Provided by the National Institute of Mental Health
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 with the 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) and
by industry, effective treatments have been developed to help people with OCD.
How Common Is OCD?
About 2.3 percent of the U.S. population ages 18 to 54—approximately 3.3 million
Americans—has 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
percent of the total mental health bill of $148 billion.
What Causes OCD?
There is growing evidence that OCD represents abnormal functioning of brain
circuitry, probably involving a part of the brain called the striatum. OCD is
not caused by family problems or attitudes learned in childhood, such as an
inordinate emphasis on cleanliness, or a belief that certain thoughts are
dangerous or unacceptable. 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 striatum. 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, sertraline, 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 is 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 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
other brain disorders, such as Tourette's syndrome. Appropriate diagnosis and
treatment of other disorders are important to successful treatment of OCD.
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