Obsessive-compulsive personality disorder (OCD)
Obsessive-compulsive personality disorder (OCD)- is a mental disorder caused by obsession with obsessive thoughts or actions. The neurosis of compulsive states can manifest itself in the thoughts, fears or actions of a person.
The main clinical manifestations of OCD:
-Obsessive thoughts are painful, arising from the will, but recognized by the patients as their own, ideas, beliefs, images, which in a stereotypical form forcibly invade the consciousness of the patient and which he tries to somehow resist.
–Obsessive impulses – this prompts to perform actions, usually destructive and dangerous( for example, jump out onto the road in front of a moving car, hurt a child or shout out obscene words while in society.)
– Compulsive actions are repetitive, meaningless actions (for example, washing hands twenty or more times a day) Some of them may be ritualized for the purpose of protection. The latter aim to prevent him or objectively improbable events, dangerous for the patient or his loved ones. Others of them have a clear connection with the obsessive thoughts that preceded them, for example, repeated washing hands – with thoughts of infection. Other rituals (for example, the regular unfolding of clothing on some complex system before putting it on) have no such connection. Some patients feel an irresistible urge to repeat this action a certain number of times; if this does not work, they are forced to start all over again. Patients are invariably aware that their rituals are illogical, but when trying to resist, uncontrollable restlessness can begin. Both obsessional thoughts and rituals inevitably lead to problems in daily activities.
Obsessive meditation (“mental chewing gum”) – is an internal debate, in which the arguments for and against even the simplest everyday actions are infinitely revised. Some obsessive issues concern actions that could be performed or not completed, such as turning off the gas stove tap or locking the door; others concern actions that could harm other people.
At the moment, the specific cause of OCD is unknown. There are several well-founded hypotheses:
– Violations in the exchange of neurotransmitters first of all, serotonin and dopamine, norepinephrine and gamma-aminobutyric acid (GABA).
-Genetic predisposition (obsessive-compulsive disorders are found in about 5-7% of parents of patients with such disorders)
-Infectional diseases of the brain
Modern therapy of compulsive conditions must necessarily provide for a complex effect: combination of psychotherapy with pharmacotherapy.
Excellent results are obtained from the use of cognitive-behavioral psychotherapy. This technique allows the patient to resist OCD, modify or simplify the procedure of “rituals”, reducing it to a minimum. The basis of the technique is the patient’s understanding of the disease and incremental resistance to its symptoms.
According to some authors, the most effective form of behavioral therapy for OCD is the method of exposure and prevention. The exposure consists in the presence of the patient in a situation that provokes discomfort associated with obsessions. At the same time, the patient is given instructions on how to resist compulsive rituals – to prevent a reaction. Unlike drug therapy, after the withdrawal of symptoms of obsessive-compulsive disorder is often exacerbated, the attainable behavioral effect of psychotherapy persists for several months and even years.