Obsessive compulsive disorder is defined by feelings of compulsion to perform repetitive behaviors or dwell on obsessive thoughts. It is caused by genetic and biochemical factors and treated with antidepressants, exposure therapy, and other psychotherapies. The main clinical features are obsessive thoughts, images, doubts, and rituals performed to relieve anxiety. Nurses assess patients' obsessive and compulsive behaviors, provide a structured schedule, and support efforts to reduce ritualistic behaviors.

1. SUSHEEL
DAYALWANSI
(Assistant nursing
lecturer)
OBSESSIVE
COMPULSIVE
DISORDER

2. DEFINITION
Obsessive compulsive disorder is a state in
which “The outstanding symptoms is a feeling
of subjective compulsion– to carry out some
action, to dwell on an idea, to recall an
experience, or ruminate on an abstract topic.
OR
OCD is define as the repetitive same of
experience, recall moments, behavior and
activity, such as washing the hands, repetition
of words.

3. ETIOLOGY
 Genetic factors (Monozygotic twins 35% )
Biochemical factors (Abnormal secretion
of neurotransmitter serotonin ( 5-HT
Hydroxytryptamine )
Psychoanalytic theory
Behavior therapy- this theory explains
obsession as a condition of stimulus to
anxiety also called as learned theory.

4. CLINIC FEATURES
 OBSESSIONAL THOUGHTS:- These are words, ideas,
& beliefs that intrude forcibly into the patient mind.
 OBSESSIONAL IMAGES:- Repeated images, scenes,
and abnormal sexual practices.
 OBSESSIONAL RUMINATION:- ( Thoughts
rumination)
 OBSESSIONAL DOUBTS:- Checking again and again
stoves, lock, door & window.
OBSESSIONAL IMPULSES:- Behave a violent &
embarrassing kind such as injuring a child, shoutinng
in church.
OBSESSIONAL SLOWNESS:- It leads to marked
slowness in daily activities.

5.  OBSESSIONAL RITUALS:- Doing repetitive
action or activity such as washing hand 20
times per day. (Thought of contamination)
OTHERS:-
 Recurrent unwanted thoughts.
 Repetitive acts.
 Lack of concentration & task completion.
 Impaired social or work functioning.
DIAGNOSTIC EVALUATION:-
 By demonstration of ritualistic behavior that is
irrational or excessive.
 By M.R.I. & C.T. scan.
 Positron emission tomography scanning (Increase
glucose metabolism in part of basal ganglia)

6. TREATMENT
A. PHARMACOTHERAPY:-
Antidepressants (Fluvoxamine, sertraline)
Anxiolytics (Benzodiazepines, clonazepam)
B. BEHAVIOR THERAPY:-
Exposure and response prevention
Thought stoppage (chair sit method , one thought, self
hypnosis)
Relaxation therapy
Desensitization (process of reducing sensitivity)
Aversive Conditioning.
C. OTHER THERAPY:-
Supportive psychotherapy
E.C.T.- for patient refractory to other forms of
treatment.

7. NURSING MANAGENT
ASSESSMENT:-
 Collect the physical , psychological & social data.
 Assess patient repetitive ideas & action.
 Assess the patient obsession & compulsive physical
functioning.
NURSING DIAGNOSIS:-
 Ineffective individual coping related to under
developed ego, punitive superego, avoidance
learning, possible biochemical changes, evidenced
by ritualistic behavior or obsessive thoughts.
 Altered role performing related to the need to
perform rituals, evidenced by inability to fulfill usual
patterns of responsibility.

8. NURSING INTERVENTION
 Work with patient to determine types of
situation that increase anxiety and result in
ritualistic behavior.
Support patient’s efforts to explore the
meaning and purpose of the behavior.
Provide structured schedule of activities for
patient, include adequate time for completion
of rituals.
Give positive reinforcement for non ritualistic
behavior.
Encourage patient to discuss conflicts.