Obsessive-compulsive disorder

Obsessive-compulsive disorder, as well as abbreviated( OCD), refers to complexes of symptoms that are grouped together and derived from the combined Latin terminology obsessio and compulsio.

The very obsession in translation from Latin means siege, taxation, blockade, and compulsions in Latin means compelling.

For obsessive drives, varieties of compulsive phenomena( obsessions) are characterized by intolerable and very insurmountable drives that arise in the head against mind, will and feelings. Very often they are accepted by the patient as unacceptable and appear contradictory to his moral and ethical principles and are never realized in comparison with impulsive impulses of compulsion. All these drives of the patient themselves are aware of how wrong and very hard they are experienced. The very emergence of these drives by the nature of its incomprehensibility very often contributes to the induction of a feeling of fear in the patient.

The very term compulsions is often used to refer to obsessions in the sphere of movements, as well as obsessive rituals.

If we turn to domestic psychiatry, we will find that obsessive states are psychopathological phenomena characterized by the emergence of certain phenomena in the patient's mind, accompanied by a painful sense of coercion. Obsessive states are characterized by the appearance of involuntary, contrary to the will itself, obsessive desires with a clear awareness. But these obsessions themselves are alien, superfluous in the psyche of the patient, but he can not get rid of them himself. The patient has a close connection with emotionality, as well as depressive reactions and feelings of unbearable anxiety. When these symptoms occur, it is established that they do not affect intellectual activity itself and, in general, are alien to his thinking, and do not lower his level, but worsen the performance and productivity of mental activity. For the entire period of the illness, a critical attitude is maintained to the ideas of obsession. Obsessive states are preliminarily divided into obsessive-intellectually-affective( phobias), as well as motor( compulsions).In most cases, the structure of the obsessive-compulsive disorder combines several of their types. Separation of obsessions of abstract, or indifferent in content( affectively indifferent), for example, arrhythmia, is often unjustified. When analyzing neurogenesis psychogenesis, it is realistic to see the depressed state as a basis.

Obsessive-compulsive disorder - causes of

Genetic factors of the psychasthenic personality, as well as intrafamily problems, are the causes of obsessive-compulsive disorder.

With elementary obsessions in parallel with psychogeny there are cryptogenic reasons, under which the very cause of experiencing is hidden. Obsessive-compulsive states are observed predominantly in people with psychasthenic character, and fears of an obsessive nature are of particular importance here, as well as these ns. Are in the period of neurosis-like conditions at the time of sluggish schizophrenia, epilepsy, endogenous depressions, after craniocerebral injuries and somatic diseases, with hypochondriacal-phobic or nosophobic syndrome. Some researchers believe that in the clinical picture of the genesis of obsessive-compulsive disorder plays an important role the psychological trauma, as well as conditioned reflex stimuli, which became pathogenic due to their coincidence with other stimuli that had previously caused a sense of fear. Not a little important role is played by situations that have become psychogenic due to the confrontation of opposing trends. But it should be noted that these same specialists note that obsessive states arise in the presence of various characteristics of character, but still more often in psychasthenic individuals.

To date, all these obsessions have been described and included in the International Classification of Diseases under the names of "obsessive-compulsive disorder".

OCD is very common with a high incidence rate and needs urgent involvement of psychiatrists in the problem. At present, the concept of the etiology of the disease has expanded. And it is very important that the treatment of obsessive-compulsive disorder is directed towards serotonergic neurotransmission. This discovery has made it possible in the future to cure millions in the world, who have become ill with obsessive-compulsive disorder. How to replenish the body with serotonin? This will help tryptophan - an amino acid, which is in a single source - food. And already in the body Tryptophan is converted into serotonin. With this transformation there is mental relaxation, and a feeling of emotional well-being is created. Further, Serotonin acts as a precursor of melatonin, which regulates the biological clock.

This discovery about the intense inhibition of serotonin reuptake( SSRI) is the key to the most effective treatment of obsessive-compulsive disorder and was the very first phase of the revolution in clinical studies that observed the effectiveness of such selective inhibitors of

Obsessive-compulsive disorder - the history of

The Obsessive ClinicStates attracted the attention of researchers since the XVII century.

They first started talking about them in 1617, and in 1621 E. Barton described the obsessive fear of death. Investigations in the field of obsession are described by F. Pinel( 1829), and I. Balinsky introduced the term "obsessions", which were included in the Russian psychiatric literature. Since 1871, Westphalus introduced the term "agoraphobia", which denotes the fear of being present in public places.

In 1875, M. Legrand de Sol, analyzing the characteristics of the dynamics of the course of obsessive-compulsive disorder in forms of insanity doubts, together with delusions of touch, found that the gradually increasing complexity of the clinical picture, in which obsessive doubts are replaced by the fear of touching objects in the environment, andMotor rituals are added to which the life of the sufferers complies.

Obsessive-compulsive disorder in children

But only in the XIX-XX centuries. Researchers were able to more clearly describe the clinical picture and provide an explanation for the syndromes of obsessive-compulsive disorders. The most obsessive-compulsive disorder in children often falls on adolescence or adulthood. The maximum of clinically isolated manifestations of OCD is allocated in the range of 10 to 25 years.

Obsessive-compulsive disorder - symptoms of

The main features of obsessive-compulsive disorder are repetitive and very obsessive thoughts( obsessive), as well as compulsive actions( rituals).

Simply speaking, the core of OCD is the obsessive-compulsive syndrome, which is a collection of thoughts, feelings, fears, memories in the clinical picture, and all this arises in addition to the desire of the patients, but still with the awareness of all the soreness and a very critical attitude. Understanding the unnaturalness and all illogicality of compulsive states, as well as ideas, patients are very powerless in their attempts to overcome them independently. All obsessional motives, as well as ideas, are accepted as alien personalities and, as if from within. In patients, obsessive actions are the performance of rituals that act as a relief to anxiety( this can be hand washing, bandage dressing gauze, frequent change of linen in order to prevent infection).All attempts to ward off unbidden thoughts, as well as motivations, lead to a severe internal struggle, which is accompanied by intense anxiety. These obsessions are included in the group of neurotic disorders.

Prevalence among the OCD population is very high. Sufferers from obsessive-compulsive disorder account for 1% of patients who are treated in psychiatric hospitals. It is believed that men, like women, fall ill to the same degree.

Obsessive-compulsive disorder is characterized by the appearance of thoughts of an obsessive painful nature for independent reasons, but given out to patients as their personal beliefs, ideas, images. These thoughts forcibly enter the patient's mind in a stereotypical form, but at the same time he tries to resist them.

This is the combination of the inner sense of compulsive persuasion, and the effort to resist it, speaks of the presence of obsessive symptoms. Thoughts, obsessive character can also take the form of individual words, poetic lines, phrases. For the sufferer, they can be indecent, shocking, and also blasphemous.

The obsessive images themselves are very lively scenes that are often violent, as well as repulsive( sexual perversions).

Obsessive impulses of include motivations to commit acts, usually destructive or dangerous, and also capable of disgracing. For example, shout out in society, obscene words, and also jump out sharply in front of a moving car.

Obsessive rituals of include repetitive activities, for example, counting, repetition of certain words, repetition of often meaningless acts such as washing hands up to twenty times, but some can develop obsessive thoughts about the impending infection. Some rituals of patients include a constant ordering in the unfolding of clothes, taking into account the complex system. One part of the patients experiences an irresistible and wild impulse to carry out the action a number of times, and if this does not happen, the diseased are forced to repeat all over again. Themselves themselves recognize the illogic of their rituals and deliberately try to hide this fact. Sufferers experience and consider their symptoms as a sign of beginning madness. All these obsessional thoughts, as well as rituals, contribute to the emergence of problems in everyday life.

Obsessive reflections of or simply mental gum, are akin to internal debates, under which all arguments for and against, including very simple everyday actions, are constantly reviewed. Separate obsessive doubts refer to actions that could allegedly have been misconstrued, as well as incomplete, for example( shutting down the gas stove tap, and locking the door, and others referring to actions that could possibly harm other personalities( presumably, driving byA bicyclist on a car to knock him down.) Very often doubts are caused with religious precepts and rites, namely remorse.

As for compulsive actions, they are often characterized by repeatingThe

Obsessive thoughts of in themselves, as well as compulsive rituals, are characterized by a number of distinctive symptoms, Are capable of increasing in certain situations, namely, the nature of obsessive thoughts about harming other people is often amplified in the kitchen or elsewhere where there are prickly prismsDMetI.The patients themselves often try to avoid such situations and there may be a similarity to the anxiety-phobic disorder. By itself, anxiety is an important component in obsessive-compulsive disorder. Some rituals weaken the alarm, and after other rituals it increases.

Obsessions have a peculiarity to intensify within the framework of depression. In some patients, the symptomatology resembles a psychologically understandable response to obsessive-compulsive symptoms, while in others, recurring episodes of depressive disorders occur due to independent reasons.

Obsessions ( obsessions) are divided into sensory or imaginative, which is characterized by the development of painful affect, as well as obsessive states of affectively neutral content.

Obsessive feelings of antipathy, actions, doubts, obsessive memories, ideas, drives, fears about the usual actions get to the obsessive states of the sensual plan.

Under obsessive doubt, uncertainty arises that arose in spite of sound logic, as well as reason. The patient begins to doubt the correctness of the decisions taken, as well as committed and committed actions. The very content of these doubts is different: fears about the locked door, closed faucets, closed windows, off electricity, off gas;Service doubts about the correctly written document, addresses on business papers, whether the figures are specified. And despite a multiple check of the perfect action, obsessive doubts do not disappear, but only cause psychological discomfort.

Obsessive memories are filled with persistent and irresistible sad memories of unpleasant, as well as shameful events, which are accompanied by a sense of remorse and shame. These memories prevail in the mind of the patient and this despite the fact that the patient tries to distract from them in any way.

obsessive urges are being pushed to the realization of a harsh or very dangerous action. At the same time the patient experiences a feeling of fear, horror and confusion about the impossibility of getting rid of him. The patient has a wild desire to rush under the train, and also to push under the train of a loved one or kill a brutal way of a wife, as well as a child. Those who are ill at the same time are very tormented and worried about the implementation of these actions.

Obsessions also appear in various versions. In some cases, a vivid vision of the very results of the obsessive drives is possible. At this point the patients vividly represent the vision of the cruel act they committed. In other cases, these obsessions are presented as something implausible, even as absurd situations, but the diseased are mistaken for the real. For example, the belief and conviction of the sick that the buried relative was betrayed to the land still alive. At the peak of compulsive ideas, the realization of their absurdity, as well as the improbability itself, disappears and the acute confidence in their reality prevails.

An obsessive sense of antipathy, this includes obsessive blasphemous thoughts, as well as antipathy towards loved ones, unworthy thoughts towards respected people, towards saints, and also church ministers.

For obsessive actions are characterized by acts that are committed against the wishes of the sick and despite all the deterrent efforts made for them. Some of the obsessive actions weigh on the patient himself and so continues until they are realized.

And other obsessions pass by the patient himself. The most excruciating are the compulsive actions, when people pay attention to them.

The obsessive fear of or phobia includes fear of big streets, fear of height, limited or open spaces, fear of large concentrations of people, fear of sudden death, and fear of contracting an incurable disease. And in some patients there are phobias with fear of everything( panphobia).And finally, there may be an obsession of fear( phobophobia).

Nosophobia or hypochondriacal phobias are associated with the obsessive fear of any serious illness. Very often there are stroke, cardio, AIDSophobia, syphilis, phobia of malignant tumors. At the peak of anxiety, the sick often lose critical attitude towards their health and often resort to doctors for examination, as well as treatment of non-existent diseases.

Specific or isolated phobias include obsessive fears caused by a specific situation( fear of height, thunder, nausea, pets, dental treatment, etc.).Patients experiencing fear are characterized by avoidance of these situations.

Obsessive fears are often supported by the development of rituals - actions that are involved in magical spells. Rituals are carried out because of protection from imaginary misfortune. Rituals can include snapping fingers, repeating certain phrases, singing a melody and so on. In such cases, the relatives themselves do not at all suspect about the existence of such disorders in relatives.

Obsessive-compulsive affective-neutral character includes obsessive thinking, as well as an obsessive account or the recollection of neutral events, formulations, terms, and so on. These obsessions burden the patient and interfere with his intellectual activity.

Contrast obsessions or aggressive obsessions include blasphemous as well as blasphemous thoughts, obsessions are filled with fear of fear of harming not only yourself but others.

Those who are sick with contrasting obsessions are concerned about the irresistible desire to shout cynical words that contradict morality, they are able to commit dangerous, as well as ridiculous actions in the form of mutilating themselves, as well as their loved ones. Often obsessions go together with phobias of objects. For example, fear of sharp objects( knives, forks, axes and stuff).To this group of contrasting obsessions are sexual obsessions( the desire of perverted sexual acts with children, animals).

Misophobia - obsessive ideas of pollution( fear of contamination by earth, urine, dust, feces), small objects( glass fragments, needles, specific types of dust, microorganisms);Fear of ingestion of harmful, as well as poisonous substances( fertilizers, cement, toxic waste).

In many cases, the fear of pollution itself can be limited, manifested only for example in personal hygiene( very frequent change of clothes, repeated washing of hands) or household issues( food processing, frequent washing of floors, prohibition of pets).Of course, such monophobia does not affect the quality of life, they are perceived by others as personal habits in cleanliness. Clinically recurring variants of these phobias belong to a group of heavy obsessions. They consist in cleaning things, and also in a certain sequence using detergents and towels, which allow to keep sterility in the bathroom. Outside the apartment, the ill connects protective measures. On the street appears only in a special and maximum covered clothing. At later stages of the disease, patients themselves avoid pollution, moreover they are afraid of going out and not leaving their own apartments.

One of the places in the series of obsessions occupied obsessive actions, as isolated, monosymptomatic motor disorders. In childhood they include tics. Those who are ill with ticks are able to shake their heads, as if checking whether my hat is sitting well, making movements with my hand, as if discarding disturbing hair and constantly blink my eyes. Along with obsessive tics, such actions as biting of lips, spitting, etc.

Obsessive-compulsive disorder - treatment of

are observed. As it was noted earlier, cases of complete recovery are relatively rare, but it is possible to stabilize the condition, as well as to alleviate the symptoms. Light forms of obsessive-compulsive disorder are favorably treated at an outpatient level, and the reverse development of the disease occurs no earlier than 1 year after the treatment.

The more severe forms of obsessive-compulsive disorder( phobia of infection, acute objects, contamination, contrast presentations or numerous rituals) become more resistant to treatment.

Obsessive-compulsive disorder is very difficult to distinguish from schizophrenia, as well as Tourette's syndrome.

Tourette's syndrome, as well as schizophrenia, interfere with the diagnosis of obsessive-compulsive disorder, so to avoid these diseases you need to contact a psychiatrist.

To effectively treat obsessive-compulsive disorder, it is necessary to remove stressful events, and pharmacological intervention should be directed to serotonergic neurotransmission. Unfortunately, science is powerless to cure this spiritual affliction forever, but many specialists use the method to stop thinking.

A reliable method of treatment for OCD is drug therapy. Self-medication should be avoided, and a visit to a psychiatrist should not be postponed.

Those who suffer from obsessions often attract family members to their rituals. In this situation, relatives should treat the patient firmly, but also sympathetically, if possible, softening the symptoms.

Drug therapy in the treatment of obsessive-compulsive disorder includes serotonergic antidepressants, anxiolytics, small antipsychotics, MAO inhibitors beta-blockers to stop vegetative manifestations, as well as triazole benzodiazepines. But atypical neuroleptics - quetiapine, risperidone, olanzapine in combination with SSRI antidepressants or with antidepressants such as moclobemide, tianeptine, and benzodiazepine derivatives( this is alprazolam, bromazepam, clonazepam) are the main ones in the treatment of obsessive-compulsive disorder.

One of the main tasks in the treatment of obsessive-compulsive disorder is the establishment of cooperation with the sick. It is important to encourage the patient to believe in recovery and overcome prejudices against the harm of psychotropic drugs. Obligatory support from relatives in the likelihood of healing a patient

Obsessive-compulsive disorder - rehabilitation

Social rehabilitation includes the establishment of intra-family relations, training in proper interaction with other people, vocational training and skills training for everyday life. Psychotherapy is aimed at gaining faith in oneself, in loving oneself, in mastering ways to solve everyday problems.

Often obsessive-compulsive disorder is prone to recurrence, and this in turn requires a long-term preventive intake of medications.