Obsessions are defined as recurrent, intrusive thoughts, impulses, or images, which can lead to anxiety. Patients consider them as a product of their own mind, like ‘Thought Insertion’ phenomenon. They find them excessive, irrational, and senseless, at some time during the illness like ‘Illusions’. Patient tries to resist or neutralise them. Compulsions are repetitive behaviours/mental acts performed in response to obsessions – reduce anxiety temporarily. They are Ego-dystonic (not acceptable to self), with good/poor/absent insight (delusional belief). OCD treatment involves medication and psychotherapies. The most common comorbidity associated with OCD is Depression.
A child is said to be diagnosed with PANDAS (Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus infections) if a child develops sudden OCD, tic disorder, or both precipitated by Group A Beta-haemolytic Streptococcus infection such as strep throat or scarlet fever. There is an autoimmune destruction to basal ganglia.
In DSM-IV, OCD was placed in ‘Anxiety disorders.’ But in DSM-V, it has been placed under – ‘Obsessive-Compulsive and related disorders.’ The obsessions and compulsions cause severe distress, are time consuming (more than 1 hour a day) or interfere significantly with normal routine, lifestyle, academic or occupational functioning, or social activities or relationships of the patient.
Combination of Medical treatment and Psychotherapy
Tulasi Healthcare a group of psychiatric hospital and rehabilitation centre provides holistic OCD treatment in Delhi. A team of 7 psychiatrists and 30 psychologists is available.