1. Obsessive-compulsive disorder
Alan

2. Definition
• Obsessive-compulsive disorder is an anxiety disorder
characterized by unreasonable thoughts and fears
(obsessions) that lead you to do repetitive behaviors
(compulsions).

3. Introduction
• affects almost 3% of world’s population.
• Start anytime from preschool to adulthood
– Typically between 20-24.
• many different forms of OCD – differ from person to
person.
• cause of OCD is still unknown.
• Better when diagnosed early.

4. Specific criteria to be clinically diagnosed
• Anxiety disorder with presence of obsessions or
compulsions.
• ego dystonic – realize thoughts and actions are
irrational or excessive.
• Must take up more than 1 hour a day.
• Must disrupt daily routine.
• Symptoms can’t result from effects of other medical
conditions or substances.

5. Obsessions
• repetitive and constants thoughts, images or
impulses that cause anxiety or distress.
• thoughts, images, or impulses not about real-life
problems.
• Try to ignore or counter act thoughts, images, or
impulses.
• thoughts, images, or impulses “recognized as a
product of one’s own mind and not imposed from
without”.

6. Compulsions
• Repetitive behaviors or mental acts person does in
reaction to obsessions.
• behaviors or mental acts done to avoid or decrease
distress.
• behaviors or mental acts are clearly excessive or
not realistic.

7. History
• 14th & 15th century thought people were possessed
by the devil and treated by exorcism
• 17th century thought people were cleansing their
guilt
• 18th century finally considered medical issue
• 20th century began treating with behavioral
techniques

8. Theories
• Scientist split into 2 groups
– Psychological disorder where people are
responsible for feelings they have
– Abnormalities in the brain

9. Causes
• Serotonin is involved in regulating anxiety
• Abnormality in the neurotransmitter serotonin
– In order to send chemical messages serotonin must bind
to the receptor sites located on the neighboring nerve
cells
– OCD suffers may have blocked or damaged receptor
sites preventing serotonin from functioning to full potential
• Possible genetic mutation
– Some people suffering have mutation in the human
serotonin transporter gene

11. OCD and the Brain
• PET scans show people with OCD have different
brain activity from others
• Another theory: miscommunication between the
orbital frontal cortex, the caudate nucleus, and
the thalamus
– Caudate nucleus doesn’t function properly and
causes thalamus to become hyperactive and sends
“never-ending” worry signals between OFC and
thalamus  OFC responds by increasing anxiety

12. PET scans indicate differences in brain activity of OCD patients
versus normal

13. Comorbidity
• Has excessive comorbidity with other diseases
• Common diseases: Depression, Schizophrenia, Tourette
Syndrome
• Depression is the most common
– Many people with OCD suffered from depression first
– 2/3 of OCD patients develop depression  makes OCD
symptoms worse and more difficult to treat
• People with OCD common diagnosed as Schizophrenic 
hard to separate obsessions from delusions

14. Treatment
• Only completely curable in rare cases
• Most people have some symptom relief with
treatment
• Treatment choices depend on the problem and
patients preferences
• Most common treatments:
– Behavioral Therapy
– Cognitive Therapy
– Medication

15. Cognitive-Behavioral Therapy
• Cognitive: change the way they think to deal with their fears
• Behavioral: change the way they react to “anxiety-provoking”
situations
• Exposure and Response Prevention
– Slowly learning to tolerate anxiety associated with not
performing ritual behavior
• Psychotherapy
– Talking with therapist to discover what causes the anxiety
and how to deal with symptoms
• Systematic Desensitization
– Learning cognitive strategies to deal with anxiety then
gradual exposure to feared object

16. Cognitive-Behavioral Therapy cont…
• Should be done when people are ready for it
• Must be customized for each person’s specific form of OCD
and their needs
• No side affects except increased anxiety with exposure to
fear
• Often lasts about 12 weeks
• Positive effects off CBT last longer than those of
medication
• If OCD returns can successfully treat again with same
therapy
• Best treatment approach for most is CBT combined with
medication

17. Medication
• Anxiolytic benzodiazepine such as chloradiazepoxide or diazepam
 give temporary relief from anxiety but not really effective on
obsessions and compulsions
• Antidepressants because of common depression
• Selective Serotonin Reuptake Inhibitors (SSRIs): alter the levels of
neurotransmitter serotonin in the brain which helps brain cells
communicate with one another
– Prevents excess serotonin from being pumped back into
original neuron that released it
– Then can bind to receptor sites of nearby neurons and send
chemical message that can help regulate anxiety and obsessive
compulsive thoughts
– Most effective drug treatment helping about 60% of patients
– Ex: Prozac, Zoloft, Lexapro, Paxil

18. Conclusion
• OCD is a complicated issue
• Most cases are incurable
• Best form of treatment is CBT in combination with
medication
• Most important thing that can be done to discover
more about OCD and its treatments is to research
the brain