OBSSESSIVE COMPULSIVE

DISORDER (OCD)
STEVYANA SURYARAHMAN
201520401011108
JUNITA ANGGRAINI
201520401011154

Definition
Obsessivecompulsive disorder
(OCD) is a neuropsychiatric disorder
characterized by obsessions or
compulsions (or both) that are
distressing, time-consuming, or
substantially impairing
About 3.3 million adults ages 18-54
have OCD. (National Institute of
Mental Health)
Equally common in both males &

Epidemiology

GENERAL REQUIREMENTS
The person must have recognized at some
point that the obsessions or compulsions are
excessive or unreasonable.
These recurrent obsessions or compulsions
must be severe enough to be time consuming
(taking up more than 1 hour per day).
The obsessions/compulsions must cause a
marked distress or significantly interfere with
the individuals normal routine, occupational
functioning, or usual social activities or
relationships with others.

OBSESSIONS
Recurrent & persistent thought, impulses, or
images that are experienced, at some time during
the disturbance, as intrusive and inappropriate &
that cause marked anxiety or distress.
The thoughts, impulses, or images arent simply
excessive worries about life problems.
The person attempts to ignore or suppress 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/her own mind (not imposed from without as in
thought insertion).

COMMON OBSESSIONS
(Thoughts)
Repeated thoughts about
contamination (public restrooms or
shaking hands).
Repeated doubts (leaving lights on or
leaving the door unlocked)
Things or objects need to be in a
particular place or order (intense
distress when objects are disordered
or asymmetrical)

COMPULSIONS
Repetitive behaviors (e.g., hand washing,
ordering, checking) or mental acts (e.g., praying,
counting, repeating words silently) that the
person feels driven to perform in response to an
obsession, or according to rules that must be
applied rigidly.
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 realistic way with what they are designed to
neutralize or prevent or are clearly excessive.

COMMON COMPULSIONS
(Behaviors)
Hand washing (so repetitive that they
become raw).
Counting (how many cards in a deck,
over and over again).
Cleaning (spots on windows)
Checking (the lights to make sure
theyre off; locked doors every few
minutes.
Request/demand assurances
Repeat actions & ordering.

Pathophysiology
Several brain structures and functions have been
implicated in OCD. Studies have consistently
shown hyperactivity in the orbitofrontal cortex and
caudate. Other key implicated regions (suggesting
abnormalities in functional or structural
connections) include the anterior cingulate cortex,
thalamus, amygdala, and parietal cortex.
Neuropsychological studies involving patients with
OCD have shown deficits in cognitive abilities that
are linked to the functioning of the frontal lobe and
its related frontosubcortical structures, such as
executive functioning, impulsivity in motor
function, and cognitive inflexibility (i.e., not
changing behavior on the basis of new
information).

Diagnostic

Differential Diagnosis
Anxiety disorder
Due to a General
Medical Condition
Substance induced
Anxiety Disorder
Body Dysmorphic
Disorder
Specific or Social
Phobias
(Trichotillomania)

Major Depressive
Episode
Generalized
Anxiety Disorder
Tic Disorder
Stereotypic
Movement Disorder

OCD Treatment
Strategies

People with OCD usually have

considerable insight into their
own problems.
Most of the time, they know
their obsessive thoughts are
senseless or exaggerated,
and that their compulsive
behaviors are not really
necessary
However, this knowledge is
not sufficient to enable them
to stop obsessing or carrying
out their rituals
Education is one of the most
powerful weapons needed to
win the battle over OCD

OCD Treatment
Strategies
T y p e s o f T re a tm e n t
P h a rm a c o th e ra p y
S e r o t o n in R e u p t a k e I n h ib it o r s
C lo m ip r a m in e
( A n a fr a n il)

F lu o x e t in e
(P ro z a c )

S e r t r a lin e
( Z o lo ft )

F lu v o x a m in e
(L u v o x )

P a r o x a t in e
( P a x il)

Treatment

Behavior Therapy
A specific behavior therapy approach called
exposure and response prevention is effective.
In this approach, the patient is deliberately and
voluntarily exposed to the feared object or idea,
either directly or by imagination, and then is
prevented from carrying out the usual
compulsive response.
When treatment works well, the patient
gradually experiences anxiety form the
obsessive thoughts and becomes able to do
without the compulsive actions for extended
periods of time.

 90% of patients who

underwent behavior
therapy had at least a 30%
reduction in obsessions
and compulsions
Patients who are unwilling
to participate in behavior
therapy do benefit from
only pharmacotherapy
treatment, but symptoms
reoccur when the
medication is stopped.

Cognitive Therapy

OCD Prognosis

Studies have shown that

OCD patients who
participate in both types of
therapy will be able to
function well in both their
work and social lives if the
following factors are
included:
The patient must be highly
motivated
The patients family must
be cooperative
The patient must be
faithful in fulfilling
homework assignments

OCD Prognosis

OCD tends to last for years,

even decades. The symptoms
may become less severe from
time to time, and there may
be long intervals where
symptoms are mild
For most, the symptoms are
chronic
With a combination of
pharmacotherapy and
behavior therapy, symptoms
can be controlled