Obsessive-Compulsive Disorder.

People with obsessive-compulsive disorder (OCD) suffer intensely from recurrent, unwanted thoughts (obsessions) or rituals (compulsions), which they feel they cannot control. Rituals such as handwashing, counting, checking, or cleaning are often performed with the hope of preventing obsessive thoughts or making them go away. Performing these rituals, however, provides only temporary relief, and not performing them markedly increases anxiety. Left untreated, obsessions and the need to perform rituals can take over a person's life. OCD is often a chronic, relapsing illness.

Fortunately, through research supported by the National Institute of Mental Health (NIMH) and by industry, effective treat-ments have been developed to help people with OCD.

How Common Is OCD?

* About 2.3% of the U.S. population ages 18-54 - approximately 3.3 million Americans - has OCD in a given year.

* OCD affects men and women equally.

* OCD typically begins during adolescence or early childhood.

* OCD cost the U.S. $8.4 billion in 1990 in social and economic losses, nearly 6% of the total mental health bill of $148 billion.

What Treatments Are Available for OCD?

Treatments for OCD have been developed through research supported by the NIMH and other research institutions. These treatments, which combine medications and behavioral therapy (a specific type of psychotherapy), are often effective.

Several medications have been proven effective in helping people with OCD: clomipramine, fluoxetine, fluvoxamine, sertraline, and paroxetine. If one drug is not effective, others should be tried. A number of other medications are currently being studied. A type of behavioral therapy known as "exposure and response prevention" is very useful for treating OCD. In this approach, a person is deliberately and voluntarily exposed to whatever triggers the obsessive thoughts, and then is taught techniques to avoid performing the compulsive rituals and to deal with the anxiety.

Recent Research Findings

There is growing evidence that OCD represents abnormal functioning of brain circuitry, probably involving a part of the brain called the striatum. OCD is not caused by family problems or attitudes learned in childhood, such as an inordinate emphasis on cleanliness, or a belief that certain thoughts are dangerous or unacceptable. Brain imaging studies using a technique called positron emission tomography (PET) have compared people with and without OCD. Those with OCD have patterns of brain activity that differ from people with other mental illnesses or people with no mental illness at all. In addition, PET scans show that in patients with OCD, both behavioral therapy and medication produce changes in the striatum. This is graphic evidence that both psychotherapy and medication affect the brain.

Can People With OCD Have Other Illnesses?

OCD is sometimes accompanied by depression, eating disorders, substance abuse, attention deficit hyperactivity disorder, or other anxiety disorders. When a person also has other disorders, OCD is often more difficult to diagnose and treat. Persons with obsessive-compulsive disorder use different brain circuitry in performing a cognitive task than people without the disorder. Rauch SL, et al. J Neuropsychiatry Clin Neurosci, 1997:9:568-573.

Symptoms of OCD can also coexist and may even be part of a spectrum of other brain disorders, such as Tourette's syndrome. Appropriate diagnosis and treatment of other disorders are important to successful treatment of OCD.

For More Information About Obsessive-Compulsive Disorder and Other Anxiety Disorders

Write: The Anxiety Disorders Education Program National Institute of Mental Health 6001 Executive Blvd Room 8184, MSC 9663 Bethesda, MD 20892-9663 Or call 301-443-4513

Publications and other information are also available online from the NIMH Anxiety Disorders Web site at http://www.nimh.nih.gov/anxiety or by calling toll-free 1-88-88-ANXIETY (1-888-826-9438).

NIH Publication No. 99-4598

For More Information About NIMH

The Office of Communications and Public Liaison carries out educational activities and publishes and distributes research reports, press releases, fact sheets, and publications intended for researchers, health care providers, and the general public. A publications list may be obtained on the web at http://www.nimh.nih.gov/publist/puborder.cfm or by contacting:

Office of Communications and Public Liaison, NIMH Information Resources and Inquiries Branch 6001 Executive Blvd Room 8184, MSC 9663 Bethesda, MD 20892-9663 Phone: [phone] FAX: [phone] Mental Health FAX4U: 301-443-5158 E-mail: [e-mail] NIMH home page address: http://www.nimh.nih.gov

For information about NIMH and its programs, please email, write or phone us.

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This page was last updated: June 1, 1999.