuroscience:

  • Researchers at Johns Hopkins University have identified particular chromosomes that seem to be connected to the development of OCD, and they’ve found evidence that some of these chromosomal linkages are present in families that have multiple members with the disorder. The team is continuing to look for specific genes that may be linked to the disorder.
  • Researchers are examining the effectiveness of deep brain stimulation (DBS) in OCD patients. This treatment involves inserting an electrode into a targeted part of the brain and delivering an electrical pulse to the area. The treatment has been used in patients with movement disorders, but it has shown promise in the treatment of OCD that is resistant to other forms of treatment.
  • A study comparing MRI images of the brains of people with OCD to those of people without the disorder has found areas of the brain that consistently appear to be different in OCD sufferers. The study found that the brain’s parietal lobe, which controls attention and planning, is often smaller in people with Obsessive-Compulsive Disorder (OCD).

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

OCD Research

Scientists are working on several research projects to expand on what is known about Obsessive Compulsive Disorder (OCD).  The research will improve knowledge about the factors that increase the risk for OCD, as well as the causes, and best treatments, and will aid people living with OCD and their caregivers.

We are currently gathering the information required to support projects.

*The medical information we gather and publish is vetted and intended to be up to date, accurate and express a spectrum of recognized scientific and medical points of view. The information comes from a nucleus of informed scientists, medical doctors, peer-reviewed scientific journals and the National Institute of Health. Please note, differing points of view among scientists and physicians are common. Every effort is employed to ensure the accuracy of these different points of view. That notwithstanding, it is incumbent on persons using this information to consult with his/her physician before reaching any conclusions. Our medical information and publications are not intended to be a substitute for consultation with one’s physician.

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