Symptoms of Obsessive-Compulsive Disorder
OCD has Many Faces
- The most common problem experienced by people with OCD is excessive doubt leading to repeated checking.
- A quarter have contamination concerns, leading to repeated washing and avoiding items felt to be dirty.
- Most OCD patients save or collect too many items , and these hoarded items can cause a shortage of living space.
- Over half are concerned about symmetry and order.
- Many worry excessively about right and wrong, a condition called scrupulosity.
- Almost a third have sexual obsessions or worry about religious issues. This includes people with worries about being gay or violating a religious ritual.
- The next most common concern is about harming others or self accidentally or on purpose.
- A few worry that they have contracted a dreadful illness, like cancer or AIDS.
- Almost one in five have other concerns not described here.
Source: Ruscio, A. M., Stein, D. J., Chiu, W. T., & Kessler, R. C. (2008). The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Molecular Psychiatry.
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Symptoms
Obsessive-compulsive disorder (OCD) is a psychiatric anxiety disorder that includes distressing, intrusive thoughts and related compulsions (tasks or "rituals") to neutralize the obsessions. Obsessions are usually upsetting and the compulsions lead to temporary feelings of relief.
To be diagnosed with obsessive-compulsive disorder, one must have either obsessions or compulsions alone, or obsessions and compulsions together. Most people with OCD have both.
Obsessions are:
- Recurrent and persistent thoughts, impulses, or images that are intrusive and inappropriate. The thoughts cause severe anxiety or distress.
- The thoughts, impulses, or images are not just excessive worries about real-life problems.
- The person tries to ignore or suppress the thoughts, impulses, or images, or to neutralize them with some other thought or action.
- The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind, and are not based in reality.
Compulsions are:
- Repetitive behaviors or mental acts that the person feels they must perform in response to an obsession, or according to rigid rules.
- The behaviors or mental acts to prevent or reduce distress or prevent some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are supposed to neutralize or prevent or are clearly excessive.
In addition, at some point during the course of the disorder, the person must realize that his/her obsessions or compulsions are unreasonable or excessive. The obsessions or compulsions must be time-consuming (taking up more than one hour per day), cause distress, or cause difficulty in social, work, or school functioning. Having OCD is stressful and can lead to feelings of depression.
Prevalence
Community studies have estimated a lifetime prevalence of 2.5% and a 1-year prevalence of 0.5%-2.1% in adults. Research shows that prevalence rates of obsessive-compulsive disorder are similar in many different cultures around the world.
Onset
OCD usually begins in adolescence or early adulthood, but it may begin in childhood. Most people with OCD have a chronic waxing and waning course, with worsening of symptoms that may be related to stress.
The phrase "obsessive-compulsive" has worked its way into the wider English language, and is often used in an off-hand manner to describe someone who is meticulous or absorbed in a cause (i.e. "anal retentive"). It is also important to distinguish OCD from other types of anxiety, including the routine tension and stress that appear throughout life. Although these signs are often present in OCD, a person who shows signs of infatuation or fixation with a subject/object, or displays traits such as perfectionism, does not necessarily have OCD.
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