Obsessive compulsive disorder (OCD) is characterized by persistent unwanted thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) performed in an effort to manage associated anxiety. Common compulsions include excessive handwashing, cleaning, or checking behaviors. OCD is linked to abnormalities in brain regions involved in decision making and cognitive control like the frontal lobes and basal ganglia. Symptoms include obsessions, compulsions, anxiety, and disturbances to daily functioning and self-esteem. Treatment focuses on limiting compulsive behaviors without interrupting them, teaching coping strategies to manage anxiety, and providing a structured and predictable environment.

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Obsessive Compulsive Disorder (OCD)
Description
Obsessive Compulsive Disorder (OCD) is characterized by persistent thought and urges to
perform repeated acts or rituals, usually as a means of releasing tension or anxiety. The
frequency and intensity of the ritualistic behaviors, such as handwashing, ordering, or checking,
are time consuming (taking more than one hour per day) and cause marked distress, significant
impairment, or interfere with daily living.
1. Obsession
o The person experiences recurrent and persistent thoughts, impulses, images that are
intrusive, disturbing, inappropriate, and usually triggered by anxiety.
o The thoughts, images, and impulses are not simply excessive worries about real life
problems.
o The person recognizes the thoughts, images, and impulses are from within own mind.
2. Compulsion
o Repetitive behaviors or mental acts
that a person feels driven to perform,
which usually adhere to a rigid and
specifically defined routine.
o The behaviors and ideations are
typically aimed at reducing anxiety or
preventing some dreaded situation
from occurring.
Specific Biological Factors
There is some evidence that indicates OCD is
linked to a deficiency in serotonin.
Clients have also been shown to have abnormalities in frontal lobes and basal ganglia; it is
unclear what the implications are for clinical care.
Signs and Symptoms
Obsessions – recurrent, persistent ideas, thoughts or impulses, involuntarily coming to
awareness.
Ruminations – forced preoccupation with thoughts about a particular topic, associated with
brooding and inconclusive speculation.
Cognitive rituals – elaborate series of mental acts the client feels compelled to complete.
Compulsive motor rituals – elaborate rituals of everyday functioning such as grooming,
dressing, eating, washing or checking doors or appliances.
Other symptoms – chronic anxiety, low self-esteem, difficulty expressing positive feelings and
depressed mood.

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Nursing Diagnoses
Anxiety
Powerlessness
Ineffective verbal communication
Self-esteem disturbance
Impaired social interaction
Risk for injury
Sleep pattern disturbances
Ineffective breathing pattern
Nursing Interventions
1. Limit, but do not interrupt, the compulsive acts.
2. Teach the client to use alternate coping methods to decrease anxiety.
3. Client’s behavior maybe frustrating to staff and family. Power struggles often result. Consistency
to the approach to care is critical.
4. Assess the client’s needs carefully.
5. Provide an environment that has structure and predictability as a strategy to decrease anxiety.
6. Risk associated with the use of alcohol and drug abuse.