| Obsessive–compulsive disorder | |
|---|---|
 | |
| Frequent, excessive hand washing occurs in some people with OCD | |
| Specialty | Psychiatry |
| Symptoms | Feel the need to check things repeatedly, perform certain routines repeatedly, have certain thoughts repeatedly[1] |
| Complications | Tics, anxiety disorder, suicide[2][3] |
| Usual onset | Before 35 years[1][2] |
| Causes | Unknown[1] |
| Risk factors | Child abuse, stress[2] |
| Diagnostic method | Based on the symptoms[2] |
| Differential diagnosis | Anxiety disorder, major depressive disorder, eating disorders, obsessive–compulsive personality disorder[2] |
| Treatment | Counseling, selective serotonin reuptake inhibitors, clomipramine[4][5] |
| Frequency | 2.3%[6] |
Obsessive–compulsive disorder (OCD) is a mental disorder in which a person feels the need to perform certain routines repeatedly (called "compulsions"), or has certain thoughts repeatedly (called "obsessions").[1] The person is unable to control either the thoughts or activities for more than a short period of time.[1] Common compulsions include hand washing, counting of things, and checking to see if a door is locked.[1] Some may have difficulty throwing things out.[1] These activities occur to such a degree that the person's daily life is negatively affected,[1] often taking up more than an hour a day.[2] Most adults realize that the behaviors do not make sense.[1] The condition is associated with tics, anxiety disorder, and an increased risk of suicide.[2][3]
The cause is unknown.[1] There appear to be some genetic components, with both identical twins more often affected than both non-identical twins.[2] Risk factors include a history of child abuse or other stress-inducing event.[2] Some cases have been documented to occur following infections.[2] The diagnosis is based on the symptoms and requires ruling out other drug-related or medical causes.[2] Rating scales such as the Yale–Brown Obsessive Compulsive Scale (Y-BOCS) can be used to assess the severity.[7] Other disorders with similar symptoms include anxiety disorder, major depressive disorder, eating disorders, tic disorders, and obsessive–compulsive personality disorder.[2]
Treatment involves counseling, such as cognitive behavioral therapy (CBT), and sometimes antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) or clomipramine.[4][5] CBT for OCD involves increasing exposure to what causes the problems while not allowing the repetitive behavior to occur.[4] While clomipramine appears to work as well as SSRIs, it has greater side effects and thus is typically reserved as a second-line treatment.[4] Atypical antipsychotics may be useful when used in addition to an SSRI in treatment-resistant cases but are also associated with an increased risk of side effects.[5][8] Without treatment, the condition often lasts decades.[2]
Obsessive–compulsive disorder affects about 2.3% of people at some point in their lives.[6] Rates during a given year are about 1.2%, and it occurs worldwide.[2] It is unusual for symptoms to begin after the age of 35, and half of people develop problems before 20.[1][2] Males and females are affected about equally.[1] The phrase obsessive–compulsive is sometimes used in an informal manner unrelated to OCD to describe someone as being excessively meticulous, perfectionistic, absorbed, or otherwise fixated.[9]