What does obsessive compulsive behavior mean? Obsessive-compulsive personality disorder (OCD) - symptoms and treatment. Examples of manifestations of ACS in children

An obsessive-compulsive personality must be distinguished from a person with OCD, i.e. which one obsessive-compulsive disorder(obsessive-compulsive neurosis).

Because in the first, somewhat obsessive and ritualistic thinking and behavior may look like an anxious and suspicious trait of character and temperament, and not particularly interfere with himself and those around him, close people.

For the second, overly obsessive symptoms of OCD, for example, fear of infection and frequent hand washing, can significantly interfere with a person, both in his personal and social life. Which can also negatively affect the immediate environment.

However, it should be remembered that the first can easily become the second.

Obsessive-compulsive personality

The obsessive-compulsive personality type is characterized by the following features:

• Their keywords are "Control" and "Must"
• Perfectionism (striving for perfection)
• Consider themselves responsible for themselves and others
• They see others as frivolous, irresponsible and incompetent.
• Beliefs: “I have to manage the situation”, “I have to do everything right”, “I know what is best...”, “You have to do it my way”, “People and yourself need to be criticized in order to prevent mistakes”...
• Catastrophic thoughts that the situation will get out of control
• They control the behavior of others through excessive management, or disapproval and punishment (including the use of force and enslavement).
• They are prone to regret, disappointment, and punishment of themselves and others.
• They often experience anxiety and can become depressed if they fail

Obsessive-compulsive disorder - symptoms

In obsessive-compulsive personality disorder (OCD), the following symptoms appear: symptoms:

• Repetitive obsessive thoughts and compulsive actions that interfere with normal life
• Repetitive obsessive, ritualistic behavior (or imagination) to relieve anxiety and distress caused by intrusive thoughts
• A person with OCD may or may not recognize the meaninglessness of their thoughts and behavior.
• Thoughts and rituals take up a lot of time and interfere with normal functioning, causing psychological discomfort, including among those closest to you.
• Impossibility of independent, volitional control and resistance to automatic thoughts and ritual behavior

Associated OCD symptoms:
Depressive disorder, anxiety and panic disorder, social phobias, eating disorders (anorexia, bulimia)…

The listed accompanying symptoms may be similar to OCD, so differential diagnosis is carried out, distinguishing other personality disorders.

Obsessive disorder

The most common ritual behaviors are washing hands and/or objects, counting out loud or silently, and checking that one's actions are correct...etc.

Obsessive-compulsive disorder - treatment

Treatments for obsessive-compulsive disorder include medication and psychotherapy, such as cognitive behavioral therapy, exposure therapy, and psychoanalysis.

Typically, when OCD is severe and the person has little motivation to get rid of it, drug treatment is used in the form of antidepressants and serotonin reuptake inhibitors, non-selective serotonergic drugs and placebo tablets. (the effect is usually short-lived, and besides, pharmacology is not harmless)

For those who have suffered from OCD for a long time, and are usually highly motivated to cure, the best option is psychotherapeutic intervention without medication (medication, in some difficult cases, can be used at the beginning of psychotherapy).

However, those who want to get rid of obsessive-compulsive disorder and the accompanying emotional and psychological problems should know that psychotherapeutic intervention is labor-intensive, slow and expensive.

But those who have the desire, after a month of intensive psychotherapy, will be able to improve their condition to normal. In the future, to avoid relapses and to consolidate the results, supportive therapeutic meetings may be necessary. (SIGN UP FOR OCD PSYCHOTHERAPY)

An effective treatment for OCD is

Obsessive-compulsive disorder, or, in other words, obsessive-compulsive disorder, is mental disorder, in which a person has obsessive thoughts, ideas, images, perceptions, desires that are extremely difficult or impossible to control, and he tries to cope with them by performing various rituals, the implementation of which also causes him severe discomfort.

Basic symptoms of obsessive-compulsive disorder in adults, this is the presence of a clear cyclicity: an obsessive state arises, followed by the appearance of anxiety or other uncomfortable feelings, and then the person performs a ritual to complete this cycle for a short period of time.

What are the causes of obsessive-compulsive disorder in preschool children? find out right now.

General information and explanation of the diagnosis

Diagnosis of OCD in psychiatry - what is it? How does OCD stand for?

Obsessive-compulsive disorder refers to mental disorders, is part of a broad group of neuroses and is often accompanied by other mental illnesses, such as depressive syndrome, panic disorder, astheno-neurotic syndrome, post-traumatic stress disorder.

The name “obsessive-compulsive disorder” hides the symptomatic features of the disease:

• obsessions. Obsessions include obsessive states that a person cannot remove by force of will, and therefore repeats compulsive actions over and over again that can interrupt or alleviate discomfort, anxiety, and fear for a while;
• compulsions. These are rituals that a person repeats to cope with obsessions.

Example: a young girl, prone to developing neurosis-like conditions due to personality traits, witnesses a fire in a neighboring apartment, and this event triggers the development of obsessive-compulsive disorder.

Several times a day obsessions appear in her head: images of a burning apartment, objects on fire, obsessive chains of reasoning about how exactly a fire can start.

Before leaving home She performs compulsive rituals: turns off all electrical appliances, closes the valve on the gas pipe and checks that she has done everything correctly several times.

Repeatedly, obsessions forced her to return to the apartment again after she had already left it, and check everything again, despite the fact that everything was in order there.

Obsessive-compulsive disorder is a common mental disorder - 2-5% of people have it - and is most often found in residents of developed countries, especially those who live in large cities for a long time.

Why do obsessive actions occur? Find out from the video:

Obsessive personality type

There are a number of personality traits that increase the likelihood that a person will have obsessive-compulsive disorder, and these are established in childhood.

Characteristics of obsessive people:

The obsessive personality type is characteristic of people whom society considers potentially successful.

Their abilities, perseverance, perfectionism, directed in a successful direction, give them the opportunity to achieve significant heights.

But a tendency to ruminate, excessive self-control, blocking the emotional component, the desire to do everything as best as possible make them vulnerable Therefore, such people may develop neuroses.

This Personality is established in childhood and is associated with the pressure of parents who want their child to be the best. They punish for mistakes, even minor ones, and actively praise for successes, scolding for showing emotions and losing self-control.

In the future, children of such parents retain their developed characteristics throughout life. trying to live up to an unattainable, imposed ideal.

Obsessive-compulsive personality type! What is characteristic of this personality type? Find out from the video:

Reasons for development

The biological causes of the deviation are associated with disruptions in the metabolism of serotonin and norepinephrine, which leads to the appearance of pathological anxiety in a person. In turn, these failures arise due to:

Typically, the development of the disease is triggered by a trigger, which can be traumatic experience.

All types of obsessions, from obsessive thoughts to obsessive memories, doubts, desires, in people with obsessive-compulsive neurosis are in one way or another connected with their fears and suppressed emotions, with what they consider painful, dangerous or extremely unacceptable.

For example, fear of death will give rise to obsessions associated with it: a person will involuntarily scroll through scenarios of his own death in his head and be afraid of them; he may even have obsessive images of himself committing suicide.

Repressed sexual desires will give rise to obsessive images associated with sexual actions, thoughts, often those that the patient himself considers deeply unacceptable, therefore, when such thoughts and desires appear, he will experience acute shame and anxiety.

Where does the strong feeling of anxiety for no reason come from? Find out about this from ours.

Symptoms of neurosis and types of obsessions

The main symptom of obsessive-compulsive disorder is presence of a recurring obsession-compulsive cycle, however, the severity of the deviation can vary from mild, when the disease does not cause a person significant discomfort, to extremely severe, in which the patient is deeply immersed in a cycle of repeated obsessions and rituals, and is unable to work or study.

Features of the course of obsessive-compulsive neurosis:

Types of obsessive states:

How to stop a panic attack? you will find on our website.

OCD - psychologist's answer:

OCD and pregnancy

For most women, having a child is serious, responsible step. And the higher the intelligence and prudence of a woman, the harder she tries to ensure that both pregnancy and childbirth go as well as possible, and that the child is born healthy, grows up happy and receives everything he needs for full development.

For many women, severe symptoms of obsessive-compulsive disorder and other mental disorders first appear after the birth of their first child, which is associated both with global hormonal changes that affect mental health and with radical changes in a woman’s life and the need to adapt to new rules.

Obsessions of pregnant and recently given birth women closely related to the child, his health and life.

They are afraid that they will harm him, that they will kill him, that something will happen that will cause him to be born with problems, that the birth will go badly, that the doctors will make a mistake, that the child will be stillborn or die in the first months of life.

The likelihood of neurosis is especially high if a woman had a negative experience associated with pregnancy (miscarriages, forced abortions due to a genetic defect in the embryo, frozen pregnancy, death of a child during childbirth) and if she was anxious before pregnancy, .

Advice from psychotherapists for pregnant women:

1. Share your concerns with someone you trust, for example, a friend, mother, partner. Their support, stories about their own experiences and the experiences of close women, warmth and care are ways to alleviate or completely eliminate anxiety.
2. Analyze your worries if possible. and try to convince yourself that you are doing everything that depends on you for the child. In addition, many fears are related to the effects of hormones, which will subside over time.
3. Study information about OCD, read forums of pregnant women who describe their problems. Understanding that this difficult experience is not unique and that many women go through and have gone through the same thing can also help.

If the symptoms of obsessive-compulsive disorder are severe, you should consult a psychotherapist.

Treatment

When the first signs of OCD appear, it is important not to ignore them and try to help yourself. In some cases, mild forms of the disease can be eliminated if you change your life.

Advice from psychotherapists:

If these measures were not effective, and the neurosis manifests itself quite strongly, you need to turn to specialists and start.

Obsessive-compulsive disorder treated with medications and psychotherapy. Medicines are selected taking into account the characteristics and severity of the disease, and may include antidepressants (Imipramine, Amitriptyline, Setraline) and tranquilizers (Diazepam).

It is considered most effective for obsessive-compulsive neurosis. The patient is also taught a method of stopping thoughts, which allows you to fight obsessions.

Timely initiation of psychotherapeutic treatment can significantly improve the patient’s quality of life, and the skills he learned during therapy will allow him to help himself if the disease returns.

Obsessive-compulsive disorder - self-help techniques:

Obsessive-compulsive disorder(from lat. obsessio- “siege”, “envelopment”, lat. obsessio- “obsession with an idea” and lat. compello- “I force”, lat. compulsio- “coercion”) ( OCD, obsessive-compulsive neurosis) - mental disorder . May be chronic, progressive or episodic.

With OCD, the patient involuntarily experiences intrusive, disturbing or frightening thoughts (so-called obsessions). He constantly and unsuccessfully tries to get rid of anxiety caused by thoughts through equally obsessive and tiresome actions (compulsions). Sometimes it stands out separately obsessive(mainly obsessive thoughts - F42.0) and separately compulsive(mainly obsessive actions - F42.1) disorders.

Obsessive-compulsive disorder is characterized by the development of obsessive thoughts, memories, movements and actions, as well as a variety of pathological fears (phobias).

To identify obsessive-compulsive disorder, the so-called Yale-Brown scale is used.

Epidemiology

CNCG study

OCD and intelligence

intelligence

OCD, 5.5% - alcoholism, 3% - psychosis and affective disorders

Story

bipolar affective disorder

Antiquity and the Middle Ages

Obsessive27 phenomena have been known for a long time. From the 4th century BC. e. obsessions were part of the structure of melancholia. So, her complex according to Hippocrates included:

“Fears and despondency that have existed for a long time.”

In the Middle Ages, such people were considered possessed.

New time

The first clinical description of the disorder belongs to Felix Plater (1614). In 1621, Robert Barton described the obsessive fear of death in his book The Anatomy of Melancholy. Similar obsessive doubts and fears were described in 1660 by Jeremy Taylor and John Moore, Bishop of El. In England in the 17th century, obsessive states were also classified as “religious melancholy,” but, on the contrary, they were believed to occur due to excessive dedication to God.

19th century

In the 19th century, the term “neurosis” became widespread for the first time, and obsessions were included in this category. Obsessions began to be differentiated from delusions, and compulsions from impulsive actions. Influential psychiatrists have debated whether OCD should be classified as a disorder of the emotions, will, or intellect.

folie de doute

obsessive-compulsive disorder Zwangsvorstellung obsession, and in the USA - English. compulsion

XX century

neurasthenia Pierre Marie Felix Janet identified this neurosis as psychasthenia in his work fr. psychasthenia phobic anxiety disorders Sigmund Freud paranoia psychoses such as schizophrenia neuroses.

• fear of infection or contamination;
• fear of harming yourself or others;

Treatment

• b) There must be at least one thought or action that the patient is unsuccessfully resisting, even if there are other thoughts and/or actions that the patient is no longer resisting.
• c) The thought30 of performing an obsessive action should not in itself be pleasant (merely reducing tension or anxiety is not considered pleasant in this sense).
• d) The thoughts, images, or impulses must be unpleasantly repetitive.

It should be noted that the performance of compulsive actions is not in all cases necessarily correlated with specific obsessive fears or thoughts, but may be aimed at getting rid of a spontaneously arising feeling of internal discomfort and/or anxiety.

It includes:

• obsessive-compulsive neurosis
• obsessive neurosis
• anancaste neurosis

To make a diagnosis, it is necessary to first exclude anancastic personality disorder (F60.5).

Differential diagnosis according to ICD-10

ICD-10 notes that the differential diagnosis between obsessive-compulsive disorder and depressive disorder (F 32., F 33.) can be difficult because these two types of symptoms often occur together. In an acute episode, preference is given to the disorder whose symptoms occurred first. When both are present but neither is dominant, it is recommended to assume that the depression was primary. For chronic disorders, it is recommended to give preference to the disorder whose symptoms persist most often in the absence of symptoms of the other.

Occasional panic attacks (F41.0) or mild phobic (F40.) symptoms are not considered a barrier to a diagnosis of OCD. However, obsessive symptoms that develop in the presence of schizophrenia (F 20.), Gilles de la Tourette syndrome (F 95.2.), or an organic mental disorder are regarded as part of these conditions.

It is noted that although obsessions and compulsions usually coexist, it is advisable to establish one of these types of symptoms as the dominant one, since this may determine how patients respond to different types of therapy.

Etiology and pathogenesis

Symptoms and behavior of patients. Clinical picture

Patients with OCD are suspicious people, prone to rare, maximally decisive actions, which is immediately noticeable against the background of their dominant calm. The main signs are painful stereotypical, intrusive (obsessive) thoughts, images or desires, perceived as meaningless, which in a stereotypical form come to the patient’s mind again and again and cause an unsuccessful attempt at resistance. Their typical topics include:

• fear of infection or contamination;
• fear of harming yourself or others;
• sexually explicit or violent thoughts and images;
• religious or moral ideas;
• fear of losing or not having some things that you may need;
• order and symmetry: the idea that everything should be lined up “correctly”;
• superstition, excessive attention to something that is considered as good or bad luck.

Compulsive actions or rituals are stereotypical behaviors repeated over and over again, the meaning of which is to prevent any objectively unlikely events. Obsessions and compulsions are more often experienced as alien, absurd and irrational. The patient suffers from them and resists them.

The following symptoms are indicators of obsessive-compulsive disorder:

• obsessive, recurring thoughts;
• anxiety following these thoughts;
• certain and, in order to eliminate anxiety, often repeated identical actions.

A classic example of this disease is the fear of pollution, in which the patient experiences every contact with what he considers dirty objects causing discomfort and, as a result, obsessive thoughts. To get rid of these thoughts, he starts washing his hands. But even if at some point it seems to him that he has washed his hands sufficiently, any contact with a “dirty” object forces him to start his ritual again. These rituals allow the patient to achieve temporary relief. Despite the fact that the patient realizes the meaninglessness of these actions, he is not able to fight them.

Obsessions

Patients with OCD experience intrusive thoughts (obsessions), which are usually unpleasant. Any minor events can provoke obsessions - such as an extraneous cough, contact with an object that is perceived by the patient as unsterile and non-individual (handrails, door handles, etc.), as well as personal concerns not related to cleanliness. Obsessions can be scary or obscene in nature, often alien to the patient’s personality. Exacerbations can occur in crowded places, for example, on public transport.

Compulsions

To combat obsessions, patients use protective actions (compulsions). Activities are rituals designed to prevent or minimize fears. Actions such as constantly washing hands and face, spitting saliva, repeatedly avoiding potential danger (endlessly checking electrical appliances, closing the door, closing the zipper on the fly), repeating words, counting. For example, in order to make sure that the door is closed, the patient needs to pull the handle a certain number of times (while counting the times). After performing the ritual, the patient experiences temporary relief, moving into an “ideal” post-ritual state. However, after some time, everything repeats itself again.

Etiology

At the moment, the specific etiological factor is unknown. There are several reasonable hypotheses. There are 3 main groups of etiological factors:

1. Biological:
   1. Diseases and functional-anatomical features of the brain; features of the functioning of the autonomic nervous system.
   2. Disturbances in the exchange of neurotransmitters - primarily serotonin and dopamine, as well as norepinephrine and GABA.
   3. Genetic - increased genetic concordance.
   4. Infectious factor (PANDAS syndrome theory).
2. Psychological:
   1. Psychoanalytic theory.
   2. The theory of I.P. Pavlov and his followers.
   3. Constitutional-typological - various accentuations of personality or character.
   4. Exogenously-psychotraumatic - family, sexual or industrial.
3. Sociological (micro- and macrosocial) and cognitive theories (strict religious education, modeling of the environment, inadequate response to specific situations).

Psychological theories

Psychoanalytic theory

In 1827, Jean-Etienne Dominique Esquirol described one of the forms of obsessive-compulsive neurosis - “the disease of doubt” (fr. folie de doute). He wavered between classifying it as a disorder of the intellect and the will.

I.M. Balinsky noted in 1858 that all obsessions have a common feature - alienness to consciousness, and proposed the term “ obsessive-compulsive disorder" A representative of the French psychiatric school, Benedict Augustin Morel, in 1860 considered the cause of obsessive states to be a disturbance of emotions through a disease of the autonomic nervous system, while representatives of the German school, W. Griesinger and his student Karl-Friedrich-Otto Westphal in 1877, pointed out that they emerge when unaffected in other respects the intellect and cannot be expelled from consciousness by it, but they are based on a thinking disorder similar to paranoia. It is the term of the latter that is mute. Zwangsvorstellung, translated into English in the UK as English. obsession, and in the USA - English. compulsion gave the modern name of the disease.

XX century

In the last quarter of the 19th century, neurasthenia included a huge list of different diseases, including OCD, which was still not considered a separate disease. In 1905, Pierre Marie Felix Janet isolated this neurosis from neurasthenia as a separate disease and called it psychasthenia in his work fr. Les Obsessions et la Psychasthenie(Obsessions and Psychasthenia). In the same year, data about him were systematized by S. A. Sukhanov. The term “psychasthenia” became widely used in Russian and French science, while in German and English the term “obsessive-compulsive neurosis” was used. In the USA it became known as obsessive-compulsive neurosis. The difference here is not only in terminology. In domestic psychiatry, obsessive-compulsive disorder is understood not only as obsessive-compulsive disorder, but also as phobic anxiety disorders (F40.), which have different designations in both ICD-10 and DSM-IV-TR. P. Janet and other authors considered OCD as a disease caused by congenital features of the nervous system. In the early 1910s, Sigmund Freud attributed obsessive-compulsive behavior to unconscious conflicts that manifest as symptoms. E. Kraepelin placed it not among psychogeniuses, but among “constitutional mental illnesses” along with manic-depressive psychosis and paranoia. Many scientists attributed it to psychopathy, and K. Kolle and some others - to endogenous psychoses such as schizophrenia, but at the moment it is classified specifically as neuroses.

Treatment and therapy

Modern therapy for obsessive-compulsive disorder must necessarily include a complex effect: a combination of psychotherapy and pharmacotherapy.

Psychotherapy

The use of cognitive behavioral psychotherapy is producing results. The idea of ​​treating OCD with cognitive behavioral therapy is promoted by American psychiatrist Jeffrey Schwartz. The technique he developed allows the patient to resist OCD by changing or simplifying the procedure of “rituals”, reducing it to a minimum. The basis of the technique is the patient’s awareness of the disease and step-by-step resistance to its symptoms.

According to Jeffrey Schwartz's four-step method, it is necessary to explain to the patient which of his fears are justified and which are caused by OCD. It is necessary to draw a line between them and explain to the patient how a healthy person would behave in a given situation (it is better if the example is a person who represents an authority for the patient). As an additional technique, the “thought stopping” method can be used.

According to some authors, the most effective form of behavioral therapy for OCD is the exposure and warning method. Exposure involves placing the patient in a situation that provokes the discomfort associated with obsessions. At the same time, the patient is given instructions on how to resist performing compulsive rituals - preventing a reaction. According to many researchers, most patients achieve lasting clinical improvement after this form of therapy. Randomized controlled trials have shown that this form of therapy is superior to a range of other interventions, including placebo drugs, relaxation and anxiety management skills training.

Unlike drug therapy, after the withdrawal of which the symptoms of obsessive-compulsive disorder often worsen, the effect achieved by behavioral psychotherapy persists for several months and even years. Compulsions usually respond better to psychotherapy than obsessions. The overall effectiveness of behavioral psychotherapy is approximately comparable to drug therapy and is 50-60%, but many patients refuse to participate due to fear of increased anxiety.

Group, rational, psychoeducational (teaching the patient to be distracted by other stimuli that alleviate anxiety), aversive (using painful stimuli when obsessions appear), family and some other methods of psychotherapy are also used.

If there is severe anxiety in the first days of pharmacotherapy, it is advisable to prescribe benzodiazepine tranquilizers (clonazepam, alprazolam, gidazepam, diazepam, phenazepam). In chronic forms of OCD that cannot be treated with antidepressants of the serotonin reuptake inhibitor group (about 40% of patients), atypical antipsychotics (risperidone, quetiapine) are increasingly used.

According to numerous studies, the use of benzodiazepines and antipsychotics has a mainly symptomatic (anxiolytic) effect, but does not affect nuclear obsessional symptoms. Moreover, extrapyramidal side effects of classical (typical) antipsychotics can lead to increased compulsions.

There is also evidence that some of the atypical antipsychotics (those with antiserotonergic effects - clozapine, olanzapine, risperidone) can cause and worsen obsessive-compulsive symptoms. There is a direct relationship between the severity of such symptoms and the doses/duration of use of these drugs.

To enhance the effect of antidepressants, you can also use mood stabilizers (lithium preparations, valproic acid, topiramate), L-tryptophan, clonazepam, buspirone, trazodone, gonadotropin-releasing hormone, riluzole, memantine, cyproterone, N-acetylcysteine.

Biological therapy

It is used only for severe OCD that is refractory to other types of treatment. In the USSR, atropinocomatosis therapy was used in such cases.

In the West, electroconvulsive therapy is used in these cases. However, in the CIS countries its indications are much narrower, and it is not used for this neurosis.

Physiotherapy

According to data for 1905, the following were used to treat obsessive-compulsive disorder in pre-revolutionary Russia:

1. Warm baths (35 °C) lasting 15-20 minutes with a cool compress on the head in a well-ventilated room 2-3 times a week with a gradual decrease in water temperature in the form of rubdowns and douches.
2. Rubbing and dousing with water from 31 °C to 23-25 ​​°C.
3. Swimming in river or sea water.

Prevention

1. Primary psychoprophylaxis:
   1. Prevention of traumatic influences at work and at home.
   2. Prevention of iatrogeny and didactogeny (proper upbringing of a child, for example, not instilling in him an opinion about his inferiority or superiority, not creating a feeling of deep fear and guilt when committing “dirty” acts, healthy relationships between parents).
   3. Preventing family conflicts.
2. Secondary psychoprophylaxis (relapse prevention):
   1. Changing the attitude of patients to traumatic situations through conversations (persuasive treatment), self-hypnosis and suggestion; timely treatment when detected. Conducting regular medical examinations.
   2. Helping to increase brightness in a room is to remove thick curtains, use bright lighting, make the most of daylight hours, and light therapy. Light promotes the production of serotonin.
   3. General restorative and vitamin therapy, adequate sleep.
   4. Diet therapy (good nutrition, avoidance of coffee and alcoholic beverages, include in the menu foods with a high content of tryptophan (the amino acid from which serotonin is formed): dates, bananas, plums, figs, tomatoes, milk, soy, dark chocolate).
   5. Timely and adequate treatment of other diseases: endocrine, cardiovascular, especially cerebral atherosclerosis, malignant neoplasms, iron and vitamin B12 deficiency anemia.
   6. It is imperative to avoid the occurrence of drunkenness and especially alcoholism, drug addiction and substance abuse. Drinking alcoholic beverages irregularly in small quantities has a sedative effect and therefore cannot provoke a relapse. The effect of using “soft drugs” such as marijuana on the relapse of OCD has not been studied, so they are also best avoided.
3. All of the above related to individual psychoprophylaxis. But it is necessary at the level of institutions and the state as a whole to carry out social psychoprophylaxis - improving the health of work and living conditions, service in the armed forces.

Forecast

Chronicity is most characteristic of OCD. Episodic manifestations of the disease and complete recovery are relatively rare (acute cases may not recur). In many patients, especially with the development and persistence of one type of manifestation (arithmomania, ritual hand washing), a long-term stable condition is possible. In such cases, a gradual mitigation of psychopathological symptoms and social readaptation are noted.

In mild forms, the disease usually occurs on an outpatient basis. Reverse development of manifestations occurs within 1-5 years from the moment of discovery. There may be mild symptoms that do not significantly impair functioning except during periods of increased stress or situations in which a comorbid Axis I disorder (see DSM-IV-TR), such as depression, develops.

More severe and complex OCD with contrasting ideas, numerous rituals, complications with phobias of infection, pollution, sharp objects, and, obviously, obsessive ideas or compulsions associated with these phobias, on the contrary, may become resistant to treatment or show a tendency to relapse (50 -60% in the first 3 years) with disorders that persist despite active therapy. Further deterioration of these conditions indicates a gradual aggravation of the disease as a whole. Obsessions in this case may tend to expand. A common reason for their intensification is either the resumption of a traumatic situation, or a weakening of the body, overwork and prolonged lack of sleep.

Efforts are being made to determine which patients require long-term therapy. In approximately two thirds of cases, improvement with OCD treatment occurs within 6 months to 1 year, most often by the end of this period. In 60-80% the condition not only improves, but practically recovers. If the disease continues for more than a year, fluctuations are observed during its course - periods of exacerbations alternate with periods of remission, lasting from several months to several years. The prognosis is worse if we are talking about an anancastic personality with severe symptoms of the disease, or if there is continuous stress in the patient’s life. Severe cases can be extremely persistent; For example, a study of hospitalized patients with OCD found that three-quarters of them had unchanged symptoms 13-20 years later. Therefore, successful drug treatment should be continued for 1–2 years before discontinuation is considered and discontinuation of pharmacotherapy should be carefully considered, with most patients being advised to continue some form of treatment. There is evidence that cognitive behavioral therapy may have a longer lasting effect than some SSRIs after discontinuation. It has also been proven that people whose condition improves based on drug therapy alone tend to experience relapses after stopping the drug.

Without treatment, OCD symptoms can progress to the point where they affect the patient's life, interfering with their ability to work and maintain important relationships. Many people with OCD have suicidal thoughts, and about 1% commit suicide. Specific symptoms of OCD rarely progress to the development of physical impairment. However, symptoms such as compulsive hand washing can lead to dry and even damaged skin, and recurring trichotillomania can lead to crusting on the patient's scalp.

However, in general, OCD, in comparison with endogenous mental illnesses, like all neuroses, has a favorable course. Although the treatment of the same neurosis in different people can vary greatly depending on the social, cultural and intellectual level of the patient, his gender and age. Thus, the most successful results are in patients aged 30-40 years, women and married people.

In children and adolescents, OCD, on the contrary, is more persistent than other emotional disorders and neuroses, and without treatment after 2-5 years, very few of them fully recover.

Between 30% and 50% of children with obsessive-compulsive disorder continue to exhibit symptoms 2 to 14 years after diagnosis. Although the majority, along with those undergoing drug treatment (for example, SSRIs), experience a slight remission, less than 10% achieve it completely. The reasons for the adverse consequences of this disease are: a weak primary response to therapy, a history of tic disorders, and psychopathy of one of the parents. Thus, obsessive-compulsive disorder is a serious and chronic condition for a significant number of children.

In some cases, a condition bordering between neurosis and anancastic personality disorder is possible, which is favored by: personality accentuation according to the psychasthenic type, personality infantilism, somatic illness, long-term psychotrauma, age over 30 years or long-term OCD, developing in 2 stages:

1. Depressive neurosis (ICD-9:300.4 / ICD-10:F0, F33.0, F34.1, F43.21).
2. Obsessive borderline state (according to O.V. Kerbikov) with a predominance of obsessions, phobias and asthenia.

Characteristics of cognitive (cognitive) function

A 2009 study that used a battery of neuropsychological tasks to assess 9 cognitive domains specifically centered on executive function concluded that there were few neuropsychological differences between people with OCD and healthy participants when confounding factors were controlled.

Labor expertise

Neuroses are usually not accompanied by temporary disability. In case of prolonged neurotic conditions, the medical control commission (MCC) decides on changing working conditions and transferring to easier work. In severe cases, the VKK refers the patient to a medical-labor expert commission (VTEK), which can determine disability group III and give recommendations regarding the type of work and working conditions (light duty, shortened working hours, work in a small team).

Legislation abroad

Although research suggests that OCD sufferers are generally remarkably predisposed to keeping themselves and others safe, some legislation has blanket mental illness laws that may inadvertently have an adverse impact on the civil rights and liberties of OCD sufferers.

Statistical data

At the moment, information on research into the epidemiology of OCD is very contradictory. This is due to different methodological approaches to its calculation, which developed historically in connection with different diagnostic criteria, as well as insufficient research into the disorder, dissimulation and overdiagnosis.

Quite often the prevalence of OCD is stated to be between 1-3%. According to other updated data, its prevalence is approximately 1-3:100 in adults and 1:200-500 in children and adolescents, although clinically recognized cases are less common (0.05-1%), since many may not have this disorder diagnosed due to stigma.

Beginning of the disease. First medical consultation. Duration. Severity of OCD

Obsessive-compulsive disorder most often begins between the ages of 10 and 30. However, the first visit to a psychiatrist usually occurs only between 25 and 35 years. Up to 7.5 years can pass between the onset of the disease and the first consultation. The average age of hospitalization was 31.6 years.

The period of spread of OCD increases in proportion to the observation period. For a period of 12 months it is equal to 84:100000, for 18 months - 109:100000, 134:100000 and 160:100000 for 24 and 36 months, respectively. This rise exceeds what would be expected for a chronic disease with essential medical care provided in a stable population. During the 38 months available for the study, 43% of patients did not have a study diagnosis recorded in the official outpatient medical record. 19% did not visit a psychiatrist at all. However, 43% of patients visited a psychiatrist at least once during 1998–2000. The average frequency of visits to a psychiatrist per 967 patients is 6 times over 3 years. Based on these data, it can be concluded that patients with obsessive-compulsive disorder are not sufficiently supervised.

At the first medical examination, only one of 13 new cases in children and adolescents and one among 23 adults had OCD grade according to the Yale-Brown scale in the English study. CNCG study was hard. If we do not take into account the 31% of cases with questionable criteria, the number of such cases increases to 1:9 for persons under 18 years of age and 1:15 after. The proportion of mild, moderate and severe severity was the same both among newly diagnosed cases of OCD and among previously identified cases. It was 2:1:3 = mild: moderate: severe.

OCD and social conditions, including family life. Gender studies

OCD occurs in all socioeconomic levels. Studies on the distribution of patients into classes are contradictory. According to one of them, 1.5% of patients belong to the upper social class, 23.81% to the upper middle class and 53.97% to the middle class. According to another, among patients from Santiago, the lower class showed a greater tendency to the disease. These studies are significant for health care, since patients from the lower class cannot always get the help they need. The prevalence of OCD is also associated with educational level. The incidence of the disease is lower among those who have completed a college degree (1.9%) than among those without a college degree (3.4%). However, among those who graduated from higher education, the frequency is higher among those who graduated with an advanced degree (respectively 3.1%: 2.4%). Most patients who come for consultation cannot study or work, and if they can, they do so at a very low level. Only 26% of patients can work fully.

Up to 48% of OCD patients are single. If the degree of illness is severe before the wedding, the chance of a marriage union decreases, and if it is concluded, in half of the cases problems arise in the family.

There are certain gender differences in the epidemiology of OCD. At the age of 65 years, the disease was more often diagnosed in men (except for the period 25-34 years), and after that - in women. The maximum difference with a predominance of sick men was observed in the period 11-17 years. After 65, the incidence of obsessive-compulsive disorder fell in both groups. 68% of those hospitalized are women.

OCD and intelligence

Patients with OCD are most often people with a high level of intelligence. According to various data, among patients with OCD, the frequency of high IQ is from 12% to 28.53%. At the same time, high levels of verbal IQ.

OCD and psychogenetics. Comorbidity

The twin method shows high concordance among monozygotic twins. According to research, 18% of parents of patients with obsessive-compulsive disorder have mental disorders: 7.5% - OCD, 5.5% - alcoholism, 3% - anancastic personality disorder, psychosis and affective disorders - 2%. Among non-mental illnesses, relatives of patients with this disease often suffer from tuberculous meningitis, migraine, epilepsy, atherosclerosis and myxedema. It is unknown whether these diseases are associated with the occurrence of OCD in relatives of such patients. However, there are no absolutely accurate studies of the genetics of non-mental illnesses among patients with obsessive-compulsive disorder. 31 out of 40 patients were the first or only child. However, no correlation was found between the developmental defects and the future development of OCD. The fertility rate in patients with this disease is 0-3 for both sexes. The number of premature babies in such patients is small.

25% of patients with OCD had no comorbid conditions. 37% suffered from one other mental disorder, 38% from two or more. The most commonly diagnosed conditions were major depressive disorder (MDD), anxiety disorder (including anxiety disorder), panic disorder, and acute stress reaction. 6% were diagnosed with bipolar affective disorder. The only difference in the gender ratio was that 5% of women were diagnosed with an eating disorder. Among children and adolescents, 25% of patients with obsessive-compulsive disorder had no other mental disorders, 23% had 1, and 52% had 2 or more. The most common were MDD and ADHD. At the same time, as among healthy individuals under 18 years of age, ADHD was more common in boys (in this particular case - 2 times). 1 in 6 was diagnosed with oppositional defiant disorder and excessive anxiety disorder (F93.8). 1 in 9 girls had an eating disorder. Boys often had Tourette's syndrome.

OCD in cinema and animation

• In Martin Scorsese's film The Aviator, the main character (Howard Hughes played by Leonardo DiCaprio) suffered from OCD.
• In the movie As Good As It Gets, the main character (Melvin Adell played by Jack Nicholson) suffered from a whole complex of OCD. He constantly washed his hands, in boiling water and with new soap each time, wore gloves, ate only with his own cutlery, was afraid of stepping on a crack in the asphalt, avoided the touch of strangers, had his own ritual of turning on the light and closing the lock.
• In the TV series Scrubs, Dr. Kevin Casey, played by Michael J. Fox, suffers from OCD with a lot of rituals.
• In Orson Scott Card's novel Xenocide, an artificially bred subspecies of people who speak to the gods suffer from OCD, and their compulsive gestures are considered a rite of purification.
• The film "Dirty Love" quite realistically depicts the symptoms of OCD and Tourette's syndrome, due to which the main character Mark, played by Michael Sheen, loses his home, wife and job.
• In the series Girls, the main character Hannah Horvath suffers from OCD, which is expressed in constantly counting to eight.
• The title character of Monk suffers from OCD.
• In the movie "Inner Road" one of the main characters suffers from OCD.
• In The Big Bang Theory, main character Sheldon Lee Cooper (played by Jim Parsons) bullies his friends about the rules and conditions of being around him due to his OCD.
• On Glee, school psychologist Emma Pillsbury is obsessed with cleanliness due to OCD.
• In the TV series Scorpio, one of the characters, Sylvester Dodd, suffers from OCD.

Data

• In 2000, a group of chemists (Donatella Marazziti, Alessandra Rossi and Giovanni Battista Cassano from the University of Pisa and Hagop Suren Akiskal from the University of California, San Diego) received the Ig Nobel Prize in Chemistry for their discovery that, at the biochemical level, romantic love is indistinguishable from severe obsessive-compulsive disorder.

Literature

• Freud Z. Beyond the Pleasure Principle (1920)
• Lacan J. L'Homme aux rats. Seminaire 1952-1953
• Melman C. La nevrose obsessionelle. Seminaire 1988-1989. Paris: A.L.I., 1999.
• V. L. Gavenko, V. S. Bitensky, V. A. Abramov. Psychiatry and narcology (handbook). - Kiev: Health, 2009. - P. 512. - ISBN 978-966-463-022-8. (Ukrainian)
• A. M. Svyadoshch. Obsessive-compulsive neurosis (obsessive-compulsive and phobic neurosis). // Neuroses (a guide for doctors). - 4th, revised and expanded. - St. Petersburg: Peter (publishing house), 1997. - P. 69-95. - 448 p. - (“Practical medicine”). - 7000 copies. - ISBN 5-88782-156-6.

Today, three in one hundred adults and two in five hundred children are diagnosed with obsessive-compulsive disorder. This is a disease that requires mandatory treatment. We suggest that you familiarize yourself with the symptoms of ACS, the causes of its occurrence, as well as possible treatment options.

What is OKS?

Obsessive-compulsive syndrome (or disorder) is constantly repeating identical obsessive involuntary thoughts and (or) actions (rituals). also called obsessive-compulsive disorder.

The name of the disorder comes from two Latin words:

• obsession, which literally means siege, blockade, taxation;
• compulsion - coercion, pressure, self-coercion.

Doctors and scientists began to be interested in the syndrome back in the 17th century:

• E. Barton described the obsessive fear of death in 1621.
• Philippe Pinel conducted research on obsession in 1829.
• Ivan Balinsky introduced the definition of “obsessive thoughts” into Russian literature on psychiatry and so on.

According to modern research, obsessive syndrome is characterized as a neurosis, that is, it is not a disease in the literal sense of the word.

Obsessive-compulsive syndrome can be schematically depicted as the following sequence of situations: obsessions (obsessive thoughts) - psychological discomfort (anxiety, fears) - compulsions (obsessive actions) - temporary relief, after which everything repeats again.

Types of ACS

Depending on the accompanying symptoms, obsessive syndrome can be of several types:

1. Obsessive-phobic syndrome. Characterized by the presence of only anxieties, fears, doubts that do not lead to any further action. For example, constant rethinking of situations in the past. May also appear as
2. Obsessive-convulsive syndrome- presence of compulsive actions. They may be related to establishing constant order or monitoring security. In terms of time, these rituals can take up to several hours daily and take a lot of time. Often one ritual can be replaced by another.
3. Obsessive-phobic syndrome accompanied by convulsive, that is, (thoughts) and actions arise.

Depending on the time of manifestation, ACS can be:

• episodic;
• progressive;
• chronic.

Causes of obsessive syndrome

Experts do not give a clear answer as to why obsessive syndrome may appear. In this regard, there is only an assumption that some biological and psychological factors influence the development of ACS.

Biological reasons:

• heredity;
• consequences of traumatic brain injuries;
• complications in the brain after infectious diseases;
• pathologies of the nervous system;
• disruption of the normal functioning of neurons;
• decreased levels of serotonin, norepinephrine or dopamine in the brain.

Psychological reasons:

• psychotraumatic relationships in the family;
• strict ideological education (for example, religious);
• experienced serious stressful situations;
• stressful work;
• strong impressionability (for example, an acute reaction to bad news).

Who is susceptible to ACS?

There is a high risk of developing obsessive syndrome in people who have already had similar cases in their family - a hereditary predisposition. That is, if there is a person in the family diagnosed with ACS, then the probability that his immediate offspring will have the same neurosis is from three to seven percent.

The following types of individuals are also susceptible to ACS:

• overly suspicious people;
• those who want to keep everything under their control;
• people who suffered various psychological traumas in childhood or in whose families there were serious conflicts;
• people who were overprotected in childhood or, conversely, who did not receive enough attention from their parents;
• suffered various brain injuries.

According to statistics, there is no division in the number of patients with obsessive-compulsive disorder syndrome between men and women. But there is a tendency that neurosis most often begins to manifest itself in people aged 15 to 25 years.

Symptoms of ACS

The main symptoms of obsessive-compulsive disorder include the appearance of anxious thoughts and monotonous daily activities (for example, a constant fear of saying the wrong word or a fear of germs that forces you to wash your hands frequently). Accompanying symptoms may also appear:

• sleepless nights;
• nightmares;
• poor appetite or complete loss of it;
• gloominess;
• partial or complete detachment from people (social isolation).

Examples of manifestations of ACS in adults

How to diagnose obsessive-compulsive disorder? Symptoms of the disease can manifest differently in each person.

The most common obsessions are:

• thoughts of attacking your loved ones;
• for drivers: worry that they will hit a pedestrian;
• anxiety that you could accidentally cause harm to someone (for example, start a fire, flood, etc. in someone’s house);
• fear of becoming a pedophile;
• fear of becoming homosexual;
• thoughts that there is no love for your partner, constant doubts about the correctness of your choice;
• fear of accidentally saying or writing something wrong (for example, using inappropriate language in a conversation with your superiors);
• fear of living not in accordance with religion or morality;
• anxious thoughts about physiological problems (for example, with breathing, swallowing, blurred vision, etc.);
• fear of making mistakes in work or tasks;
• fear of losing material well-being;
• fear of getting sick, becoming infected with viruses;
• constant thoughts about happy or unlucky things, words, numbers;
• other.

Common obsessive behaviors include:

• constant cleaning and maintaining a certain order of things;
• frequent hand washing;
• security check (are the locks locked, are electrical appliances, gas, water, etc. turned off);
• often repeating the same set of numbers, words or phrases to avoid bad events;
• constant re-checking of the results of your work;
• constant counting of steps.

Examples of manifestations of ACS in children

Children are susceptible to obsessive-compulsive disorder much less frequently than adults. But the symptoms are similar, only adjusted for age:

• fear of ending up in a shelter;
• fear of falling behind parents and getting lost;
• anxiety about grades, which develops into obsessive thoughts;
• frequent hand washing, brushing teeth;
• complexes in front of peers, developing into obsessive syndrome, and so on.

Diagnosis of ACS

Diagnosis of obsessive-compulsive syndrome consists of identifying those same obsessive thoughts and actions that have occurred over a long period of time (at least half a month) and are accompanied by a depressed state or depression.

Among the characteristics of obsessive symptoms for diagnosis, the following should be highlighted:

• the patient has at least one thought or action, and he resists it;
• the idea of ​​fulfilling an impulse does not bring any joy to the patient;
• repeating an obsessive thought causes anxiety.

The difficulty is that it is often difficult to separate obsessive-depressive syndrome from simple ACS, since their symptoms occur almost simultaneously. When it is difficult to determine which of them appeared earlier, then depression is considered to be the primary disorder.

The test will help you identify the diagnosis of obsessive-compulsive syndrome. As a rule, it contains a number of questions related to the type and duration of actions and thoughts characteristic of a patient with ACS. For example:

• the amount of daily time spent thinking about obsessive thoughts (possible answers: not at all, a couple of hours, more than 6 hours, and so on);
• the amount of daily time spent performing obsessive actions (same answers as to the first question);
• sensations from obsessive thoughts or actions (possible answers: none, strong, moderate, etc.);
• Do you control obsessive thoughts/actions (possible answers: yes, no, slightly, etc.);
• Do you have problems washing your hands/taking a shower/brushing your teeth/getting dressed/washing clothes/putting things in order/taking out the trash, etc. (possible answers: yes, like everyone else, no, I don’t want to do it, constant cravings, etc.);
• how much time do you spend showering/brushing your teeth/hairstyle/dressing/cleaning/taking out the trash, etc. (possible answers: like everyone else, twice as much; several times more, etc.).

For a more accurate diagnosis and determination of the severity of the disorder, this list of questions can be much longer.

The results depend on the number of points scored. Most often, the more of them, the higher the likelihood of having obsessive-compulsive syndrome.

Obsessive-compulsive syndrome - treatment

For help in treating ACS, you should contact a psychiatrist, who will not only help in making an accurate diagnosis, but will also be able to identify the dominant type of obsessive disorder.

How can you generally defeat obsessive syndrome? Treatment of ACS involves a series of psychological therapeutic measures. Medicines fade into the background here, and often they can only maintain the result achieved by the doctor.

As a rule, tricyclic and tetracyclic antidepressants are used (for example, Melipramin, Mianserin and others), as well as anticonvulsants.

If there are metabolic disorders that are necessary for the normal functioning of brain neurons, then the doctor prescribes special drugs for example, Fluvoxamine, Paroxetine, and so on.

Hypnosis and psychoanalysis are not used as therapy. In the treatment of obsessive-compulsive disorder, cognitive-behavioral approaches are used, which are more effective.

The goal of this therapy is to help the patient stop focusing on obsessive thoughts and ideas, gradually drowning them out. The principle of operation is as follows: the patient should focus not on anxiety, but on refusing to perform the ritual. Thus, the patient no longer experiences discomfort from obsession, but from the result of inaction. The brain switches from one problem to another, and after several such approaches, the urge to perform obsessive actions subsides.

Among other well-known methods of therapy, in addition to cognitive behavioral, the “thought stopping” technique is also used in practice. The patient, at the moment of an obsession or action, is advised to mentally say to himself “Stop!” and analyze everything from the outside, trying to answer the following questions:

1. How likely is it that this will actually happen?
2. Do obsessive thoughts interfere with your normal life and to what extent?
3. How strong is the feeling of internal discomfort?
4. Will life become much easier without obsessions and compulsions?
5. Will you be happier without obsessions and rituals?

The list of questions goes on. The main thing is that their goal is to analyze the situation from all sides.

There is also the possibility that the psychologist will decide to use another treatment method as an alternative or as additional help. This depends on the specific case and its severity. For example, this could be family or group psychotherapy.

Self-help for ACS

Even if you have the best therapist in the world, you still need to make an effort yourself. Quite a few doctors - one of them, Jeffrey Schwartz, a very well-known ACS researcher - note that independent work on your condition is very important.

For this you need:

• Study all possible sources about obsessive disorder yourself: books, medical journals, articles on the Internet. Learn as much as you can about neurosis.
• Practice the skills your therapist taught you. That is, try to suppress obsessions and compulsive behavior on your own.
• Maintain constant contact with loved ones - family and friends. Avoid social isolation, as it only makes OCD worse.

And most importantly, learn to relax. Learn at least the basics of relaxation. Use meditation, yoga or other methods. They will help reduce the impact of OCD symptoms and the frequency of their occurrence.

Content

Anxiety, fear of trouble, repeated hand washing are just a few signs of a dangerous obsessive-compulsive disease. The fault line between normal and obsessive states can turn into an abyss if OCD is not diagnosed in time (from the Latin obsessive - obsession with an idea, siege, and compulsive - compulsion).

What is obsessive-compulsive disorder

The desire to check something all the time, feelings of anxiety, fear have varying degrees of severity. We can talk about the presence of a disorder if obsessions (from the Latin obsessio - “ideas with a negative connotation”) appear with a certain frequency, provoking the emergence of stereotypical behaviors called compulsions. What is OCD in psychiatry? Scientific definitions boil down to the interpretation that it is a neurosis, a syndrome of obsessive states caused by neurotic or mental disorders.

Oppositional defiant disorder, which is characterized by fear, obsession, and depressed mood, lasts for a long period of time. This specificity of obsessive-compulsive illness makes diagnosis difficult and simple at the same time, but a certain criterion is taken into account. According to the accepted classification according to Snezhnevsky, based on the peculiarities of the course, the disorder is characterized by:

• a single attack lasting from a week to several years;
• cases of relapse of a compulsive state, between which periods of complete recovery are recorded;
• continuous dynamics of development with periodic intensification of symptoms.

Contrasting obsessions

Among the obsessive thoughts encountered in compulsive illness, there arise those that are alien to the true desires of the individual himself. Fear of doing something that a person is not capable of doing due to character or upbringing, for example, blasphemy during a religious service, or a person thinks that he can harm his loved ones - these are signs of contrasting obsession. Fear of harm in obsessive-compulsive disorder leads to strenuous avoidance of the object that caused such thoughts.

Obsessive actions

At this stage, obsessive disorder may be characterized by a need to perform certain actions that bring relief. Often senseless and irrational compulsions (compulsions) take one form or another, and such wide variation makes diagnosis difficult. The occurrence of actions is preceded by negative thoughts and impulsive actions.

Some of the most common signs of obsessive-compulsive illness include:

• frequent hand washing, showering, often using antibacterial agents - this causes fear of contamination;
• behavior when fear of infection forces a person to avoid contact with door handles, toilets, sinks, money as potentially dangerous carriers of dirt;
• repeated (compulsive) checking of switches, sockets, door locks, when the disease of doubt crosses the line between thoughts and the need to act.

Obsessive-phobic disorders

Fear, albeit unfounded, provokes the appearance of obsessive thoughts and actions that reach the point of absurdity. An anxiety state in which obsessive-phobic disorder reaches such proportions is treatable, and rational therapy is considered to be the four-step method of Jeffrey Schwartz or working through a traumatic event or experience (aversive therapy). Among the phobias associated with obsessive-compulsive disorder, the most famous is claustrophobia (fear of enclosed spaces).

Obsessive rituals

When negative thoughts or feelings arise, but the patient’s compulsive illness is far from the diagnosis of bipolar affective disorder, one has to look for a way to neutralize the obsessive syndrome. The psyche forms some obsessive rituals, which are expressed by meaningless actions or the need to perform repeated compulsive actions similar to superstitions. The person himself may consider such rituals illogical, but anxiety disorder forces him to repeat everything all over again.

Obsessive-compulsive disorder - symptoms

Obsessive thoughts or actions that are perceived as wrong or painful can cause harm to physical health. Symptoms of obsessive-compulsive disorder can be single and have varying degrees of severity, but if you ignore the syndrome, the condition will worsen. Obsessive-compulsive neurosis can be accompanied by apathy and depression, so you need to know the signs that can be used to diagnose OCD:

• the emergence of an unreasonable fear of infection, fear of contamination or trouble;
• repeated obsessive actions;
• compulsive behavior (defensive actions);
• excessive desire to maintain order and symmetry, obsession with cleanliness, pedantry;
• “getting stuck” on thoughts.

Obsessive-compulsive disorder in children

It occurs less frequently than in adults, and when diagnosed, compulsive disorder is more often detected in adolescents, and only a small percentage are children under 7 years of age. Gender does not affect the appearance or development of the syndrome, while obsessive-compulsive disorder in children does not differ from the main manifestations of neurosis in adults. If parents manage to notice signs of OCD, then it is necessary to contact a psychotherapist to choose a treatment plan using medications and behavioral or group therapy.

Obsessive-compulsive disorder - causes

A comprehensive study of the syndrome and many studies have not been able to give a clear answer to the question about the nature of obsessive-compulsive disorders. Psychological factors (stress, problems, fatigue) or physiological (chemical imbalance in nerve cells) can affect a person’s well-being.

If we look at the factors in more detail, the causes of OCD look like this:

1. stressful situation or traumatic event;
2. autoimmune reaction (consequence of streptococcal infection);
3. genetics (Tourette's syndrome);
4. disruption of brain biochemistry (decreased activity of glutamate, serotonin).

Obsessive-compulsive disorder - treatment

Almost complete recovery is not excluded, but long-term therapy will be required to get rid of obsessive-compulsive neurosis. How to treat OCD? Treatment of obsessive-compulsive disorder is carried out comprehensively with sequential or parallel use of techniques. Compulsive personality disorder in severe forms of OCD requires medication or biological therapy, and in mild cases, the following methods are used. This:

• Psychotherapy. Psychoanalytic psychotherapy helps to cope with some aspects of compulsive disorder: adjusting behavior during stress (exposure and warning method), teaching relaxation techniques. Psychoeducational therapy for obsessive-compulsive disorder should be aimed at deciphering actions, thoughts, and identifying causes, for which family therapy is sometimes prescribed.
• Lifestyle correction. A mandatory review of the diet, especially if there is a compulsive eating disorder, getting rid of bad habits, social or professional adaptation.
• Physiotherapy at home. Hardening at any time of the year, swimming in sea water, warm baths of medium duration and subsequent wiping.

Drug treatment for OCD

A mandatory item in complex therapy, requiring a careful approach from a specialist. The success of drug treatment for OCD is associated with the correct choice of drugs, duration of use and dosage for exacerbation of symptoms. Pharmacotherapy provides for the possibility of prescribing medications of one group or another, and the most common example that can be used by a psychotherapist for the recovery of a patient is:

• antidepressants (Paroxetine, Sertraline, Citalopram, Escitalopram, Fluvoxamine, Fluoxetine);
• atypical antipsychotics (Risperidone);
• mood stabilizers (Normotim, Lithium carbonate);
• tranquilizers (Diazepam, Clonazepam).

Video: obsessive-compulsive disorders

Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and give treatment recommendations based on the individual characteristics of a particular patient.

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