Obsessive–compulsive disorder, also referred to as obsessive neurosis or OCD (Obsessive Compulsive Disorder), is a condition classified among personality disorders. Obsessive neurosis occurs in approximately 2–3% of the population. The first symptoms of this type of disorder usually appear between the ages of 10 and 19.
What is Obsessive–Compulsive Disorder (OCD)?
Obsessive–compulsive disorders belong to the group of mental disorders; therefore, this condition does not belong to the group of mental illnesses. People with obsessive neurosis are characterized by a persistent pattern of behavior manifested in a constant pursuit of perfection. The main symptoms characteristic of OCD are obsessions (persistent, recurring thoughts) and compulsions (performing repetitive compulsive actions). Obsessive neurosis is diagnosed equally in women and men, with the difference that the first symptoms appear around the age of 20 in women and around the age of 16 in men.
Symptoms of Obsessive–Compulsive Disorder
The main symptoms present in people with obsessive–compulsive disorder are obsessions and compulsions.
Obsessions are recurring, intrusive thoughts over which the person suffering from this condition has no control. Any attempts to resist or push away intrusive thoughts only lead to their intensification. A person experiencing obsessions is aware of their irrational nature, yet they remain beyond their full control.
Compulsions, which constitute one of the main symptoms of OCD, are repetitive, seemingly purposeless behaviors or rituals performed in a specific way and in a fixed order. Most often, obsessions and compulsions occur simultaneously (for example, the compulsion to wash hands is associated with obsessive thoughts about fear of dirt or contamination).
Other symptoms that may also occur in the course of obsessive neurosis include: lowered mood, inability to think and act freely, affective disturbances, and symptoms of depersonalization (a disturbance in the perception of oneself and the surrounding environment).
Causes of Obsessive–Compulsive Disorder
The causes of obsessive–compulsive disorder consist of a combination of psychosocial and biological factors.
Psychosocial factors
Psychosocial factors play an important role in the development of obsessive neurosis. Research shows that individuals suffering from this type of personality disorder often come from families where emotions were not openly expressed. Families were typically characterized by strict discipline and the use of punishment. In people with obsessive–compulsive disorders, the dominant emotion is guilt, which is associated with an excessive sense of responsibility. Obsessions and compulsive behaviors that appear in obsessive neurosis serve to reduce tension resulting from anxiety and guilt.
Biological factors
Obsessive–compulsive disorders may also originate from past infections of the nervous system, injuries to the central nervous system, or may result from the course of neurological disorders. Studies also indicate a significant role in the pathogenesis of OCD of neurotransmitter imbalances, particularly serotonin and dopamine. Another possible cause of obsessive neurosis may be hormonal imbalance (elevated levels of oxytocin, somatostatin, growth hormone, and cortisol in the plasma).
How is Obsessive–Compulsive Disorder Diagnosed?
The diagnosis of obsessive–compulsive disorder is based on the following criteria:
► presence of a persistent pattern of preoccupation with order and perfectionism at the expense of flexibility and openness,
► this behavioral pattern appears in early adulthood and is present in various situations,
► presence of obsessions and/or compulsions,
► rigidity regarding morality, ethics, and values,
► excessive dedication to work at the expense of leisure and pleasure,
► hoarding objects and difficulty discarding items even if they have no sentimental value,
► the patient perceives the symptoms as exaggerated or unreasonable,
► symptoms reported by the patient significantly impair daily functioning,
► symptoms cause distress and occupy the patient for at least 1 hour per day,
► symptoms significantly impair social and occupational functioning,
► the disorder is not the result of the use of psychoactive substances or medications.
How is Obsessive–Compulsive Disorder Treated?
Treatment of obsessive neurosis is based on a combination of psychotherapy and pharmacological treatment. The main treatment method is cognitive–behavioral therapy (CBT). A commonly used technique is exposure with response prevention, which involves exposing the patient to anxiety-provoking stimuli while working on refraining from compulsive behaviors. Studies have shown the effectiveness of this form of treatment in patients with compulsive disorders.
Although cognitive–behavioral therapy is most often the first-line treatment for obsessive neurosis, psychodynamic psychotherapy can also be a helpful method, particularly for individuals who want to analyze more deeply the sources of their difficulties. If psychotherapy does not produce the expected results, pharmacological treatment should be introduced. Selective serotonin reuptake inhibitors (SSRIs) are most commonly used in the treatment of obsessive neurosis.
Prepared by:
MA Barbara Wróblewska
Literature
Rabe – Jabłońska J. (2017). Diagnosis and treatment of obsessive–compulsive disorder. Psychiatry.
Seligman M., Walker E., Rosenhan D. (2003). Psychopathology. Poznań: Zysk & Co. Publishing.