OBSESSIVE-COMPULSIVE DISORDER

Mr. DEEPAK SHARMA M.Sc.(NSG)previous

P.G. COLLEGE OF NSG GWALIOR 2015-16

INTRODECTION Obsessions – are unwanted thought images

that effect lot of stress and anxiety

Compulsions – are behaviors or acts that are carried out to reduce anxiety

Obsessive compulsive disorder (OCD) is

a mental disorder where people feel the need to check things repeatedly, perform certain routines repeatedly.

DEFINITION

Obsessive-Compulsive Disorder (OCD) is a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over.

OR Obsessive-compulsive disorder (OCD) is

characterized by unreasonable thoughts and fears (obsessions) that lead you to do repetitive behaviors (compulsions).

EPIDAMIOLOGY Obsessive–compulsive disorder affects about

2.3% of people at some point in their life.

It is unusual for symptoms to begin after the age

of thirty five and half of people develop problems

before twenty.

Males and females are affected about equally.

PREDISPOSING FACTORS1.Genetic factors

Concordance for OCD in twins is significantly higher for monozygotic twins than for dizygotic twins .

The risk is higher if the first-degree relative developed OCD as a child or teen. Ongoing research continues to explore the connection between genetics and OCD and may help improve OCD diagnosis and treatment.

Genetic factors are No single gene identified, but a number of genes play a role

CONT..2. Brain Structure and Functioning

Imaging studies have shown differences in the frontal cortex and subcortical structures of the brain in patients with OCD.

3.biocamical factorsNeurotransmitter Levels Serotonin level is

abnormal

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CONT4. Environmental factors People who have experienced abuse (physical or sexual) in childhood or other trauma are at an increased risk for developing OCD. In some cases, children may develop OCD or OCD symptoms following a streptococcal infection—this is called Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS).

SYMPTOMSObsession symptoms Fear of contamination or dirt Having things orderly and symmetrical Aggressive or horrific thoughts about harming yourself or others Unwanted thoughts, including aggression, or sexual or religious subjects

CONT..Examples of obsession signs and symptoms include: Fear of being contaminated by shaking hands

or by touching objects others have touched Doubts that you've locked the door or turned

off the stove Intense stress when objects aren't orderly or

facing a certain way Images of hurting yourself or someone else Distress about unpleasant sexual images repeating in your mind

CONT…COMPULSION SYMPTOMS

As with obsessions, compulsions typically have themes, such as:

Washing and cleaning Counting Checking Following a strict routine Orderliness

CONT..Examples of compulsion signs and symptoms include: Hand-washing until your skin becomes

raw Checking doors repeatedly to make sure

they're locked Checking the stove repeatedly to make sure it's off Counting in certain patterns

Arranging your canned goods to face the same way

DIAGNOSTIC EVALUATION History taking Mental status examination M.M.S.E. Suggested by demonstration of ritualistic

behaviour that is irrational or excessive MRI and CT SCAN shows enlarged basal ganglia is some patient

CONT.. Positron emission tomography scanning shows increased glucose metabolism in part of the basal ganglia

TREATMENTS AND THERAPIES OCD is typically treated with medication,

psychotherapy or a combination of the two. Although most patients

1.Pharmacology -Antidepressants: main function is to

increase levels of serotonin in the with OCD respond to treatment, some patients continue to experience symptoms. Brain. (e.g. Imipramine, fluvoxamine, sertraline.)

Anxiolytic drug : these drugs are used to relieve mild moderate and severe anxiety and induced sleep(examples ;diagepam, alprozolom)

TREAT CONT…

2. psychotherapy a) Behavior therapy: Behavioral therapy is

a treatment that helps change potentially self-destructing behaviors. It is also called behavioral therapy. 

Exposure and Response Prevention :this is exposure procedure combined with response prevention technique for example;

compulsive hand washers are encouraged to touch contaminated objects and then refrain from washing in order to break the negative reinforcement chain.

TREAT. CONT Thought stopping technique: it is stopping is a technique to help an Individual to learn to stop unwanted thought . Relaxation technique: it include deep breathing exercise progressive muscle Relaxation , meditation and music

TREAT CONT…b) Group therapy: It is the form of psychotherapy in which a group of patient is provide psychotherapy by a therapist as well as the patient interact with other and help problem solving.

TREAT..CONT

3. OTHER TREATMENT ECT : In severe from OCD . ECT may be used.

COMPLICATIONS

Inability to attend work, school or social activities

Overall poor quality of life Anxiety disorders Depression Eating disorders Suicidal thoughts and behavior Alcohol or other substance abuse Contact dermatitis from frequent hand-

washing