Obsessive Compulsive Disorder (OCD)
Obsessive-compulsive disorder (OCD) is characterized by intrusive thoughts, which may or may not be accompanied by compensatory acts to reduce the stress caused by these thoughts; these are referred to as obsessions and compulsions, respectively. Adolescents are more likely to have OCD, which is under-reported and under-treated. Early intervention is critical since it can cause serious debilitation. This exercise covers the assessment and treatment of obsessive-compulsive disorder, as well as the role of the interprofessional team in assessing and treating patients with this problem.
- Describe the indications and symptoms that can be used to identify the obsessive-compulsive disorder in a patient.
- Summarize the obsessive-compulsive disorder treatment plan.
- Explain how OCD affects neural networks.
- Examine the value of strengthening interprofessional care coordination to improve the delivery of care for individuals with obsessive-compulsive disorder.
Obsessive-compulsive disorder (OCD) is a disabling condition characterized by persistent intrusive thoughts that cause distress. Compulsions or routines may be used by the patient to alleviate the worry and suffering connected with these ideas. These rituals can be personal and private, or they can involve others; the rituals are used to compensate for the ego-dystonic sentiments associated with obsessional ideas, and they can result in a severe loss of function.
Among the most prevalent obsessions are:
- Anxieties of contamination,
- Sexual worries
- Religious fears
- The drive to get things “exactly so”.
Some of the compensating compulsions for these obsessions are:
- Washing and cleaning
- Sorting and Arranging.
- Obsessions, compulsions, or both are present:
The following two points are used to define obsessions:
- Recurrent thoughts, desires, or visions that are perceived as undesired at some point during the disturbance and generate significant distress in most people.
- The individual tries to repress such ideas, urges or visions with another thought or action (i.e., by replacing them with a compulsion).
The following two factors define compulsions:
- Repetitive actions or thoughts that a person feels compelled to perform as a result of an obsession.
- The behavioral or mental acts that are intended to reduce worry or suffering, or to prevent some dreaded situation; nevertheless, they do not correlate in a realistic way with the problem they are intended to prevent, or they are manifestly excessive.
- Obsessions take up a lot of time or create clinically substantial distress or impairment in social, occupational, or other vital aspects of life.
- The physiological consequences of a substance (e.g., a drug of abuse, a medicine) or another medical condition are not the factors causing obsessive-compulsive symptoms.
- The symptoms of another mental disorder do not better explain the disturbance
- Excessive worries, as in a generalized anxiety disorder;
- preoccupation with appearance, as in a body dysmorphic disorder;
- difficulty discarding or parting with possessions, as in a hoarding disorder;
- hair pulling, as in trichotillomania a hair-pulling disorder;
- skin picking, as in excoriation [skin-picking] disorder;
- stereotypies, as in a stereotyping disorder;
- Eating disorders are characterized by ritualized eating habits.
- drug or gambling obsession, as observed in substance-related and addiction disorders;
- sickness anxiety disorder is characterized by an obsession with having an ailment;
- Impulses, as seen in disruptive, impulse-control, and conduct disorders;
- sexual drives or fantasies, as shown in paraphilic disorders;
- thought insertion or delusional preoccupations, as seen in schizophrenia spectrum and other psychotic illnesses; or
- repetitive behavior patterns, as seen in autism spectrum disorders.
OCD is listed as one of the ten most debilitating conditions by financial loss and a deterioration in the quality of life by the WHO because it has the potential to impede one’s social growth and development.
Obsessive-compulsive disorder (OCD) has no recognized cause, however, it is most likely multifactorial. There is a genetic tendency since genetic factors account for 45 to 65 percent of the variance in OCD.
An inability to cope with uncertainty, a sense of greater responsibility, and magical thinking appears to predispose people to obsessive-compulsive behaviors.
OCD appears to be inherited, as evidenced by twin and family studies. According to studies, children’s heritability ranges from 45 percent to 65 percent, whereas adults’ heredity ranges from 27 percent to 45 percent. Having an OCD family member raises your chances of having OCD. OCD has been linked to a variety of neurological disorders, including Parkinson’s disease, Sydenham chorea, traumatic brain injury (TBI), Tourette syndrome, Huntington’s disease, and epilepsy, to name a few.
Screening for the correct symptoms of obsessive-compulsive disorder is critical. The brief OCD screener is a standard tool.
It asks the patient to rank the following items in order of severity:
- Obsessive thoughts and compulsions take up a lot of time.
- Obsessive thoughts are interfering with your life.
- Obsessive thoughts cause a lot of pain.
- Obsessions must be overcome.
- Controllability of obsessive ideas
- The amount of time devoted to compulsive behavior
- Compulsive behavior’s interference
- The anguish that comes with compulsive conduct
- Anti-compulsive behavior resistance
- Controllability of obsessive behaviors
Treatment / Management
SSRIs and cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) are the mainstays of obsessive-compulsive disorder (OCD) treatment.
ERP entails exposing the patient to their anxieties while also encouraging them to resist the impulse to conduct a compulsion. The goal is to rebuild the mind and change the habitual patterns that have developed as a result of participation in the compulsion.
CBT seeks to change negative and harmful ideas. The patient can use mindfulness approaches like meditation and relaxation in addition to CBT and ERP. In a 2012 study focusing on Mindfulness-Based Cognitive Therapy, they discovered that over the course of eight weeks, two-thirds of their patients had a decrease in OCD symptoms. Unlike ERP, MBCT does not require deliberately exposing patients to their fears. Nonetheless, when a stressful incident occurs, the patient is urged to take time to reflect on their thoughts and feelings. MBCT focuses on the attitude toward preoccupation rather than the ideas.
A Word from Tulasi Healthcare
Tulasi Healthcare is a psychiatric rehab center in Gurgaon providing treatment for people suffering from mental disorders. Obsessive-compulsive disorder (OCD) is a crippling condition that is frequently under-reported. Screening people for symptoms of the disease is critical. It is critical to educate medical professionals, as well as those who work in educational systems with teenagers, to be more alert.
We’re getting closer to identifying what OCD is by pinpointing specific locations in the brain and focusing on the chemicals involved. Because OCD affects such a large percentage of the population, having therapists who are trained to deal with it is critical. As health care providers, it is our obligation to promote awareness and inform patients about treatment alternatives.
Primary care professionals, psychiatrists, psychologists, psychiatric nurses, social workers, and pharmacists work together to enhance outcomes. Prescriptions are reviewed by pharmacists, who also educate patients and their families and aid the team by screening for drug interactions. Clinicians can also seek advice from board-certified psychiatric pharmacists in order to administer the most effective medications.
Psychiatric nurses keep track of patients, educate them, and keep the rest of the team up to date on their progress. Patients with OCD may benefit from this multidisciplinary approach to treatment.