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Obsessive Compulsive Disorder (OCD)

 
  Source: Dr Cheryl Loh, Associate Consultant, Psychological Medicine, Changi General Hospital
 
 
     
 

Obsessive Compulsive Disorder is characterised by repetitive, intrusive, senseless thoughts which the patient identifies as his own but is unable to control (obsessions); as well as repetitive behaviours which are meant to reduce the anxiety caused by the obsession (compulsions). For example, obsessional thoughts about germs causing unbearable illness may be associated with the compulsion to clean.

What are the causes for OCD?
OCD is a type of anxiety disorder.

What are the common OCDs?
The common obsessions found in OCD are obsessions of contamination with compulsion to clean, obsessions of completeness with compulsion to check and obsession of symmetry and order with compulsion to arrange. These are the common ones but multiple others are possible.

What are the symptoms of OCD sufferers?
Most obvious will be the repetitive behaviours or thoughts which the person will find senseless but be unable to stop. If prevented from carrying out the repetitive acts, they will feel unbearable anxiety and become agitated and restless.

Anecdote: What are the worst cases of OCD seen in your experience?
Prefer not to talk about my own patients.

What kinds of treatment/drugs are prescribed for these OCDs?
OCD is usually treated with anti-anxiety medications, the most common group being the selective serotonin re-uptake inhibitors (SSRIs). Psychotherapy may also be suggested. The most frequent kind suggested when there are obvious compulsions is behaviour therapy.

Can one be cured of OCD? If so, how?
With medication or behaviour therapy, about 50-70% of patients can expect to recover from their symptoms. A combination of treatment and continuing medication for a longer period of time also seems to help relapse after an episode.

Behavioural training/correction: Does it work? How does it work?
The behaviour therapy for OCD with obvious compulsions is called exposure and response prevention. It is based on the idea that patients can be exposed to their feared situation is graded levels (starting with least feared situation) and taught at each level to tolerate the anxiety the situation arouses in them. After a period of tolerating and coping with the excessive anxiety, there will be a natural decrease in anxiety. From this experience, patients learn not to repeat their compulsions and to tolerate their anxiety better, which in turn reduces it.

     
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