Obsessive-Compulsive Disorder
People with obsessive-compulsive disorder (OCD) suffer intensely
from recurrent unwanted thoughts (obsessions) or rituals
(compulsions), which they feel they cannot control. Rituals
such as handwashing, counting, checking, or cleaning are often
performed in hope of preventing obsessive thoughts or making them go
away. Performing these rituals, however, provides only temporary
relief, and not performing them markedly increases anxiety. Left
untreated obsessions and the need to perform rituals can take over a
person's life. OCD is often a chronic, relapsing illness.
Fortunately, through research supported by the National Institute
of Mental Health (NIMH), effective treatments have been developed to
help people with OCD.
How Common Is OCD?
- About 2.3% of the U.S. population (3.3 million Americans)
experiences OCD in a given year.
- OCD affects men and women equally.
- OCD typically begins during adolescence or early childhood; at
least one-third of the cases of adult OCD began in childhood.
- OCD cost the U.S. $8.4 billion in 1990 in social and economic
losses, nearly 6% of the total mental health bill of $148 billion.
What Causes OCD?
There is growing evidence that OCD has a neurobiological basis.
OCD is no longer attributed to family problems or to attitudes
learned in childhood - for example, an inordinate emphasis on
cleanliness, or a belief that certain thoughts are dangerous or
unacceptable. Instead, the search for causes now focuses on the
interaction neurobiological factors and environmental influences.
Brain imaging studies using a technique called positron emission
tomography (PET) have compared people with and without OCD. Those
with OCD have patterns of brain activity that differ from people
with other mental illnesses or people with no mental illness at
all. In addition, PET scans show that in patients with OCD, both
behavioral therapy and medication produce changes in the caudate
nucleus, a part of the brain. This is graphic evidence that both
psychotherapy and medication affect the brain.
What Treatments Are Available for OCD?
Treatments for OCD have been developed through research
supported by the NIMH and other research institutions. These
treatments, which combine medications and behavioral therapy (a
specific type of psychotherapy), are often effective.
Several medications have been proven effective in helping
people with OCD: clomipramine, fluoxetine, fluvoxamine and
paroxetine. If one drug is not effective, others should be tried.
A number of other medications are currently being studied.
A type of behavioral therapy known as "exposure and response
prevention" is very useful for treating OCD. In this approach, a
person's deliberately and voluntarily exposed to whatever triggers
the obsessive thoughts and then, is taught techniques to avoid
performing, the compulsive rituals and to deal with the anxiety.
Can People With OCD Also Have Other Physical or Emotional
Illnesses?
OCD is sometimes accompanied by depression, eating disorders,
substance abuse, attention deficit hyperactivity disorder, or
other anxiety disorders. When a person also has other disorders,
OCD is often more difficult to diagnose and treat. Symptoms of OCD
can also coexist and may even be part of a spectrum of
neurological disorders, such as Tourette's syndrome. Appropriate
diagnosis and treatment of other disorders are important to
successful treatment of OCD.
The content of this fact sheet was adapted from material
published by the National Institute of Mental Health.
For additional resources, please call 1-800-969-NMHA.
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