Diagnosis and Treatment of ObsessiveCompulsive Disorder

Obsessive-compulsive disorder (OCD) is characterized by recurrent obsessions and compulsions that cause marked distress and significant functional impairment (Dell’Osso, 2007). OCD is one of the more common serious mental illnesses. The shame and secrecy associated with it, as well as lack of recognition of its characteristic symptoms, can lead to delay in diagnosis and treatment. Effective psychological and drug treatments are available for the distressing, time-consuming, repetitive thoughts and rituals and the associated functional impairment. Obsessions are unwanted ideas, images or impulses that repeatedly enter a person’s mind. Although recognized as being self-generated, they are experienced as egodystonic (out of character, unwanted, and distressing). Compulsions are repetitive stereotyped behaviors or mental acts driven by rules that must be applied rigidly. They are not inherently enjoyable and do not result in the completion of any useful task. To qualify for the diagnosis, the symptoms must be disabling. OCD occurs throughout the life span and children as young as six or seven present with the characteristic-impairing symptoms. Recent epidemiological studies report prevalence rates of 0.8% in adults and 0.25% in 5-10-year-old children, although earlier studies suggested rates as high as 1-3% in adults and 1-2% in children and adolescents. The World Health Organization rates OCD as one of the top 20 most disabling diseases. The current best-validated instrument is the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), which exists both in adults and children (Heymann, 2006).