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Obsessive Compulsive Disorder

Obsessive-compulsive disorder (OCD) is not a common psychiatric disorder but it is very distressing and disabling for the patient. The symptoms of the disease might look harmless at their face value and the patient himself/herself recognizes their irrelevant nature but is incapable of controlling them.

Most common symptom of OCD is preoccupation with cleanliness. The patient is not satisfied with his/her well washed hands and continues with actions like hand washing, bathing, cleaning utensils, cupboards, floors and even money etc., although all the time wanting to stop. Along with the repetitive ritualistic behaviour of cleaning some of the patients develop other repetitive actions like checking and rechecking. Some repetitive behaviour might become rather bizarre like going round and round in a fixed pattern and keeping count of all the actions performed.

Another common symptom of OCD is obsession with certain ideas or images or impulses to perform some unusual or horrific actions. The theme of such obsessions differs in different patients. Some common themes are about God, Guru, religion and sex.. The thoughts are disturbing as the patients recognize that these are their thoughts but feel helpless to stop them. The content of the thoughts is also negative in connotation like abuses for God, insulting and debasing thoughts for Guru, pornographic imagery with persons forbidden to have sex with.

There can be fear of contamination e.g. becoming contaminated by shaking hands or touching door- knobs.

Time consuming and lasting doubts like having left the door unlocked or wondering whether one has performed some act such as having hurt someone are not uncommon.
Repeated counting, silently repeating words or even praying endlessly can be symptoms of OCD.

Some patients need to have things in particular order and experience intense distress when objects are in disorder.

Horrific impulses can take the form of wanting to hurt one’s own child or shout obscenities in public places. As the patients are aware of the irrelevant nature of these ideas, they do not act on these impulses but are distressed that they only thought such bad thoughts.

All patients of OCD are very exhausted, anxious, depressed and even have suicidal intentions. They tend to loose sleep and are not capable of performing the expected routine daily tasks required according to their age, gender and status.

OCD can be best managed when the treatment starts early in the course of illness. Management with anti-depressant medication and behaviour therapy is quite effective and patients even with long standing illness also benefit. The treatment is of course for life as there are always chances of relapse of the illness after stopping the medication.

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