obsessive
compulsive
disorder
The essential feature of this
disorder is recurrent obsessional thoughts or compulsive
acts. (For brevity, "obsessional" will be used
subsequently in place of "obsessive-compulsive"
when referring to symptoms.) Obsessional thoughts are
ideas, images or impulses that enter the individual's
mind again and again in a stereotyped form. They are
almost invariably distressing (because they are violent
or obscene, or simply because they are perceived as
senseless) and the sufferer often tries, unsuccessfully,
to resist them. They are, however, recognized as the
individual's own thoughts, even though they are
involuntary and often repugnant. Compulsive acts or
rituals are stereotyped behaviours that are repeated
again and again. They are not inherently enjoyable, nor
do they result in the completion of inherently useful
tasks. The individual often views them as preventing some
objectively unlikely event, often involving harm to or
caused by himself or herself. Usually, though not
invariably, this behaviour is recognized by the
individual as pointless or ineffectual and repeated
attempts are made to resist it; in very long-standing
cases, resistance may be minimal. Autonomic anxiety
symptoms are often present, but distressing feelings of
internal or psychic tension without obvious autonomic
arousal are also common. There is a close relationship
between obsessional symptoms, particularly obsessional
thoughts, and depression. Individuals with obsessive-compulsive
disorder often have depressive symptoms, and patients
suffering from recurrent depressive disorder may develop
obsessional thoughts during their episodes of depression.
In either situation, increases or decreases in the
severity of the depressive symptoms are generally
accompanied by parallel changes in the severity of the
obsessional symptoms. Obsessive-compulsive disorder is equally common in men and women, and there are often prominent anankastic features in the underlying personality. Onset is usually in childhood or early adult life. The course is variable and more likely to be chronic in the absence of significant depressive symptoms. |
Diagnostic
guidelines > For a definite diagnosis, obsessional symptoms or compulsive acts, or both, must be present on most days for at least 2 successive weeks and be a source of distress or interference with activities. The obsessional symptoms should have the following characteristics: (a) they must be
recognized as the individual's own thoughts or impulses: Includes: |