Obsessive-Compulsive Disorder (OCD) Patient Information Fact Sheet

What is obsessive-compulsive disorder?
Obsessive-compulsive disorder (OCD) is an anxiety disorder in which sufferers develop recurrent or persistent obsessions. They then develop compulsive actions in order to relieve the anxiety caused by these obsessions. Most adults with this disorder recognize that their behavior is irrational, but there is broad variation in insight as to how unreasonable or inappropriate certain behavior is. Children with OCD are usually unaware of their behavior being inappropriate.

OCD may be associated with other anxiety, depressive or eating disorders. Many people with OCD also suffer from nervous tics.

OCD is thought to affect around one person per 100 adults and one person per 200 children, and is found equally in men and women. It usually begins in adolescence or early adulthood but may develop in childhood. There are generally two age ranges when OCD first appears: (1) between ages 8 and 12 or (2) between the late teens and early adulthood. There is some evidence that OCD may run in families.

What are the symptoms of OCD?
One of the definitions of OCD is that the obsessions and corresponding compulsive behavior take up more than 1 hour of the person's time each day and cause distress to that person. The obsessions are irrational and are unrelated to worries about real life such as financial or work problems. If not treated, OCD may progress until the obsessions take up all of a sufferer's waking time. One of the most common obsessions is worry about contamination, in which the person fears they might be contaminated by germs from ordinary objects or from shaking another person's hand. The compulsive behavior, which develops in order to relieve this anxiety, is hand washing, which may become so excessive that the person's skin becomes raw as a result.

Others may worry that a task, such as locking a door or turning off the stove, has not been completed. The sufferer may be driven to checking every few minutes that the door is locked or repeatedly checking that the stove is off. There may be a need to do things in a certain order or to repeat them a certain number of times. In some cases items must be placed in a certain position and the sufferer may become greatly distressed if they become disordered. The resulting compulsions are all excessive and unrealistic.

What causes OCD?
The exact reason OCD occurs is not known, although it often begins during episodes of increased stress. It is also thought that some people may be genetically predisposed to the condition. although this has not been proved. Some experts believe that OCD is caused by a chemical imbalance in the brain; it has been proposed that serotonin, a chemical messenger in the brain, may be involved. Serotonin is also known as 5-hydroxytryptamine (5-HT).

How is OCD treated?
There are medicines available that may help some people with OCD. These medicines belong to a group known as selective serotonin reuptake inhibitors (SSRIs) or 5HT-reuptake inhibitors. They are thought to act in OCD by blocking the reuptake of serotonin (5-HT) in the brain, thereby increasing the amount available in certain areas. The drugs available include: escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox CR), clomipramine, paroxetine (Paxil) or sertraline (Zoloft). Other treatment may involve cognitive therapy (a form of psychotherapy) or behavioral therapy.

Further information
International OCD Foundation: www.ocfoundation.org
National Institute of Mental Health: www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml

Last Reviewed: June 2013