Provided by the National Institute of Mental Health
People with Obsessive-Compulsive disorder (OCD),
an anxiety disorder, suffer intensely from recurrent, unwanted thoughts
(obsessions) and/or repetitive behaviors (compulsions) that they feel they
cannot control. Repetitive behaviors such as handwashing, counting, checking, or
cleaning are often performed with the hope of preventing obsessive thoughts or
making them go away. Performing these so-called "rituals," however, provides
only temporary relief, and not performing them markedly increases anxiety. Left
untreated, obsessions and the need to carry out rituals can take over a person's
life. OCD is often a chronic, relapsing illness. Fortunately, research—including
studies supported by NIMH—has led to the development of treatments to help
people with OCD.
Facts About OCD
Approximately 3.3 million American adults ages 18 to 54, or about 2.3 percent of
people in this age group in a given year, have OCD.1
The first symptoms of OCD often begin during childhood or adolescence.2
OCD is equally common in males and females.2
OCD is sometimes accompanied by depression, eating disorders, substance abuse,
or other anxiety disorders.2,3,4 Symptoms of OCD can also coexist and may even
be part of a spectrum of other brain disorders, such as Tourette's syndrome.5
Appropriate diagnosis and treatment of other co-occurring disorders are
important to successful treatment of OCD.
Treatments for OCD
Treatments for OCD include medications and behavioral therapy, a specific type
of psychotherapy. The combination of these treatments is often most effective.6
Several medications have been proven helpful for people with OCD: clomipramine,
fluoxetine, fluvoxamine, sertraline, and paroxetine. If one drug does not work,
others should be tried. A number of additional 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.
Research Findings
There is growing evidence that OCD represents abnormal functioning of brain
circuitry, probably involving a part of the brain called the striatum.7 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 individuals
with OCD, both behavioral therapy and medication produce changes in the
striatum. This is graphic evidence that both psychotherapy and medication affect
the brain.
Persons with OCD use different brain circuitry in performing a cognitive task
than people without the disorder.7
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For More Information
Please visit the following link for more information about organizations that
focus on obsessive-compulsive disorder.
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All material in this fact sheet is in the public domain and may be copied or
reproduced without permission from the Institute. Citation of the source is
appreciated.
NIH Publication No. 01-4598
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References
1 Narrow WE, Rae DS, Regier DA. NIMH epidemiology note: prevalence of anxiety
disorders. One-year prevalence best estimates calculated from ECA and NCS data.
Population estimates based on U.S. Census estimated residential population age
18 to 54 on July 1, 1998. Unpublished.
2 Robins LN, Regier DA, eds. Psychiatric disorders in America: the Epidemiologic
Catchment Area Study. New York: The Free Press, 1991.
3 Regier DA, Rae DS, Narrow WE, et al. Prevalence of anxiety disorders and their
comorbidity with mood and addictive disorders. British Journal of Psychiatry
Supplement, 1998; (34): 24-8.
4 Wonderlich SA, Mitchell JE. Eating disorders and comorbidity: empirical,
conceptual, and clinical implications. Psychopharmacology Bulletin, 1997; 33(3):
381-90.
5 Sheppard DM, Bradshaw JL, Purcell R, et al. Tourette's and comorbid syndromes:
obsessive compulsive and attention deficit hyperactivity disorder. A common
etiology? Clinical Psychology Review, 1999; 19(5): 531-52.
6 Hyman SE, Rudorfer MV. Anxiety disorders. In: Dale DC, Federman DD, eds.
Scientific American® Medicine. Volume 3. New York: Healtheon/WebMD Corp., 2000,
Sect. 13, Subsect. VIII, p. 1.
7 Rauch SL, Savage CR, Alpert NM, et al. Probing striatal function in
obsessive-compulsive disorder: a PET study of implicit sequence learning.
Journal of Neuropsychiatry and Clinical Neuroscience, 1997; 9(4): 568-73.
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