Symptoms of Obsessive-Compulsive Disorder
Introduction to the Symptoms, Diagnosis and Prevalence of OCD
Jul 27, 2008
OCD can affect both adults and children, and usually has an adolescent onset. In some cases, OCD may be considered mild and may be treated using self-directed methods. In more serious cases, OCD can be disabling, markedly affecting a number of life areas.
In the US, the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) set the criteria for diagnosing mental disorder. The common obsessions and compulsions listed below reflect data collected in western populations. It is notable that the nature of obsessions and compulsions varies across different cultures.
The Obsessions in OCD
Obsessions are intrusive and recurrent thoughts, impulses or images that are unwanted, difficult to ignore and not based on real-life problems. For example, someone with OCD may experience obsessive thoughts about being in contact with germs. People with OCD are aware that these obsessions are a product of their own mind and will try to ignore or deal with them.
Common obsessions include:
- Contamination
- Safety or harm
- Unwanted acts of aggression
- Unwanted sexual or religious thoughts
- A need for precision and symmetry
The Compulsions in OCD
Compulsions are repetitive behaviours or mental acts driven by strict rules, or in attempt to relieve the anxiety brought on by the obsessions. Using the above example of germs, someone with OCD may try to neutralize their anxiety by excessively washing their hands.
Compulsive behaviours are either an excessive response (such as the continual hand-washing) or they have no logical connection to the obsession at all. For example, someone with OCD may have an obsession about a loved one dying, which they may try to neutralize with counting.
Common compulsions include:
- Excessive cleaning
- Checking, putting items in order
- Counting
- Repeating routine activities
- Hoarding items
Diagnosing OCD
According to the DSM-IV criteria, symptoms must be pervasive and time-consuming, or significantly impacting on life areas such as work and relationships. When considering a diagnosis of OCD, doctors are also advised to check that the obsessions and/or compulsions are not restricted to other disorders that may present with similar symptoms, such as body dsymorphic disorder.
OCD is often not recognized for many years. This may be due to the following:
- People with OCD may feel embarrassed about their symptoms, which may inhibit them from seeking advice.
- Some symptoms are not observable to others.
In a review of OCD, published in the BMJ Clinical Review in 2006, Dr Heyman et al suggest that all doctors, not just those specializing in psychiatry, need to be more aware of OCD.
People with OCD are aware that their obsessions and/or compulsions don’t make sense, however, the OCD notes children to be an exception. The term “with poor insight” is used in diagnosis when a person presenting with symptoms of OCD does not recognize the senselessness of their obsessions and/or compulsions.
Prevalence of Obsessive-Compulsive Disorder
In the US, approximately 2.3% of the adult population have OCD, and international research has shown similar figures worldwide. There does not appear to be a gender bias with OCD, however, males are more likely to develop OCD in childhood, compared with early adulthood in females.
Read Obsessive-Compulsive Disorder for more information on the symptoms, diagnosis and management of the disorder. Those experiencing symptoms of depression and/or OCD should seek advice from a qualified health practitioner.
Sources
Obsessive-Compulsive Disorder (OCD) Criteria, Diagnostic and Statistical Manual of Mental Disorders (4th edition & text revision), published 2000, American Psychiatric Association.
Clinical Review – Obsessive-compulsive disorder, British Medical Journal, accessed: August 2006, author: Heyman, I et al.
Obsessive-Compulsive Disorder, emedicine, accessed: 27th July 2008, author: Greenberg, W.
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