Q 1. What is OCD?
Answer: Obsessive-compulsive disorder (OCD) is a common psychiatric disorder that affects all ages and where a person has an obsession and/or compulsion or both.
Q 2. What is obsession & Compulsion?
Answer: Obsessions are recurrent, persistent & unwanted intrusive thoughts, images, or urges/impulses produce escalating anxiety despite a person’s effort to avoid/exclude them.
Compulsions are repetitive stereotypes behaviors in response to the obsessions that transiently reduce anxiety but time-consuming.
Q 3. What are the common symptoms of OCD?
Answer: The presentation of obsessions and compulsions is heterogeneous in adults and in children and adolescents. The symptoms of an individual patient can overlap and change with time.
Four major obsessions- contamination (45%), pathological doubt (42%), intrusive thoughts (sexual, aggression), symmetry (31%). Other obsessions are a religious obsession, obsessive phobia, etc.
Common compulsions are – checking (63%), washing (50%), counting, symmetry or precision, hoarding, need to ask or confess.
Q 4. How OCD is diagnosed?
Answer: OCD is diagnosed by the presence of obsessions, compulsion, or both which is time-consuming (take more than 1 hour per day) and causes clinically significant distress or impairment in personal, family, social or occupational life.
Q.5. What are the causes of OCD?
Answer: The actual causes of OCD are unknown, but there are many plausible causes that include:
a) Genetics b) Immunological c) Psychological d) Biochemical
Q. 6. What are the common comorbid disorders with OCD?
Answer: The most common comorbid disorders with OCD are – MDD (67%), Social Phobia (25%), GAD, Alcohol Use Disorder, Panic Disorder, Eating Disorder, Personality Disorder, Tourette’s disorder (5-7%), Tics (20-30%)
Q. 7. How to treat a case of OCD?
Answer: The two main treatments for OCD are psychotherapy and medications. Psychotherapy and medications often combinedly are the most effective treatment.
Other treatments of resistant OCD are ECT, Deep brain stimulation (DBS), Transcranial magnetic stimulation (TMS), and Psychosurgery.
Q.8. What is psychological therapy or psychotherapy in OCD?
Answer: In OCD the psychological treatment, Cognitive -behavior therapy (CBT) is most effective.
Patients with compulsions ERP (Exposure and response prevention) is the most effective treatment, which is a type of CBT. Some OCD patients need cognitive therapy like thought stopping, thought distraction, thought challenging, acceptance and commitment therapy, etc.
Q.9. What is the drug treatment for OCD?
Answer: The main medicines prescribed are a type of antidepressant called SSRIs (Selective Serotonin Reuptake inhibitors) and also Clomipramine, a TCA.
Approved by FDA (Food and Drug Administration) USA to treat OCD include: Clomipramine, Fluoxetine, Fluvoxamine, Paroxetine, Sertraline.
You may need to take an SSRI for 8-12 weeks before you notice any benefit.
Most people need treatment for at least one year.
Q.10. Can OCD be treated without drugs?
Answer:
Yes, OCD can be treated without drugs. In mild OCD with Cognitive behavior therapy (CBT), exposure and response prevention (ERP) is effective.
Q 11. How long do we have to continue the treatment?
Answer:
In some studies, treatment of OCD should be continued at least 6 months after remission of symptoms.
In another study, 1-year of continuation of medication and psychotherapy 50% of OCD patients recover completely.
Q 12. What is the outcome (prognosis) of OCD?
Answer:
OCD is a chronic disease with wax and wanes in its course. 20-30% of patients significantly improve with treatment, 40-50% moderate improvement, and 20-30% worse prognosis.
In another study, 50% of patients completely recover after 1 year of treatment.
Q 13. What is the treatment of OCD in pregnancy and lactation?
Answer: The two main treatments are Cognitive Behavioural Therapy and Medication. These can be used alone or in combination.
Cognitive Behavioural Therapy (CBT): CBT helps you examine patterns of thoughts and behaviour
that distressing you. You will usually see a therapist on a weekly basis.
Sometimes you can attend a full course of sessions over a shorter period.
Medication: The
ones most commonly used for OCD are called Selective Serotonin Reuptake
Inhibitors (SSRIs).