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Obsessions and Compulsions

OCD is classified by the American Psychiatric Association as an anxiety disorder. OCD consists of obsessions, which are persistent, inappropriate ideas, thoughts, impulses, or images, and compulsions, which are the actions or rituals a person performs in response, often in an attempt to relieve the anxiety caused by the obsessions.[1]

The most frequent obsession is the fear of being contaminated — a 2006 comprehensive prospective study of people with OCD found 57.7% experienced this fear. Also common in the study were pathological doubt (56.0%), the need to arrange things in a symmetrical way (47.8%), and aggressive thoughts (45.4%). The study showed that the most common compulsions were checking (68.9%), cleaning (60.1%), and repeated actions (56.3%).[2]

People who suffer from OCD often feel embarrassed by their thoughts and behaviors, which can contribute to delays in seeking treatment, being diagnosed, and receiving treatment.[3][4][5] Sometimes OCD is difficult to diagnose because other psychiatric conditions are present.[1]

Physicians diagnose OCD when recurrent obsessions and compulsions are severe enough to cause serious distress, are time-consuming (more than 1 hour per day), and interfere with normal routines, such as work, social activities, or relationships with others.[1]

There are also some useful screening tools and symptom severity scales that could allow you and your healthcare provider to evaluate your symptoms and their severity in order to determine if a full psychiatric evaluation is warranted.

"My need for everything to be in order makes it hard to live with other people. To most people I just seem like a really neat, well-organized person, but those closest to me recognize that there is something deeper going on.

Putting things away and organizing takes a lot of time, and I often keep people waiting because I need things to be put away in their proper place before we can leave the house."

- Amanda O.

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References:

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  1. ^ American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed, text revision. Washington, DC: American Psychiatric Association; 2000.
  2. ^ Pinto A, et al. The Brown Longitudinal Obsessive Compulsive Study: clinical features and symptoms of the sample at intake. Journal of Clinical Psychiatry. 2006;67:703-11.
  3. ^ Torres AR, et al. Obsessive-compulsive disorder: prevalence, comorbidity, impact, and help-seeking in the British National Psychiatric Morbidity Survey of 2000. American Journal of Psychiatry. 2006;163:1978-1985.
  4. ^ Torres AR, et al. Treatment seeking by individuals with obsessive-compulsive disorder from the British psychiatric morbidity survey of 2000. Psychiatric Services. 2007;58:977-82.
  5. ^ Lensi P, et al. Obsessive-compulsive disorder. Familial-developmental history, symptomatology, comorbidity and course with special reference to gender-related differences. British Journal of Psychiatry. 1996;169(1):101-7.

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