الهام الجماس

Obsessive-Csompulsive Disorder (25/9/2013)

Elham aljammas

Obsessive-Compulsive Disorder

affects 3% of world’s population Start from preschool to adulthoodTypically (20-24)cause still unknown Better :diagnosed early

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Definition

Specific criteria to be clinically diagnosedAnxiety disorder with presence of obsessions or compulsionsego dystonic – realize thoughts and actions are irrational or excessiveMust take up more than 1 hour a day Must disrupt daily routineSymptoms can’t result from effects of other medical conditions or substances

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 impulsesthoughts, images, or impulses “recognized as a product of one’s own mind and not imposed from without”

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


compulsion

Theories

Psychological disorder Abnormalities in the brain

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

OCD and the Brain

PET scans show people with OCD have different brain activity from othersAnother theory: miscommunication between the orbital frontal cortex, the caudate nucleus, and the thalamusCaudate 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

Comorbidity

Has excessive comorbidity with other diseasesCommon diseases: Depression, Schizophrenia, Tourette Syndrome Depression is the most common Many people with OCD suffered from depression first2/3 of OCD patients develop depression  makes OCD symptoms worse and more difficult to treat

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



Cognitive-Behavioral Therapy
Cognitive: change the way they think to deal with their fearsBehavioral: change the way they react to “anxiety-provoking” situationsExposure and Response PreventionSlowly learning to tolerate anxiety associated with not performing ritual behaviorPsychotherapyTalking with therapist to discover what causes the anxiety and how to deal with symptomsSystematic DesensitizationLearning cognitive strategies to deal with anxiety then gradual exposure to feared object

Cognitive-Behavioral Therapy

Should be done when people are ready for itMust be customized for each person’s specific form of OCD and their needsNo side affects except increased anxiety with exposure to fearOften lasts about 12 weeksPositive effects off CBT last longer than those of medicationIf OCD returns can successfully treat again with same therapyBest treatment approach for most is CBT combined with medication

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 depressionSelective 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 itThen can bind to receptor sites of nearby neurons and send chemical message that can help regulate anxiety and obsessive compulsive thoughtsMost effective drug treatment helping about 60% of patientsEx: Prozac, Zoloft, Lexapro, Paxil

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