Obsessive-Compulsive Disorder (OCD)
Is obsessive-compulsive disorder curable? Comprehensive information about the causes, symptoms, and treatments for OCD.
Symptoms and Causes
Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by recurrent unwanted thoughts or images (obsessions), frequently manifesting as fears, which lead to repetitive behaviors (compulsions) aimed at relieving the anxiety caused by the obsession. This behavior is uncontrollable, impairing normal daily functioning.
There are different types of OCD depending on the cause of the obsessions:
- Contamination OCD: characterized by fear of contamination by viruses, bacteria, or germs, resulting in excessive hygiene practices. This may manifest as constant cleaning at home, repeated hand washing, or avoidance of contact with others.
- Verification OCD: involves the need to repeatedly check certain situations or actions, such as ensuring the gas valve is turned off or the door is locked.
- Order OCD: characterized by obsession with order and symmetry; affected individuals believe that something bad will happen if items are not properly arranged. Common behaviors include organizing pencils by length or clothing by color.
- Repetition OCD: involves the compulsion to repeat actions a specific number of times, such as repeating a word several times or pressing a switch a precise number of times.
- Impulse Phobia: characterized by intrusive fear of harming others or oneself.
- Hoarding OCD: characterized by accumulation of large quantities of objects, usually to avoid discarding something perceived as important. Unlike Diogenes syndrome, this does not necessarily involve garbage.
Managing OCD requires psychological or psychiatric treatment, as attempts to ignore obsessions increase stress and anxiety, leading to more intrusive thoughts and progressive worsening. Although full remission is not always possible, pharmacological treatments show very good results.
Symptoms
OCD typically presents with both obsession and compulsion symptoms, although some patients exhibit symptoms of only one type:
- Fear of dirt or contamination.
- Unwanted, usually negative, intrusive thoughts (e.g., aggression or inappropriate sexual content).
- Low tolerance to uncertainty.
- Frequent checking behaviors.
- Excessive concern for order.
- Persistent sensation of unfinished tasks.
- Avoidance of certain situations due to fear.
- Physical symptoms such as dermatitis, palpitations, muscle tension, gastrointestinal disorders, or memory impairment.
Causes
Although the exact causes of OCD have not been fully determined, studies suggest associations with:
- Dysfunction of certain brain circuits, e.g., basal ganglia.
- Serotonin dysregulation (a neurotransmitter regulating emotions, appetite, and body temperature).
- Genetic components.
- Anxiety-reduction mechanisms.
Risk Factors
Factors increasing the likelihood of developing OCD include:
- Family history.
- Mental health disorders (depression, anxiety, tics, etc.).
- Stressful life events.
Complications
If untreated or worsening, OCD can cause:
- Difficulties in social and personal relationships.
- Occupational or academic problems.
- Poor quality of life.
Prevention
OCD cannot be prevented, but risk may be reduced through basic health and emotional well-being measures.
Which specialist treats obsessive-compulsive disorder?
Clinical psychologists and psychiatrists diagnose and treat OCD.
Diagnosis
Specialists diagnose OCD through:
- Psychological evaluation based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria. To confirm OCD, at least four of the following must be met:
- Persistent concern for order.
- Preoccupation with rules, schedules, lists.
- Excessive dedication to work.
- Rigidity regarding ethical or moral issues.
- Resistance to discarding unnecessary or damaged objects.
- Refusal to delegate tasks.
- Obstinacy.
- Physical examination to rule out other conditions.
Treatment
Most cases benefit from a combined treatment approach including:
- Psychotherapy: sessions aim to increase tolerance to anxiety caused by not responding to stimuli. Cognitive therapy is often effective in correcting distorted or overvalued beliefs.
- Medication: antidepressants currently show the best efficacy and fewer side effects.
