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Saturday, September 29, 2007

What are the symptoms of Obsessive-Compulsive Disorder?


OCD involves having both Obsessions and compulsions. A person with OCD may sometimes have one or the other.

Common Obsessions are: contamination fears of germs, dirt, etc. imagining having harmed self or others, imagining losing control or aggressive urges, intrusive sexual thoughts or urges, excessive religious or moral doubt, forbidden thoughts A need to have things "just so" A need to tell, ask, confess common compulsions: washing repeating checking touching counting

OCD symptoms can occur in people of all ages. Not all Obsessive-Obsessive behaviors represent an illness. Some rituals (e.g., bedtime songs, religious practices) are a welcome part of daily life. Normal worries, such as contamination fears, may increase during times of stress, such as when someone in the family is sick or dying. Only when symptoms persist, make no sense, cause much distress, or interfere with functioning do they need clinical attention.

Obsessions
Obsessions are thoughts, images, or impulses that occur over and over again and feel out of your control. The person does not want to have these ideas. He finds them disturbing and intrusive, and usually recognizes that they don't really make sense. People with OCD worry excessively about dirt and germs and become obsessed with the idea that they are contaminated or contaminate others. They may have Obsessive fears of having inadvertently harmed someone else even though they usually know this is not realistic. Obsessions are accompanied by uncomfortable feelings, such as fear, disgust, doubt, or a sensation that things have to be done in a way that is "just so."
Compulsions
People with OCD try to make their Obsessions go away by performing compulsions. Compulsions are acts the person performs over and over again, often according to certain "rules." People with an obsession about contamination may wash constantly to the point that their hands become raw and inflamed. A person may repeatedly check that she has turned off the stove or iron because of an obsessive fear of burning the house down. She may have to count certain objects over and over because of an obsession about losing them. Unlike compulsive drinking or gambling, OCD compulsions do not give the person pleasure. Rather, the rituals are performed to obtain relief from the discomfort caused by the obsessions.
Other features of Obsessive-Compulsive Disorder
OCD symptoms cause distress, take up time (more than an hour a day), or significantly interfere with the person's work, social life, or relationships. Most individuals with OCD recognize that their Obsessions are coming from their own minds and are not just excessive worries about real problems. They realize that the compulsions they perform are excessive or unreasonable. When someone with OCD does not recognize that their beliefs and actions are unreasonable, this is called OCD with poor insight. OCD symptoms tend to wax and wane over time. Some may be little more than background noise; others may produce extremely severe distress.

What causes Obsessive-Compulsive Disorder?
There is no proven cause of OCD. Research suggests that OCD involves problems in communication between the front part of the brain (the orbital cortex) and deeper structures (the basal ganglia). These brain structures use the chemical messenger serotonin. It is believed that insufficient levels of serotonin are involved in OCD. Drugs that increase the brain concentration of serotonin often help improve OCD symptoms.

Pictures of the brain at work also show that the brain circuits involved in OCD return toward normal in those who improve after taking a serotonin medication or receiving cognitive-behavioral psychotherapy. Although it seems clear that reduced levels of serotonin play a role in OCD, there are no laboratory tests for OCD. The diagnosis is made based on an assessment of the person's symptoms. When OCD starts suddenly in childhood in association with strep throat, an autoimmune mechanism may be involved, and treatment with an antibiotic may prove helpful.

Is Obsessive-Compulsive Disorder Inherited?
No specific genes for OCD have been identified. Research suggests that genes do play a role in the development of the disorder. Childhood-onset OCD runs in families (sometimes in association with tic disorders). When a parent has OCD, there is a slightly increased risk that a child will develop OCD, although the risk is still low. When OCD runs in families, it is the general nature of OCD is inherited, not specific symptoms. Thus a child may have checking rituals, while his mother washes compulsively.

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