This document discusses obsessive-compulsive disorder (OCD). It defines obsessions and compulsions as recurrent, persistent thoughts, images, urges, or rituals. A key characteristic of OCD is that the patient realizes their obsessions are irrational but feels compelled to perform compulsions in response. Common themes of obsessions include dirt, aggression, order, and illness. Typical compulsions include checking, cleaning, counting, and seeking reassurance. Cognitive-behavioral therapy and medication that increases serotonin are effective treatments. OCD can significantly interfere with daily life if left untreated.

1. DR.MD.GIAS UDDIN SAGOR
ASSOCIATE PROF.& HEAD PSYCHIATRY
CMOSHMC, CTG.

2. Obsessions
Recurrent
Persistent thoughts
Impulses,
Images
Rituals,
Preoccupations
Feeling,
Idea, or Sensation.

3. Compulsions
Repetitive
Conscious,
Standardized,
Recurrent behavior,

4. Characteristic feature
A patient with OCD
realizes the irrationality
of the obsession and
experiences both the
obsession and the
compulsion as
egodystonic.

5. Characteristic feature:
subjective sense of a struggle
the patient resist the
Obsession ,which nevertheless
intrudes into awareness.
conviction that to think some
thing is to make it more likely
to happen .
obsessions are recognized by
the person as her own and not
implanted from else where.
obsessions are regarded as un
true or senseless.

6. Principal Features of
OCD
Obsessional forms:
Thoughts
Rumination
Doubts
Impulses
Phobias
Slowness

7. Themes of
obsessions
Dirt and
contamination
Aggression
Orderliness
Illness
Sex
Religion

8. Compulsive Behaviors
 Checking
 Cleaning
 Grooming
 Washing hands ,
 Bathing, Showering ,
 Tooth brushing
 Counting
 Dressing
 Avoiding
 Seeking constant reassurance and
approval
 Masturbation
• Praying
• Repeating words
silently,Touching,Licking,Spitting

9. Epidemiology
Lifetime prevalence
in the general
population
estimated at 2 to 3
percent.

10. Course and prognosis of OCD
Predictors of worse
prognosis:
Early age of onset
Longer duration of illness
Presence of both obsession
and compulsion personality
disorder .
Predictors of good prognosis:
social and occupational
adjustment is good
if symptoms are episodic

11. Treatment
• During last 20 years,
two effective methods
for treating OCD have
been developed:
– Cognitive-Behavioural
Psychotherapy (CBT)
– Medication with a
serotonin reuptake
inhibitor (SRI)

12. Stages of Treatment
• Acute Treatment
Phase:
Treatment is aimed
at ending the
current episode of
OCD.
• Maintenance
Treatment:
Treatment is aimed
at preventing future
episodes of OCD.

13. Components of Treatment
• Education
• Psychotherapy
• Medication

14. Medication
- Clomipramine (may be the
best but has the most
adverse side effects)
- Fluvoxamine
- Fluoxetine
- Sertraline
They inhibit the reuptake of
serotonin into synaptic
nerve terminals

15. Best Treatment Approach
• Best Tr Multi-Modal – that considers the Bio-
Psycho-Social aspects of the person:
• OCD may improve with habilitative changes,
person centered planning, specific behavioral
intervention plans and appropriate
medication treatment and ongoing
monitoring of effectiveness treatment
approach.

16. • Difficulties in Producing
Change

17. OBSESSIVE-COMPULSIVE OR RELATED DISORDER DUE TO ANOTHER
MEDICAL CONDITION
• Body Dys morphic
Disorder
• Hoarding Disorder
• Hair-Pulling Disorder
(Trichotillomania)
• Excoriation (Skin-
Picking) Disorder

18. Body Dysmorphic Disorder
Preoccupation
with an imagined
defect in
appearance. If a
slight physical
anomaly is
present, the
person’s concern
is markedly
excessive.

19. Hoarding Disorder
Hoarding is the acquisition of, and failure to discard,
large numbers of items that appear to have little or
no value.

20. Hair-Pulling Disorder
(Trichotillomania)
Trichotillomania is
an impulse control
disorder
characterized by the
compulsive urge to
pull out one's hair,
leading to hair loss
and balding,
distress, and social
or functional
impairment.

21. Excoriation (Skin-Picking) Disorder
Excoriation disorder
is an impulse control
disorder
characterized by the
repeated urge to
pick at one's own
skin, often to the
extent that damage
is caused.

22. Complications
The obsessions or
compulsions are
• Time-consuming
• Interfere significantly
with the person’s normal
routine,
• Occupational
functioning,
• Usual social activities,
• Relationships.