Obsessive-Compulsive Disorder

Datasources/Obsessive-Compulsive Disorder/Article-eng.md

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+# Analysis:  Obsessive-Compulsive Disorder!!
+<!----------------------------------------------------- Contents ------------------------------------------------>
+## Table of contents
+1. [About](#About)
+2. [Differential Diagnosis](#differential-diagnosis)
+3. [Types of OCD](#types-of-OCD)
+4. [Signs and symptoms of OCD](#signs-and-symptoms-of-OCD)
+5. [Complications](#complications)
+6. [Prognosis](#prognosis)
+7. [Consultations](#consultations)
+  -[Deterrence and Patient Education](#deterrence-and-patient-education)
+8. [Conclusion](#conclusion)
+9. [References](#references)
+
+---
+
+## About
+
+Obsessive-Compulsive Disorder (OCD) is a prevalent psychiatric disorder affecting 1% to 3% of the global population, characterized by intrusive thoughts, known as obsessions, and repetitive actions, or compulsions. These symptoms affect patients not only by consuming a significant portion of their time but also by causing marked distress and functional impairment. The complex etiology of OCD involves cognitive, genetic, and neural factors, making the condition's diagnosis challenging and necessitating the exclusion of other psychiatric conditions that present similarly. Further complicating matters, OCD frequently coexists with other psychiatric disorders, requiring comprehensive identification and treatment for optimal clinical outcomes. While the combination of medication and psychotherapy is generally effective, emerging evidence supports using neuromodulation techniques (eg, deep brain stimulation and transcranial magnetic stimulation) for treatment-resistant cases.
+
+Obsessive-compulsive disorder (OCD) is a disabling condition estimated to affect 1% to 3% of individuals throughout their lifetime. This psychiatric disorder is characterized by obsessions and compulsions, which consume a significant amount of time and lead to notable distress and impairment. Obsessions refer to intrusive and repetitive thoughts, urges, or mental images that are challenging to control. These thoughts often lack a clear purpose and are accompanied by distress.Compulsions involve repetitive actions or mental events that individuals with OCD feel compelled to perform to alleviate the distress caused by the obsessions or to prevent a feared consequence from occurring. Additionally, individuals with OCD may also engage in avoidance behaviors of obsession-triggering situations.
+
+OCD is a heterogeneous condition that arises from a complex interplay of genetic and environmental risk factors.Most adults are distressed by the ego-dystonic nature of their obsessions and are aware that their compulsive behaviors are abnormally excessive. Children often have difficulty describing their obsessions. In OCD patients, common obsessions and their associated compulsive behaviors include fear of contamination leading to excessive cleaning, fear of harm linked to repetitive checking of security measures, intrusive, aggressive, or sexual thoughts paired with mental rituals, and a focus on symmetry accompanied by ordering or counting.Though hoarding behaviors are usually specific to hoarding disorder, they can occur in OCD to prevent perceived harm. These behavior sets are consistently observed worldwide, suggesting a degree of commonality in OCD symptom dimensions. OCD can also present with rarer symptoms, including scrupulosity, obsessive jealousy, and musical obsessions.
+
+The understanding of OCD has evolved significantly over time. Historically framed in religious terms as a moral failing or demonic possession, OCD was first medically described by Esquirol. Freud subsequently characterized the condition using the term obsessive neurosis, positing that OCD originated with a regression in the anal phase of psychosexual development. In the third edition of the Diagnostic and Statistical Manual (DSM-III), OCD was grouped with phobias under a single diagnosis. Later, the DSM-IV classified the condition as an anxiety disorder. The DSM-5 has reclassified OCD into the category "Obsessive-Compulsive and Related Disorders," alongside conditions like hoarding and body dysmorphia. This reclassification acknowledges shared characteristics, such as phenomenology, comorbidity, and underlying neurobiological factors.WHO lists OCD as 1 of the 10 most disabling conditions caused by financial loss and decreased quality of life.In The Diagnostic and Statistical Manual of Mental Disorders fifth edition Text Revision (DSM-5 TR), which was published by the American Psychiatric Association (APA) in 2022, OCD sits under the category of obsessive-compulsive and related disorders.
+
+<p align="center">
+  <img src="Assets\ocd.jpeg" alt="OCD" style="width: 40%; border: 2px solid white;">
+</p>
+
+
+## Differential Diagnosis
+
+OCD has symptoms similar to several other psychiatric conditions. Differentiating OCD from these conditions is essential for accurate diagnosis and effective treatment planning, as part of the criteria for OCD diagnosis involves ensuring that the symptoms of another mental disorder do not better explain the disturbance. However, OCD may also occur along with other psychiatric disorders, which can complicate clinical diagnosis. The following are some commonly considered differential diagnoses and the features that can separate from OCD:[3]
+
+   ~ Generalized Anxiety Disorders: OCD involves irrational or odd obsessions, distinct from real-life worries found in generalized anxiety disorder. Compulsions are typically present in OCD but not in anxiety disorders.
+   ~ Specific Phobia: Unlike OCD, fears in specific phobia are circumscribed to particular objects or situations and don't involve rituals or compulsions.
+   ~ Social Anxiety Disorder: Fears with this condition are related to social interactions, and avoidant behaviors are aimed at reducing social fears rather than neutralizing obsessions.
+   ~ Major Depressive Disorder: Ruminative thoughts in major depressive disorder (MDD) are mood-congruent and not linked to compulsive behaviors, unlike the intrusive obsessions in OCD.
+   ~ Body Dysmorphic Disorder: This condition involves obsessions and compulsions related only to physical appearance.
+   ~ Trichotillomania: Compulsive hair-pulling without the presence of obsessions differentiates trichotillomania from OCD.
+   ~ Hoarding Disorder: Difficulty in discarding possessions characterizes hoarding disorder; if hoarding is driven by OCD-like obsessions, an OCD diagnosis is given instead.
+   ~ Eating Disorders: Unlike OCD, the focus of obsessions and compulsions in disorders like anorexia nervosa is on weight and food. Ritualized eating behaviors are associated with eating disorders.
+   ~ Tic Disorders: Tics and stereotyped movements are generally less complex than compulsions and are not aimed at neutralizing obsessions. A dual diagnosis may be warranted for overlapping symptoms.
+   ~ Psychotic Disorders: Although some OCD patients may have poor insight or delusional beliefs, they do not exhibit other psychotic symptoms like hallucinations.
+   ~ Obsessive-compulsive personality disorder: OCD is characterized by intrusive, distressing obsessions and compulsions aimed at alleviating this distress, with individuals often recognizing their symptoms as excessive. In contrast, obsessive-compulsive personality disorder (OCPD) involves a chronic pattern of perfectionism and rigid control, without the presence of obsessions or compulsions, and is often perceived by the individual as rational and desirable.
+
+
+## Types of OCD
+
+OCD can affect different people in different ways. According to the charity OCD-UK, five main categories that OCD can fall into include:
+Concern with checking
+
+A person with OCD may feel the need to check repeatedly for problems. This might include:
+
+    checking taps, alarms, door locks, house lights, and appliances to prevent leaks, damage, or fire
+    checking their body for signs of illness
+    confirming the authenticity of memories
+    repeatedly checking communication, such as e-mails, for fear of having made a mistake or offending the recipient
+
+These checks can be time-consuming and significantly affect a person’s daily life, routines, and relationships.
+Fears of contamination
+
+Some people with OCD feel a continual, overwhelming need to wash. They may fear that objects that they touch are contaminated, which can lead to:
+
+    excessive toothbrushing or handwashing
+    repeated cleaning of the home
+    avoiding crowds for fear of contracting germs
+
+Some people may also experience a sense of contamination if they feel someone mistreats or criticizes them. They may try to remove this feeling by washing.
+
+Read about OCD and cleaning.
+Hoarding
+
+This involves a person feeling unable to throw away used or useless possessions.
+Intrusive thoughts
+
+This involves feeling unable to prevent repetitious unwanted thoughts. These may involve violence, including suicide or harming others.
+
+The thoughts can cause intense distress, but the person is unlikely to act in a way that reflects this violence.
+
+Learn about OCD intrusive thoughts.
+Symmetry and orderliness
+
+A person with this type of OCD may feel the need to arrange objects in a certain order to avoid discomfort or harm. For example, they may repeatedly rearrange the books on a shelf.
+Suicide prevention
+
+If you know someone at immediate risk of self-harm, suicide, or hurting another person:
+
+    Ask the tough question: “Are you considering suicide?”
+    Listen to the person without judgment.
+    Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
+    Stay with the person until professional help arrives.
+    Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.
+
+If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.
+
+## Signs and symptoms of OCD
+
+OCD involvesTrusted Source obsessions, compulsions, or both. These can cause distress and interfere with the person’s ability to perform routine activities.
+Obsessions
+
+Everyone worries. However, in people with OCD, worries and anxiety can take over, making it hard to carry out everyday tasks.
+
+Common topics of this anxiety include:
+
+    contamination by bodily fluids, germs, dirt, and other substances
+    violence, such as the fear of acting on an urge to self-harm or hurt others
+    perfectionism, which may involve the fear of losing things or an intense focus on exactness or remembering things
+    responsibility, including a fear of being responsible for a catastrophic event
+    unwanted sexual thoughts, including thoughts about inappropriate activities
+    religious or superstitious beliefs, such as a concern about offending God or stepping on cracks in the sidewalk
+    identity, which may include sexual orientation or gender identity
+
+Compulsions
+
+Not every repetitious behavior is a compulsion. Most people use repetitive behaviors, such as bedtime routines, to help them manage everyday life.
+
+For a person with OCD, the need to perform repetitious behavior is intense, occurs frequently, and is time-consuming. The behavior may take on a ritualistic aspect.
+
+Some common examples include:
+
+    washing and cleaning, including handwashing
+    monitoring the body for symptoms
+    repeating routine activities, such as getting up from a chair
+    mental compulsions, such as repeatedly reviewing an event
+
+OCD in children
+
+OCD symptoms oftenTrusted Source start in adolescence, but they sometimes emerge in childhood.
+
+Complications among young people and children with OCD include:
+
+    low self-esteem
+    disrupted routines
+    difficulty with school and schoolwork
+    physical illness, due to stress, for example
+    trouble forming or maintaining friendships and other relationships
+    other mental health problems
+
+## Complications
+
+OCD is included in the top 10 disabling disorders by the WHO. Patients with OCD tend to avoid situations that make them uncomfortable, which may lead to decreased social interactions and a poor quality of life. Most who struggle with OCD go undetected for years. If OCD goes untreated, the pattern is harder to break as structural changes to the brain take place.Duration of untreated OCD is associated with worse clinical outcomes.Early intervention is vital.
+
+<p align="center">
+  <img src="Assets\OCD1.png" alt="" style="width: 40%; border: 2px solid white;">
+</p>
+
+
+## Prognosis
+
+OCD is a chronic condition characterized by fluctuating periods of symptom exacerbation and remission. Due to this disorder, daily functioning is significantly impaired. Furthermore, OCD is associated with an elevated risk of mortality. Despite the utilization of CBT and SSRIs, a substantial proportion of patients remain unresponsive. Specifically, between 25% and 40% of patients do not experience symptom alleviation when treated with either CBT or SSRIs. Furthermore, only a minority achieve full remission, and approximately half of successfully treated patients continue to manifest residual symptoms.
+
+OCD associated with hoarding symptoms generally results in a more unfavorable prognosis. Clinical data from DSM-IV field trials involving 431 patients revealed that the fear of harm was the most commonly reported obsessive symptom. A significant association between OCD and suicidal tendencies has been confirmed, with contributory factors including coexisting anxiety and depression, as well as a history of suicide attempts. Additionally, the association between OCD and suicidal tendencies remains significant even when controlling for depressive symptoms or mood instability.
+
+## Consultations
+
+Utilizing cognitive behavioral therapy (CBT) with a focus on exposure and response prevention is the cornerstone of nonpharmacological treatment for OCD. Therefore, seeking consultation with a highly skilled and experienced therapist in administering this specialized form of therapy is crucial. Medical consultations may vary depending on the severity and specific nature of the compulsions exhibited. For instance, if a patient engages in excessive hand-washing, dermatological issues like dermatitis may arise, necessitating consultation with a dermatologist. Comprehensive treatment should address the patient holistically, encompassing psychological symptoms and any resulting medical conditions. Coordination of care with other healthcare clinicians (eg, pediatrics or family medicine) is also vital, especially for monitoring potential side effects of medications, including weight gain and tics.
+
+
+### Deterrence and Patient Education
+
+
+In OCD, the patient's insight is not lacking. Only 2% to 4% lack insight into their OCD.However, most people do not seek treatment until the disorder has become severely advanced. As most symptoms present during adolescence, clinicians should inform and educate appropriate individuals, including parents, fellow medical personnel, and those in the school systems, about this disorder.
+
+
+<p align="center">
+  <img src="Assets\ocd3.jpeg" alt="" style="width: 40%; border: 2px solid white;">
+</p>
+
+## When to Contact a Medical Professional?
+
+You should call 911 or the local emergency number if:
+
+  ▸ The person loses consciousness at any time.
+  ▸ There is any other change in the person's alertness (for example, confusion or seizures).
+  ▸ The person has a fever over 102°F (38.8°C).
+  ▸ You notice symptoms of heatstroke (such as rapid pulse or rapid breathing).
+  ▸ The person's condition does not improve or gets worse despite treatment
+
+
+## Conclusion 
+
+Obsessive-Compulsive Disorder (OCD) is a complex mental health condition characterized by persistent, intrusive thoughts (obsessions) and repetitive behaviors or mental acts (compulsions). It can significantly impact daily functioning and quality of life, often leading to distress and impairment. Early diagnosis and intervention are crucial for managing OCD effectively, with cognitive-behavioral therapy (CBT) and medications like SSRIs being the most effective treatments. Understanding and awareness of OCD are vital in reducing stigma and promoting empathy towards those affected. Continuous research and advancements in treatment approaches offer hope for better outcomes, helping individuals lead more fulfilling lives. The importance of support from family, friends, and mental health professionals cannot be overstated in aiding recovery and managing the disorder.
+---
+
+## References
+
+1. MEDICALNEWSTODAY
+2. National Institute Of Health(NIH)
+
+<div align="center">
+
+**>"Behind every obsessive thought lies the strength to challenge and overcome, reshaping the mind one thought at a time."**
+
+</div>