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Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

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Obsessive-Compulsive Disorder

What is it?

Obsessive-compulsive disorder (OCD) is an anxiety state marked by recurrent, unwanted thoughts or images (obsessions) and unwanted repetitive behaviors (compulsions). Common obsessions include fear of contamination from germs, thoughts of aggressive behavior, and fear of harming oneself; common compulsions include rechecking locked doors, repetitive hand washing, and excessive neatness. People who suffer from OCD recognize that their obsessions and compulsions are unreasonable but they cannot resist the intruding thoughts or ritualistic behavior. Symptoms, which usually first appear in the teens or 20s, are often severe enough to interfere with daily functioning. People with OCD do not necessarily have both obsessions and compulsions; either one is sufficient for a diagnosis. Though previously considered rare,OCD is now estimated to affect 2 to 3 percent of the population.

What Causes It?

  • OCD may be related to an imbalance in certain neurotransmitters (brain chemicals).
  • There appears to be a relationship between OCD and certain neurological or psychological disorders; these include Tourette's syndrome, trichotillomania, body dysmorphic disorder, and hypochondriasis.

Prevention

OCD is not preventable.

Diagnosis

  • A diagnosis is often made based on a personal history of the disorder.
  • A psychiatric evaluation assists in identifying the disorder.
  • A physical examination may rule out physical causes of symptoms that mimic anxiety states, such as asthma or overactive thyroid.

How to Treat It

  • Selective serotonin reuptake inhibitors (SSRIs)—a common class of antidepressants—are effective in treating OCD. However, improvements are more likely for compulsions than for obsessions.
  • The antianxiety drug buspirone may be prescribed to diminish obsessions.
  • A combination of medication and psychotherapy is usually recommended.

When to Call a Doctor

  • Call a doctor if obsessive thoughts interfere with daily functioning or if compulsive behaviors consume an excessive amount of time. d Obsessive-Compulsive Disorder