Common, chronic, and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (’obsessions’) and/or behaviours (’compulsions’) that the patient feels the urge to repeat over and over
Aetiology
Mean age of onset - 20
Peak incidence for males - 13-15
Peak incidence for females - 24-25
Clinical features
Obsessional thoughts
Unwanted and uncontrolled thoughts and intrusive images that the person finds it very difficult to ignore
Examples include an overwhelming fear of contamination with dirt or germs or violent or explicit images that keep appearing in their mind
Compulsive acts
Repetitive actions the person feels they must do, generating anxiety if they are not done
Often these compulsions are a way for the person to handle the obsessions e.g. checking that all electrical equipment is turned off to settle the anxiety of obsessing about the house burning down
This is a normal behaviour, but in OCD the person may check every plug in the house 10 times before being able to go to sleep or leave
Investigations
Diagnostic criteria
Obsessional symptoms or compulsive acts must be present most days for at least 2 weeks AND be a source of distress and interference with activities
Obsessions must be individuals own thoughts
Resistance must be present
Rituals are not pleasant
Obsessional thoughts/images/impulses must be repetitive
Management
Low intensity psychological intervention - CBT and ERP