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Fs obsessive-compulsive disorder (maech 08).pub
Obsessions are intrusive, irrational thoughts — unwanted ideas or impulses that
repeatedly come up in a person’s mind. Again and again, the person experiences
disturbing thoughts, such as “My hands must be contaminated; I must wash them”; “I may have left the gas stove on”; “I am going to injure my child.” On one level, the
sufferer knows these obsessive thoughts are irrational but on another level, he or she
fears these thoughts might be true. Trying to avoid such thoughts creates great
Compulsions are repetitive rituals such as hand washing, counting, checking,
hoarding, or arranging. An individual repeats these actions, perhaps feeling momen-
tary relief, but without feeling satisfaction or a sense of completion. People with OCD feel they must perform these compulsive rituals or something bad will happen.
Most people at one time or another experience obsessive thoughts or compulsive behaviors. Obsessive-compulsive disorder occurs when an individual experiences
obsessions and compulsions for more than an hour each day, in a way that interferes
The National Institute of Mental Health estimates that more than 2% of the U.S.
population will suffer from OCD at some point in their lives.
OCD is often described as “a disease of doubt”. Sufferers experience “pathological
doubt” because they are unable to distinguish between what is possible, what is
probable, and what is unlikely to happen.
Response to treatment varies from person to person. Most people treated with
effective medications find their symptoms reduced by about 40 to 50%. That can
often be enough to change their lives, to transform them into functioning individuals.
People with OCD generally attempt to hide their problem rather than seek help. Often they are remarkably successful in concealing their obsessive-compulsive symptoms
from friends and co-workers. An unfortunate consequence of this secrecy is that peo-ple with OCD generally do not receive professional help until years after the onset of their disease. By that time, the obsessive-compulsive rituals may be deeply ingrained and very difficult to change. OCD will not go away by itself, so it is important to seek treatment. OCD is a chronic disease. Fortunately, effective treatments are available that make life with OCD much easier to manage.
People from all walks of life can get “talk therapy”, but there is evidence cate. Scientists have also observed OCD. It strikes people of all social that behavior therapy can be effective, that people with OCD have and ethnic groups, and both males alone or in combination with medica- increased metabolism in the basal and females. Symptoms typically tion. People with OCD can often say ganglia and the frontal lobes of the begin during the teenage years or “why” they have obsessive thoughts or brain. This, scientists believe, young adulthood.
why they behave compulsively. But causes repetitive movements, rigid the thoughts and the behavior continue. thinking, and lack of spontaneity.
suggests that OCD results from a People whose brains are injured levels of the hormone vasopressin.
chemical imbalance in the brain. For sometimes develop OCD, which years, mental health professionals suggests it is a physical condition. incorrectly assumed OCD resulted Clinical researchers have implicated from bad parenting or personality certain brain regions in OCD. They defects. This theory has been dis- have discovered a strong link between proven over the last 20 years. OCD OCD and a brain chemical called symptoms are not relieved by
psychoanalysis or other forms of mitter that helps nerve cells communi-
Can OCD be effectively treated? Yes, with medication and behavior
toms associated with OCD. The directly or by imagination, and are
SSRIs most commonly prescribed for then discouraged or prevented from OCD are Luvox (fluvoxamine), Paxil carrying out the usual compulsive
(paroxetine), Prozac (fluoxetine), and response. For example, a compul-
Zoloft (sertraline). Medications sive hand-washer may be urged to
should be tried consistently for 10 to touch an object he or she believes is 12 weeks before effectiveness can be contaminated and denied the oppor-
Behavior therapy is not tradi- consumer gradually experiences
tional psychotherapy. It is “exposure less anxiety from the obsessive
and response prevention”, and it is thoughts and becomes able to re-
effective for many people with OCD. frain from the compulsive actions
Consumers are deliberately exposed for extended periods of time.
NAMI San Diego, a non-profit organization, provides education, support
services, and advocacy to improve the quality of life of everyone affected by
mental illnesses. It is an affiliate of the National Alliance on Mental Illness (NAMI) and NAMI California. Its membership includes persons with brain
disorders, their families, friends, mental health professionals and supportive
NAMI offers monthly informational meetings, a monthly newsletter, free
educational programs, a lending library of books and video-tapes, and support meetings for consumers and families throughout the county.
Original information supplied by NAMI National. This information may be reproduced for non-commercial purposes only, and must include NAMI’s name, logo, and contact information (may 2005)
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LA PASSION CLASSIFICATRICE EN PSYCHIATRIE : UNE MALADIE CONTEMPORAINE ? Claire GEKIERE, psychiatre de secteur dans le Nord-Isère Colloque du CEFA : « PASSIONS », 8-9 décembre 2006, Paris Trier, compter, classer passionne les psychiatres de longue date. De « L’aliéniste » décrit par Machado de Assis en 1881, qui interne dans sa maison de fous les quatre cinquièmes des habitants de la