Overview
This lecture covers the key features, risk factors, treatments, and research opportunities related to Obsessive-Compulsive Disorder (OCD).
What is Obsessive-Compulsive Disorder?
- OCD is a chronic disorder marked by uncontrollable, recurring thoughts (obsessions) and repetitive behaviors (compulsions).
- Individuals feel compelled to perform certain behaviors repeatedly to reduce distress caused by obsessions.
Risk Factors
- Genetics: Having a first-degree relative with OCD increases risk, particularly if their onset was in childhood/adolescence.
- Brain Structure/Function: Differences in frontal cortex and subcortical brain areas are observed in those with OCD.
- Environment: Childhood trauma or abuse raises the likelihood of developing OCD.
- In rare cases, children may develop OCD symptoms after strep infection (PANDAS).
Treatments and Therapies
- Medication: SRIs and SSRIs (e.g., clomipramine, fluoxetine, fluvoxamine, sertraline) are commonly prescribed and may require higher doses than for depression.
- Antipsychotic medications may be used if SSRIs/SRIs are ineffective, especially with co-occurring tic disorders.
- Psychotherapy: Cognitive behavioral therapy (CBT), especially Exposure and Response Prevention (EX/RP), is highly effective.
- Some patients may need combination treatments or newer therapies like deep brain stimulation (DBS).
Other Important Information
- OCD often co-occurs with anxiety, depression, or body dysmorphic disorder; these should be considered in treatment planning.
- Medication changes should only be made under medical supervision to avoid withdrawal or worsening symptoms.
Research and Clinical Trials
- Clinical trials test new treatments or approaches for OCD and are primarily for advancing scientific knowledge.
- Participation decisions should be made in consultation with a health professional.
- Trials can be found at ClinicalTrials.gov.
Key Terms & Definitions
- Obsessions — persistent, unwanted thoughts or urges.
- Compulsions — repetitive behaviors performed to relieve obsessions.
- Selective Serotonin Reuptake Inhibitors (SSRIs) — medications that increase serotonin levels in the brain, used to treat OCD.
- Exposure and Response Prevention (EX/RP) — a CBT method encouraging exposure to obsession triggers without performing compulsions.
- PANDAS — Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections; sudden OCD onset after strep infection.
Action Items / Next Steps
- Read “Obsessive-Compulsive Disorder: When Unwanted Thoughts Take Over” brochure.
- Review current statistics on OCD prevalence and treatment at NIMH’s OCD statistics webpage.
- Consult ClinicalTrials.gov if interested in learning about or participating in ongoing OCD research studies.