Obsessive Compulsive Disorder

Obsessive compulsive disorder (OCD) is an anxiety disorder that affects 2 to 3 percent of the U.S. population. OCD is characterized by consuming thoughts and beliefs that typically lead to the uncontrollable performance of behaviors. For a person to be diagnosed with OCD, his or her obsessions and/or compulsions must significantly negatively impact his or her life, such as an inability to work.

There are four types of OCD: (1) contamination/cleaning, characterized by overwhelming thoughts of filth and the need to remove the filth by cleaning; (2) obsessions/checking, characterized by a fanatical need to check on things (like making sure a stove is off or a door is locked); (3) symmetry/ordering, where a person visually requires items to be as symmetrical as possible and will arrange or rearrange things so that they are precisely and symmetrically ordered; and (4) hoarding, which is characterized by a compulsion to keep items that may be old, spoiled, out of date, or otherwise unused as a result of a fear that once discarded an item may be needed. Studies have found that each type is characterized by a unique distribution of symptoms. The most common obsession is fear of contamination and the most common compulsion is checking.

Symptoms that an OCD person may experience are severe anxiety, hyperventilation, sweating, accelerated heartbeat, and a tightening of the chest. OCD usually begins in late adolescence or early adulthood (33 percent of individuals experience symptoms before the age of 15) but can (rarely) develop at an earlier age. OCD affects U.S. adult men and women equally, but males develop OCD earlier than women (between 5 and 6 years of age compared to between 20 and 29 years of age, respectively). Women with OCD are more likely than men to be married with children and to have a past history of an eating disorder or major depression. Studies have found that OCD is comorbid with other psychiatric disorders; 67 percent of persons with OCD also have major depression, 25 percent also have social phobia, and 20 to 30 percent also suffer from tics.

Although OCD has a 2.5 percent lifetime prevalence rate in the United States, families that have one clinically diagnosed OCD person in them are 6.2 times more likely to have another OCD person. Studies have cited both a genetic component (using monozygotic and dizygotic twin studies, and parent and non-twin sibling samples) as well as a learned environmental component. Some researchers believe that children who grow up watching siblings or parents performing compulsive behaviors, and/or hearing obsessive thoughts spoken aloud, are more likely to have OCD symptoms because they learn the behavior as a normal course of daily life.

The presence of symptoms does not guarantee treatment for OCD. The average number of years between the onset of OCD and treatment is 17 years. Further, the median untreated rate is 59.5 percent for persons with OCD. Treatment plans depend on the type of OCD one is experiencing and the degree of impact on the individual's life. Selective serotonin reuptake inhibitors (SSRIs) are often prescribed to mediate the effects of the anxiety experienced and also to treat depression, social phobia, or other generalized anxiety that is present in persons with OCD.

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