![]() The obsessive-compulsive symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.ĭ. The obsessions or compulsions are time-consuming (e.g., take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.Ĭ. Note: Young children may not be able to articulate the aims of these behaviors or mental acts.ī. The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive. Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly.Ģ. The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e., by performing a compulsion).ġ. Recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress.Ģ. Presence of obsessions, compulsions, or both:ġ. ![]() Recurrent thoughts of needing to do things in a balanced or exact fashionĪ. Recurrent thoughts about being a pedophile or sexually deviant recurrent thoughts about acting sexually inappropriate toward othersĪvoiding situations that trigger the thoughts, performing mental rituals to counteract the thoughts Thoughts about being immoral and eternal damnationĪsking forgiveness, praying, reassurance seekingįear of making inappropriate comments in public Recurrent worries about doing things incorrectly or incompletely, thereby negatively affecting the patient or othersĬhecking excessively, performing actions in a particular order Monitoring the news for reports of violent crimes, asking for reassurance about being a good personįear of being contaminated or contaminating others fear of being contaminated by germs, infections, or environmental factors fear of being contaminated by bad or immoral persons Patients with OCD should be closely monitored for psychiatric comorbidities and suicidal ideation.įear of harming others, recurrent violent images There are a variety of options for treatment-resistant OCD, including clomipramine or augmenting an SSRI with an atypical antipsychotic. ![]() Patients with severe symptoms or lack of response to first-line therapies should be referred to a psychiatrist. When effective, long-term treatment with an SSRI is a reasonable option to prevent relapse. ![]() Patients with OCD require higher SSRI dosages than for other indications, and the treatment response time is typically longer. Recommended first-line therapies are cognitive behavior therapy, specifically exposure and response prevention, and/or a selective serotonin reuptake inhibitor (SSRI). Patients can experience significant improvement with treatment, and some may achieve remission. Early recognition and treatment with OCD-specific therapies may improve outcomes, but there is often a delay in diagnosis. It is a complex disorder with a variety of manifestations and symptom dimensions, some of which are underrecognized. Obsessive-compulsive disorder (OCD) is a chronic illness that can cause marked distress and disability. ![]()
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