Related articles: Obsessive-Compulsive Disorder
Definition
Obsessive-compulsive disorder is a psychiatric disorder characterized by:
- recurring thoughts, ideas, images or impulses ( obsession ) that trigger a state of anxiety
- compelling need ( compulsion ) to put in place something that can reduce that anxious state.
Symptoms can begin in childhood, adolescence or early adulthood, but, in most cases, the problem occurs between the ages of 15 and 25.
The cause of obsessive-compulsive disorder is still not entirely clear. Sometimes it seems to depend on a lack of balance in some neurotransmitters, sometimes on development in a family environment characterized by extreme control and empowerment.
Most common symptoms and signs *
- Acrophobia
- anguish
- Performance anxiety
- Depression
- derealization
- dysphoria
- Mood disorders
- ecolalia
- Restlessness
- Nervousness
- Leg itch
- Mood swings
Further indications
The obsessive-compulsive disorder manifests itself in numerous forms, but the symptomatology is mainly characterized, as the name of the condition suggests, by the presence of obsessions and compulsions (anancasmo).
- Obsessions : they are ideas, images or repetitive impulses, which emerge suddenly and become intrusive. Obsessive thoughts cause anxiety and are perceived as disturbing and uncontrollable by those who experience them. The dominant theme can be damage, risk, danger, contamination, contagion, doubt, loss or aggression. For example, people who suffer from obsessive-compulsive disorder can exaggeratedly fear dirt, germs and / or other substances deemed disgusting; they can be terrified of inadvertently causing harm to themselves or others (of any nature: health, economic, emotional, etc.), of losing control of their impulses by becoming aggressive, perverted or self-injuring.
- Compulsions : they are particular actions or repetitive and afinalistic rituals, which the subject performs to try to neutralize the obsessions (eg wash their hands to compensate for the thought of contamination; control the gas closure repeatedly to prevent serious accidents; avoid the people who can induce the fear of behaving aggressively etc.). These behaviors are aimed, therefore, at containing the emotional discomfort caused by the thoughts and impulses that characterize the obsessions described above.
People who suffer from obsessive-compulsive disorder, for example, avoid stepping on the intersections between the floor tiles, have to make sure for a defined number of times that they have actually closed the front door, mutter slurred sentences or repeat some words. Furthermore, they may have doubts about the feeling they have towards their partner or about their sexual orientation, even though they usually recognize that this is not justified.
At least 80% of patients have the combination of obsessions and compulsions, while less than 20% have only obsessive thoughts or perform compulsive acts.
Both obsessions and compulsions are the cause of a marked discomfort and significantly interfere with the usual work, school and social activities: often, relationships deteriorate and performance at school or at work may fall. Depression is a frequent secondary characteristic.
At some point, individuals with obsessive-compulsive disorder recognize that their obsessions do not reflect real risks and the behaviors put in place to alleviate concerns are excessive. The maintenance of awareness, although sometimes scarce, differentiates obsessive-compulsive disorder from psychotic disorders, in which contact with reality is lost.
If obsessive compulsive disorder is not adequately treated, first of all with a specific cognitive-behavioral psychotherapy, it tends to become chronic and worsen over time.
Treatment involves psychotherapy, pharmacotherapy or, especially in the most severe cases, the combination of both. Selective serotonin reuptake inhibitors (SSRIs) and clomipramine (a tricyclic antidepressant with potent serotonergic effects) prove to be useful in controlling the disorder.
Also exposure therapy and ritual prevention is usually effective; the essential element of this approach is the exposure to situations or people that trigger the obsessions and compulsions that cause anxiety.
