1) Obsessive-compulsive disorder (OCD) is a mental disorder characterized by uncontrollable, recurring thoughts and behaviors that one feels compelled to repeat, like checking things repeatedly or performing certain routines. 2) OCD affects about 1-2% of people worldwide at some point in their lives, with symptoms usually beginning before age 35. 3) While the causes are unknown, genetics and environmental factors like illness or abuse may play a role. Treatment involves medication like SSRIs and psychotherapy such as cognitive behavioral therapy.

1. MR. SHEMIL PALLIYAL
CLINICAL INSTRUCTOR
DMWIMS
WAYANAD

2. INTRODUCTION
Obsessive–compulsive disorder (OCD) is a mental
disorder where people feel the need to check things
repeatedly, perform certain routines repeatedly, or
have certain thoughts repeatedly.

3. DEFIINITION
OBSESSIVE-COMPULSIVE DISORDER (OCD) IS A COMMON,
CHRONIC AND LONG-LASTING DISORDER IN WHICH A
PERSON HAS UNCONTROLLABLE, REOCCURRING
THOUGHTS (OBSESSIONS) AND BEHAVIORS
(COMPULSIONS) THAT HE OR SHE FEELS THE URGE TO
REPEAT OVER AND OVER.

4. EPIDEMIOLOGY
Obsessive–compulsive disorder affects about 2.3% of people at
some point in their life. Rates during a given year are about
1.2% and it occurs world wide. It is unusual for symptoms to
begin after the age of thirty five and half of people develop
problems before twenty.
Males and females are affected about equally.

5. CAUSES

6. GENETICS
There appear to be some genetic components with identical
twins more often affected than non-identical twins.[2] Further,
individuals with OCD are more likely to have first-degree family
members exhibiting the same disorders than do matched
controls.

7. INFECTION
Rapid onset of OCD in children and adolescents may be
caused by a syndrome connected to Group A streptococcal
infections (PANDAS) or caused by immunologic reactions to
other pathogens (PANS).

8. ENVIRONMENTAL FACTORS:
There are environmental stressors that can trigger OCD in people with a
tendency toward developing the condition
 Abuse
 Changes in living situation
 Illness
 Death of a loved one
 Work- or school-related changes or problems
 Relationship concern

9. SIGNS & SYMPTOMS

10. Obsessions are repeated thoughts, urges, or mental
images that cause anxiety.
Common symptoms include:
 Fear of germs or contamination
 Unwanted forbidden or taboo thoughts involving sex,
religion, and harm
 Aggressive thoughts towards others or self
 Having things symmetrical or in a perfect order

11. Compulsions are repetitive behaviors that a person with OCD feels
the urge to do in response to an obsessive thought.
Common compulsions include:
 Excessive cleaning and/or handwashing
 Ordering and arranging things in a particular, precise way
 Repeatedly checking on things, such as repeatedly checking to see
if the door is locked or that the oven is off
 Compulsive counting

12.  Not all rituals or habits are compulsions. Everyone double checks
things sometimes. But a person with OCD generally:
 Can't control his or her thoughts or behaviors, even when those
thoughts or behaviors are recognized as excessive
 Spends at least 1 hour a day on these thoughts of behaviors
 Doesn’t get pleasure when performing the behaviors or rituals, but
may feel brief relief from the anxiety the thoughts cause
 Experiences significant problems in their daily life due to these
thoughts or behaviors

13. Some individuals with OCD also have a tic disorder.
Motor tics are sudden, brief, repetitive movements,
such as eye blinking and other eye movements, facial
grimacing, shoulder shrugging, and head or shoulder
jerking. Common vocal tics include repetitive throat-
clearing, sniffing, or grunting sound

15. There is no lab test to diagnose OCD. The doctor bases his or
her diagnosis on an assessment of the patient's symptoms,
including how much time the person spends performing his or her
ritual behaviors.

16. Yale–Brown Obsessive Compulsive
Scale (Y-BOCS)
 The scale is a 10-item scale, each item rated from 0 (no
symptoms) to 4 (extreme symptoms), yielding a total possible
score range from 0 to 40. The scale includes questions about the
amount of time the patient spends on obsessions, how much
impairment or distress. The same types of questions are asked
about compulsions (e.g., time spent, interference, etc.) as well.
The results can be interpreted based on the total score.

17. Y-BOCS SCORE
 0–7 is sub-clinical;
 8–15 is mild;
 16–23 is moderate;
 24–31 is severe;
 32–40 is extreme

18. TREATMENT

19. TREATMENT
OCD is typically treated with medication,
psychotherapy or a combination of the two. Although
most patients with OCD respond to treatment, some
patients continue to experience symptoms.

20. MEDICATION
1. Serotonin reuptake inhibitors (SRIs) and selective serotonin
reuptake inhibitors (SSRIs) are used to help reduce OCD
symptoms.
2. If symptoms do not improve with these types of medications,
research shows that some patients may respond well to an
antipsychotic medication

21. PSYCHOTHERAPY
Psychotherapy can be an effective treatment for adults and children
with OCD. Research shows that certain types of psychotherapy,
including cognitive behavior therapy (CBT) and other related
therapies (e.g., habit reversal training) can be as effective as
medication for many individuals. Research also shows that a type of
CBT called Exposure and Response Prevention (EX/RP) is effective in
reducing compulsive behaviors in OCD

23. OCD cannot be prevented. However, early
diagnosis and treatment can help reduce the time
a person spends suffering from the condition.