Obsessive-compulsive disorder is a psychological disorder due to overwhelming anxiety that manifests in terms of obsessive thoughts and compulsive behaviors. An individual suffering from obsessive-compulsive disorder experiences obsessive and intrusive thoughts such as anxiety, fear, uneasiness, apprehension and sexual drives that persist notwithstanding suppressive psychological effects that tend to distract the thoughts.
The obsessive thoughts elicits compulsive behaviors such as routine habits of counting, sex, hand-washing, aggressiveness, watching, and many other habits as physical efforts of suppressing the intrusive thoughts. According to National Institute of Mental Health, “obsessive compulsive disorder is an anxiety disorder characterized by recurrent obsessions and/or repetitive compulsive behaviors … repetitive behaviors such as hand-washing, counting, checking, or cleaning are often performed with the hope of preventing obsessive thoughts or making them go away” (2010, p.1).
Therefore, obsessive thoughts and compulsive behaviors are the major characteristics associated with the obsessive-compulsive disorder. In order to explore obsessive-compulsive disorder, this essay examines prevalence rates, symptoms, diagnosis, prognosis and treatment of the disorder.
Epidemiological studies indicate that obsessive-compulsive disorder ranks fourth among psychiatric disorders in the United States. The epidemiological research studies by Epidemiological Catchment Area revealed that approximately 2-3% of the population suffers from obsessive-compulsive disorder and this prevalence is relatively constant across all nations.
Krochmalik and Menzies argue that, “the Cross-National Obsessive Compulsive Disorder Collaborative Group study assessed and compared the prevalence of obsessive compulsive disorder in six countries …results revealed comparable prevalence rates of as those from the Epidemiological Catchment Area study in the United States” (2003, p.19). The findings imply that obsessive compulsive disorder has relatively constant prevalence rates across nations and cultures. Comparative gender and age studies have shown that obsessive disorder has no significant variability in the population. “Similar with most psychological disorders, obsessive compulsive disorder normally starts in adolescent and young adult life, with males often experiencing it earlier than females; however, there appears to be little gender difference in the occurrence of the disorder” (Krochmalik & Menzies, 2003, p.23).
Hence, obsessive-compulsive disorder has no gender preference for it uniformly affects the population in the United States and across the world. Though prevalence rates are low, estimates show that there are more people suffering from the obsessive-compulsive disorder because the condition is hard to diagnose while at the same time people do not seek medical interventions.
Persons suffering from obsessive-compulsive disorder experience obsessive thoughts and/ or compulsive behaviors. Obsessive thoughts are feelings of anxiety that persist in spite of psychological suppressive effects. An Individual suffering from the disorder portrays characteristic symptoms of obsessions such as fears of the unknown, abstract imaginations, sexual drives, aggressions, cleanness, religious beliefs, and apprehension among other obsessive thoughts that distort psychological coordination. The obsessive thoughts are intrusive because they repeatedly penetrate the mind of an individual despite the psychological efforts to eliminate them. Obsessive and intrusive thoughts are chronic and persistent in an individual because they are overwhelming, and these characteristics differentiate these thoughts from normal thoughts.
In response to the obsessive thoughts, an individual portrays compulsive behaviors as cleaning, abnormal habits, counting, hoarding, sex, and many repetitive actions. According to Freeston, “compulsions are repetitive behaviors or mental acts that the person feels driven to perform and can either be overt and observable by others, such as checking that a door is locked, or a covert mental act that cannot be observed” (2005, p.16). The degree of the obsessive-compulsive disorder determines the extent of overt and covert behaviors that an individual portrays.
Like many psychological disorders, psychiatrists can diagnose obsessive-compulsive disorder based on obsessive thoughts or compulsive behaviors or both in an individual.
Structured Clinical Interview Disorder IV (SCID-IV) and Anxiety Disorders Interviews Schedule IV (ADIS-IV) are two main diagnostic standards involved in diagnosis and classification of obsessive-compulsive disorder. Swinson argues that, “the ADIS-IV assesses fewer disorders than the SCID-IV but provides more detailed assessment of the anxiety disorders … the ADIS-IV elicits more information than is needed to rule in or out a diagnosis of obsessive compulsive disorder” (2001, p.230). For effective diagnosis of the obsessive-compulsive disorder, patient should confirm having experiences of obsessive thoughts and compulsive behaviors for psychiatrist to analyze the disorder appropriately.
Usually, it is difficult to diagnose a patient who has obsessive thoughts only or covert behaviors, but overt behaviors apparently depict the symptoms of the disorder.
Uniqueness of the obsessive-compulsive disorder is that it shows slow onset and progression during adolescence or young adult life, making it difficult to diagnose unless the patient is aware of the disorder. Various studies have found out that traumatic experiences usually accelerate progress of the disorder into symptomatic stage where obsessive thoughts and compulsive behaviors become quite evident. Even though psychotherapy and chemotherapy significantly reduce the symptoms associated with the obsessive-compulsive disorder, prospective study conducted for 40 years have found out that, “approximately 60% of the patients displayed signs of general improvement within 10 years of illness, increasing to 80% by the end of the study. However, only 20% achieved full remission even after almost 50 years of illness,” (Freeston, 2001, p.19).
A poor prognosis might occur due to the presence of other mental disorders that complicate the disorder, the symptomatic extent of the disorder, and inability to resist obsessive thoughts and compulsive behavior. On the other hand, a good prognosis occurs due to asymptomatic extent of the disorder, absence of other mental disorders and ability to resist obsessive thoughts and compulsive behaviors.
Therapy interventions such as cognitive behavioral therapy and chemotherapy have proved to be effective in treatment of the obsessive-compulsive disorder. In behavioral therapy, the patient goes through exposure and response prevention technique where psychotherapists induce constant obsessive thoughts while preventing compulsive thoughts, which eventually lead to habituation and resistance to the anxiety effects. Chemotherapy utilizes serotonin reuptake inhibitors such as benzodiazepines, fluoxetine and tricyclic antidepressants many other drugs in order to reduce excessive anxiety elevated by serotonin.
Koran and Hanna (2010), argue that, “whether to utilize cognitive behavioral therapy, serotonin reuptake inhibitors, or combined treatment will depend on factors that include the nature and severity of the patient’s symptoms, the nature of any co-occurring psychiatric and medical conditions and their treatments” (p.11). Out of these treatment techniques, combined therapy has proved to be effective in the treatment of the severe condition of obsessive-compulsive disorder.
Obsessive-compulsive disorder is the fourth cause of mental conditions in the world and it occurs due to the excessive anxiety that elicits obsessive thoughts and ultimately compulsive behaviors as psychological mechanism of regulating the disorder. Persistent thoughts and repetitive behaviors are major characteristics of the obsessive-compulsive disorder. The nature of the disorder, presence of other mental disorder, ability of the patient to resists anxiety and the kind of therapy determines prognosis of obsessive-compulsive disorder.
Early, diagnosis, combined therapy and ability of the patient to regulate anxiety are critical in treatment of the obsessive-compulsive disorder.
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, & Hanna, G. (2010). Practice Guide for the Treatment of Patients with Obsessive Compulsive Disorder. American Psychological Association, 4 (9), 1-96. Krochmalik, A., & Menzies, R.
(2003). The Nature of Obsessive Compulsive Disorder. New York: John Wiley & Sons.
National Institute of Mental Health, (2010). Obsessive Compulsive Disorder. United States Department of Health and Human Services, 6,1-23 Swinson, R. (2001).
Obsessive-Compulsive Disorder: Theory Research, and Treatment. New York: Guilford Press.