Obsessive compulsive disorder - Research Paper Example

DSM-IV-TR diagnostic criteria The following four criteria are useful to define obsession in the the DSM-IV-TR (APA, 2000): •Recurrent and persistent thoughts, impulses, or images are experienced at some time during the disturbance as intrusive and inappropriate and cause marked anxiety and distress. Persons with this disorder recognize the pathologic quality of these unwanted thoughts (such as fears of hurting their children) and would not act on them, but the thoughts are very disturbing and difficult to discuss with others.

•The thoughts, impulses, or images are not simply excessive worries about real-life problems. •The person attempts to suppress or ignore such thoughts, impulses, or images or to neutralize them with some other thought or action. •The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind (not imposed from without, as in thought insertion). The following 2 criteria are used to define compulsions in DSM-IV-TR (APA, 2000): •An individual performs repetitive behaviors (eg, hand washing, ordering, checking) or mental acts (eg, praying, counting, repeating words silently) in response to an obsession or according to rules that must be applied rigidly.

The behaviors are not a result of the direct physiologic effects of a substance or a general medical condition. •The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation. However, these behaviors or mental acts either are not connected in a way that could realistically neutralize or prevent whatever they are meant to address or they are clearly excessive. Clinical presentation The diagnosis of OCD is mainly done based on clinical history and presentation.

It is important to establish the age off onset of the condition. Also, any history of tics must be noted. Common obsessions include safety, contamination, doubting of perception or memory, need for symmetry or order, scrupulosity and unwanted sexual thoughts. Common compulsions include checking, hand washing, cleaning, counting, touching objects and arranging objects. In many cases comorbid conditions like eating disorders, mood and anxiety disorders, somatoform disorders, impulsive disorders and ADHD can be present.

It is important to identify these conditions and also include them in treatment. OCD is frequently associated with Tourette disorder and this condition must be identified and ruled out. Other problems associated with OCD include loss of interpersonal relationships and loss of functioning of the individual (Greenberg, 2011). Etiology The exact cause of OCD is not yet understood. However, there is some evidence that abnormalities in the serotonin neuro-transmission can occur. Other abnormalities include defective dopaminergic transmission and defective glutamatergic abnormalities.

Some researchers are of the opinion that an increase in metabolic activity and blood flow in certain regions of brain like thalamus, limbic structures, caudate and orbitofrontal cortex. Thus, OCD symptoms mainly occur due to impairment in the inhibition of specific orbitofrontal-subcortical circuitry that are involved in the regulation of autonomic responses and strong emotions. there is a strong heritability for OCD and this is based on various twin studies. Genes related to dopaminergic, serotonergic and