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Obsessive Compulsive Disorder

Obsessive-Compulsive Disorder (OCD)

Obsessive-Compulsive Disorder (OCD) is characterized by the presence of either obsessions, compulsions or both. Obsessions are recurrent and persistent thoughts, urges or mental images that are intrusive and unwanted. In many cases, these psychological intrusions cause significant distress and anxiety. Compulsions are repetitive behaviours or mental actions that a person feels driven to perform in order to relieve the anxiety and distress caused by an obsession or to prevent a feared event from happening. For example, before going to bed every night, a person might be tormented by an obsessive idea that they will go blind while they sleep and that the only way to prevent becoming blind is to engage in a compulsive repetitive behaviour such as thoroughly scrubbing their bathroom countertop 11 times before going to bed.

Obsessions and compulsions differ across people, however, there are commonalities among persons who suffer from Obsessive-Compulsive Disorder such as:

Obsessions:

  • Contamination
  • Symmetry
  • Forbidden or taboo thoughts, usually sexual
  • Religious desecration, profanity, blasphemy
  • Aggressive/violent thoughts
  • Pedophilic attraction
  • Contracting a disease
  • Fear of harm/illness coming to oneself or others

Compulsions:

  • Counting
  • Checking
  • Picture taking
  • Cleaning, disinfecting, hand washing
  • Ordering, organizing
  • Repetitive behaviours (switching lights on and off, touching objects according to specific rules typically involving symmetry, numbers, etc.)
  • Mental acts (praying, counting, repeating words silently, thought suppression)

The lifetime prevalence of OCD in North America is reported to be 2.3%, however, it is well-known that the rate is significantly higher, especially when taking into account subclinical cases that still require treatment. The age of onset of most cases of OCD appear between childhood (approx 8 years of age) and early adulthood (approx 19 years).

Exposure and Response Prevention (ERP) and Cognitive-Behavioural Therapy (CBT) are scientifically well-established approaches to treating Obsessive-Compulsive Disorder. Psychodynamic/Insight-Oriented approaches are also very useful in elucidating the psychological origins of OCD.


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