Obsessive compulsive disorder since childhood. Obsessive Action Check

Obsessive-compulsive disorder, obsessive-compulsive disorder (OCD) is a psychoneurotic disorder that manifests itself obsessive thoughts and actions of the patient. The concept of "obsession" is translated from Latin as a siege or blockade, and "compulsion" as coercion. Healthy people have no problem brushing off unpleasant or frightening thoughts, images, or impulses. Individuals with OCD cannot do this. They constantly ponder such thoughts and get rid of them only after performing certain actions. Gradually, obsessive thoughts begin to conflict with the subconscious of the patient. They become a source of depression and anxiety, and rituals and repetitive movements cease to have the expected effect.

In the very name of the pathology lies the answer to the question: what is OCD? Obsession is the medical term for obsessive ideas, disturbing or frightening thoughts, while compulsion is a compulsive act or ritual. It is possible to develop local disorders - only obsessive with a predominance of emotional experiences, or only compulsive, manifested by restless actions. The disease is a reversible neurotic process: after psychotherapeutic and drug treatment his symptoms disappear completely.

Obsessive-compulsive disorder occurs in representatives of all socio-economic levels. Men under the age of 65 are predominantly affected. At a more advanced age, the disease is diagnosed in women. The first signs of pathology appear in patients by the age of ten. There are various phobias and obsessive-compulsive states that do not require immediate treatment and are adequately perceived by a person. In thirty-year-old patients, a pronounced clinic of the syndrome develops. At the same time, they cease to perceive their fears. They need qualified medical care in a hospital setting.

People with OCD are plagued by thoughts of countless bacteria and wash their hands a hundred times a day. They are not sure if the iron is turned off, and they return home from the street several times to check it. Patients are sure that they can harm loved ones. To prevent this from happening, they hide dangerous items and avoid casual communication. Patients will double-check several times whether they forgot to put all the necessary things in their pocket or bag. Most of them carefully monitor the order in the room. If things are out of place, there is emotional stress. Such processes lead to a decrease in working capacity and poor perception of new information. The personal life of such patients usually does not add up: they either do not create a family, or their families quickly disintegrate.

Painful obsessive thoughts and actions of the same type lead to depression, reduce the quality of life of patients and require special treatment.

Etiology and pathogenesis

The causes of obsessive-compulsive disorder are currently not fully understood. There are several hypotheses regarding the origin of this disease.

Provoking factors include biological, psychological and social.

Biological factors in the development of the syndrome:

• acute infectious diseases - meningitis, encephalitis,
• autoimmune diseases - group A hemolytic streptococcus causes inflammation of the basal ganglia,
• genetic predisposition,
• alcohol and drug addiction,
• neurological diseases,
• metabolic disorders of neurotransmitters - serotonin, dopamine, norepinephrine.

Psychological or social factors of pathology:

1. special religious beliefs
2. stressful relationships at home and at work
3. excessive parental control all areas of a child's life
4. severe stress, psycho-emotional outburst, shock,
5. long-term use of psychostimulants,
6. experienced fear due to the loss of a loved one,
7. avoidance behavior and misinterpretation of one's thoughts,
8. psychological trauma or depression after childbirth.

Panic and fear can be imposed by society. When the news is about an attack by robbers on the street, it causes anxiety, which is helped to cope with special actions - constant looking back on the street. These compulsions help patients only on initial stage mental disorders. In the absence of psychotherapeutic treatment, the syndrome suppresses the human psyche and turns into paranoia.

Pathogenetic links of the syndrome:

• the emergence of thoughts that frighten and torment the sick,
• concentration on this thought against desire,
• mental stress and increasing anxiety,
• performance of stereotyped actions that bring only short-term relief,
• return of intrusive thoughts.

These are the stages of one cyclic process leading to the development of neurosis. Patients become addicted to ritual activities that have a narcotic effect on them. The more patients think about the current situation, the more they are convinced of their inferiority. This leads to an increase in anxiety and a deterioration in the general condition.

Obsessive Compulsive Syndrome can be inherited through generations. This disease is considered moderately hereditary. However, the gene causing this condition has not been identified. In some cases, not the neurosis itself is inherited, but a genetic predisposition to it. Clinical signs of pathology arise under the influence of negative conditions. Proper upbringing and a favorable atmosphere in the family will help to avoid the development of the disease.

Symptoms

Clinical signs of pathology in adults:

1. Thoughts of sexual perversion, death, violence, intrusive memories, fear of hurting someone, getting sick or infected, worry about material loss, blasphemy and sacrilege, obsession with cleanliness, pedantry. In relation to moral and ethical principles, unbearable and irresistible attractions are contradictory and unacceptable. Patients are aware of this, often resist and are very worried. Gradually, a feeling of fear develops.
2. Anxiety following obsessive, repetitive thoughts. Such thoughts cause panic and horror in the patient. He is aware of the groundlessness of his ideas, but is not able to control superstition or fear.
3. Stereotypical actions - counting the steps on the stairs, washing hands frequently, "correct" arrangement of books, double-checking turned off electrical appliances or closed taps, symmetrical order of objects on the table, repetition of words, counting. These actions are a ritual supposedly relieving obsessive thoughts. For some patients, reading prayers, clicking joints, biting lips helps to get rid of tension. Compulsions are a complex and intricate system, in the event of the destruction of which, the patient conducts it again. The ritual is performed slowly. The patient, as it were, is delaying time, fearing that this system will not help, and internal fears will intensify.
4. Panic attacks and nervousness in the crowd are associated with the risk of contact with the "dirty" clothes of people around, the presence of "strange" smells and sounds, "oblique" looks, the possibility of losing one's things. Patients avoid crowded places.
5. Obsessive-compulsive syndrome is accompanied by apathy, depression, tics, dermatitis or alopecia of unknown origin, excessive preoccupation with one's appearance. If left untreated, patients develop alcoholism, isolation, rapid fatigue, thoughts of suicide appear, mood swings, quality of life decreases, conflict increases, disorders of the gastrointestinal tract, irritability, concentration decreases, and abuse of sleeping pills and sedatives occurs.

In children, the signs of pathology are less pronounced and occur somewhat less frequently. Sick children are afraid to get lost in the crowd and constantly hold adults by the hand, tightly clasping their fingers. They often ask their parents if they are loved because they are afraid to end up in an orphanage. Having once lost a notebook at school, they experience severe stress, forcing them to count the school supplies in their briefcase several times a day. The dismissive attitude of classmates leads to the formation of complexes in the child and skipping classes. Affected children are usually gloomy, unsociable, suffer from frequent nightmares and complain of poor appetite. Child psychologist help to suspend further development syndrome and rid the child of it.

OCD in pregnant women has its own characteristics. It develops in the last trimester of pregnancy or 2-3 months after childbirth. The obsessive thoughts of the mother are the fear of harming her baby: it seems to her that she is dropping the baby; she is visited by thoughts of sexual attraction to him; she has difficulty making decisions about vaccinations and feeding choices. To get rid of intrusive and frightening thoughts, a woman hides objects with which she can harm a child; constantly washes bottles and washes diapers; guards the sleep of the baby, fearing that he will stop breathing; examines him for certain symptoms of the disease. Relatives of women with similar symptoms should encourage her to see a doctor for treatment.

Video: analysis of the manifestations of OCD on the example of Sheldon Cooper

Diagnostic measures

Diagnosis and treatment of the syndrome are carried out by specialists in the field of psychiatry. Specific signs of pathology are obsessions - obsessive thoughts with stable, regular and annoying repetitions. They cause anxiety, anxiety, fear and suffering in the patient, are practically not suppressed or ignored by other thoughts, are psychologically incompatible and irrational.

For physicians, compulsions are important, which cause overwork and suffering in patients. Patients understand that compulsions are unrelated and excessive. For specialists, it is important that the manifestations of the syndrome last more than an hour a day, complicate the life of patients in society, interfere with work and study, and disrupt their physical and social activity.

Many people with the syndrome often do not understand or accept their problem. Psychiatrists advise patients to undergo a full diagnosis, and then begin treatment. This is especially true when obsessive thoughts interfere with life. After a psychodiagnostic conversation and differentiation of pathology from similar mental disorders, specialists prescribe a course of treatment.

Treatment

Treatment of obsessive-compulsive syndrome should begin immediately after the onset of the first symptoms. Carry out complex therapy, consisting in psychiatric and medical effects.

Psychotherapy

Psychotherapeutic sessions for obsessive-compulsive syndrome are considered more effective drug treatment. Psychotherapy cures neurosis gradually.

The following methods help to get rid of this ailment:

• Cognitive Behavioral Therapy - resistance to the syndrome, in which compulsions are minimized or completely eliminated. Patients in the course of treatment become aware of their disorder, which helps them to get rid of it forever.
• “Thought stop” is a psychotherapeutic technique that consists in stopping memories of the most vivid situations, manifested by an obsessive state. Patients are asked a series of questions. To answer them, patients must view the situation from all angles, as in slow motion. This technique makes it easier to face fears and control them.
• The method of exposure and warning - the patient is created conditions that provoke discomfort and cause obsessions. Before this, the patient is counseled on how to resist compulsive rituals. This form of therapy achieves sustained clinical improvement.

The effect of psychotherapy lasts much longer than that of drug treatment. Patients are shown the correction of behavior under stress, training in various relaxing techniques, healthy lifestyle life, proper nutrition, fight against smoking and alcoholism, hardening, water procedures, breathing exercises.

Currently, group, rational, psycho-educational, aversive, family and some other types of psychotherapy are used to treat the disease. Non-drug therapy is preferable to drug therapy, since the syndrome is perfectly amenable to correction without drugs. Psychotherapy has no side effects on the body and has a more stable therapeutic effect.

Medical treatment

Treatment of a mild form of the syndrome is carried out on an outpatient basis. Patients undergo a course of psychotherapy. Doctors find out the causes of pathology and try to establish a trusting relationship with patients. Complicated forms are treated with the use of medications and psychological corrective sessions.

Patients are prescribed the following groups of drugs:

1. antidepressants - Amitriptyline, Doxepin, Amizol,
2. neuroleptics - "Aminazin", "Sonapaks",
3. normothymic drugs - "Cyclodol", "Depakin Chrono",
4. tranquilizers - "Phenozepam", "Clonazepam".

It is impossible to cope with the syndrome on your own without the help of a specialist. Any attempts to control your mind and defeat the disease lead to a deterioration in the condition. In this case, the psyche of the patient is destroyed even more.

Compulsive-obsessional syndrome does not apply to mental illness, since it does not lead to a change and personality disorder. It is a neurotic disorder that is reversible with proper treatment. Mild forms of the syndrome respond well to therapy, and after 6-12 months its main symptoms disappear. Residual effects of pathology are expressed in a mild form and do not interfere ordinary life patients. Severe cases of the disease are treated for an average of 5 years. Approximately 70% of patients report an improvement in their condition and are clinically cured. Since the disease is chronic, relapses and exacerbations occur after discontinuation of drugs or under the influence of new stresses. Cases of a complete cure are very rare, but possible.

Preventive actions

Prevention of the syndrome is to prevent stress, conflict situations, creating a favorable environment in the family, eliminating mental injuries at work. It is necessary to properly educate a child, not to give rise to feelings of fear in him, not to instill in him thoughts about his inferiority.

Secondary psychoprophylaxis is aimed at preventing relapses. It consists in regular medical examination of patients, conversations with them, suggestions, timely treatment of the syndrome. With a preventive purpose, phototherapy is carried out, since light contributes to the production of serotonin; restorative treatment; vitamin therapy. Experts recommend that patients get enough sleep, diet, avoid bad habits, timely treatment of concomitant somatic diseases.

Forecast

Obsessive-compulsive syndrome is characterized by a chronic process. Complete recovery of the pathology is quite rare. Usually there are relapses. In the process of treatment, the symptoms gradually go away, and social adaptation begins.

Without treatment, the symptoms of the syndrome progress, disrupt the patient's ability to work and the ability to be in society. Some patients commit suicide. But in most cases, OCD has a benign course.

OCD is essentially a neurosis that does not lead to temporary disability. If necessary, patients are transferred to lighter work. Advanced cases of the syndrome are considered by VTEC specialists, who determine III group disability. Patients are issued a certificate for light work, excluding night shifts, business trips, irregular work time, direct impact harmful factors on the body.

Adequate treatment guarantees patients stabilization of symptoms and relief of vivid manifestations of the syndrome. Timely diagnosis of the disease and treatment increase the chances of patients for success.

Video: about obsessive-compulsive disorders

Psychologist, psychotherapist.

obsessive-compulsive disorder(OCD) is a mental disorder characterized by intrusive, unpleasant thoughts that occur against the will of the patient (obsessions) and actions, the purpose of which is to reduce the level of anxiety.

To determine the severity of obsessive and compulsive symptoms, the following is used: (ed. note)

The ICD-10 describes obsessive-compulsive disorder (F42) as follows:

"The essential feature of the condition is the presence of repetitive or compulsive actions. Intrusive thoughts are ideas, images, or urges that come to the patient's mind again and again in a stereotyped form. They are almost always upsetting, and the patient often tries unsuccessfully to resist them. However, the patient considers these thoughts his own, even if they are involuntary and disgusting.
, or rituals, are stereotyped mannerisms that the patient repeats over and over again. They are not a way to have fun or an attribute of useful tasks. These actions are a way to prevent the possibility of an onset unpleasant event which the patient fears might otherwise occur, harming him or them to another person. Usually such behavior is recognized by the patient as meaningless or ineffective and repeated attempts are made to resist it. Anxiety is almost always present. If compulsive actions are suppressed, anxiety becomes more pronounced.

Personal experience of Katerina Osipova. Katya is 24 years old, 13 of them she lives with a diagnosis of OCD: (ed. note)

Symptoms of obsessive-compulsive personality disorder

• Personality is concerned with details, list, order to such an extent that life goals are lost from sight.
• Shows perfectionism that interferes with the task of completion (unable to complete the project because his own standards are not met in this project).
• Excessively devoted to work, productivity, productivity to the exclusion of leisure and friendship, despite the fact that such an amount of work is not justified by economic necessity (money is not the main interest).
• The personality is superconscious, scrupulous and inflexible in matters of morality, ethics, values ​​that do not include cultural and religious identification (intolerant).
• The personality is incapable of getting rid of spoiled or useless objects, even if they have no sentimental value.
• Resists delegating or working with other people until they present a fit for her or his way of doing things (everything must be done as she sees fit, on her terms).
• He is afraid to spend money on himself and other people, because. money should be kept for a rainy day to deal with future disasters.
• Demonstrates rigidity and stubbornness.

If more than 4 characteristics are present (usually from 4 to 8), then with a high probability we can talk about obsessive-compulsive personality disorder.

OCD develops around the age of 4-5 years, when parents place the main emphasis in education on the fact that if a child does something, then he must do it correctly. The emphasis is on achieving excellence. Such a child was supposed to be an example for other children and receive praise and approval from adults. Thus, from childhood, such a person is under the yoke of parental instructions about what she should do and what she should not do. She is overwhelmed with duty and responsibility, the need to follow the rules that were once laid down by the parent. We can notice children around us who think and act like adults. As if they are in a hurry to grow up and take on adult responsibility. Their childhood ends too soon. From childhood, they try to do more or do better than other people have already done. And this way of acting and thinking remains with them into adulthood. Such children did not learn to play, they were always busy with business. Becoming adults, they do not know how to relax, rest, take care of their needs and desires. It often happens that one of the parents (or both) themselves had OCD, did not know how to relax and rest, devoting themselves to work or household chores. The child learns such behavior from them, tries to imitate his parents, considering this a kind of norm, "because it was customary in our family."

Obsessive-compulsive individuals are very sensitive to criticism. Because if they are criticized, it means that they failed to do faster, better, more, and therefore they cannot treat themselves well, feel good. They are perfectionists. They are very tense in order to have time to do everything that they have planned, and they experience anxiety as soon as they realize that they have stopped doing some important business. They are especially anxious and guilty if they have any negative thoughts and reactions invading their work routine, and, of course, sexual thoughts, feelings and needs. They then use little rituals, such as counting to get away from invading thoughts, or doing their tasks in a certain order so that they gain control and ease their anxiety. Individuals with OCD expect equally high standards and excellence from other people, and can easily become critical when other people do not meet their high standards. These expectations and frequent criticism can cause great difficulties in personal relationships. Some relationship partners perceive OCD personalities as boring because they focus on work and have great difficulty in relaxing, relaxing, enjoying themselves.

Causes of Obsessive-Compulsive Personality Disorder

• Personality traits (hypersensitivity, anxiety, a tendency to think more than feel);
• Education with an emphasis on a sense of duty, responsibility;
• genetic predisposition;
• neurological problems;
• Stress and trauma can also trigger the OCD process in people who are prone to developing the condition.

Examples of obsessive-compulsive disorder

The most common concerns are cleanliness (such as fear of dirt, germs, and infections), safety (such as worrying about leaving the iron on in the house, which could start a fire), inappropriate sexual or religious thoughts (such as wanting to have sex with "forbidden" partner - someone else's spouse, etc.). Striving for symmetry, precision, accuracy.

Frequent hand washing or the desire to constantly rub and wash something in the house; rituals to test and protect oneself from imaginary danger, which may include whole chains of actions (for example, to enter and exit the room correctly, touch something with the hand, take three sips of water, etc.) are also fairly common examples obsessive-compulsive disorder.

Obsessive-compulsive disorder, called impulsive (obsessive) compulsive disorder, can significantly worsen the quality of life of the patient suffering from it.

Many patients mistakenly postpone visiting a doctor, not realizing that a timely visit to a specialist will reduce the risk of developing a chronic disease and help get rid of obsessive thoughts and panic fears forever.

Impulsive (obsessive) compulsive disorder is a disorder mental activity a person, manifested by increased anxiety, the appearance of involuntary and obsessive thoughts that contribute to the development of phobias and interfere with the normal life of the patient.

Violation of mental health is characterized by the presence of obsessions and compulsions. Obsessions are thoughts that involuntarily arise in the human mind, which lead to the emergence of compulsions - special rituals, repetitive actions that allow you to get rid of obsessive thoughts.

In modern psychology, mental health disorders are classified as a type of psychosis.

The disease may:

• be in an advanced stage
• be episodic;
• run chronically.

How the disease begins

Obsessive-compulsive disorder is formed in people aged 10-30 years. Despite a fairly wide age range, patients turn to a psychiatrist at about the age of 25-35, which indicates the duration of the course of the disease before the first consultation with a doctor.

People are more susceptible to the disease middle age, among children and adolescents, symptoms of the disorder are less common.

Obsessive-compulsive disorder at the very beginning of its formation is accompanied by:

• increased anxiety;
• the appearance of fears;
• obsession with thoughts and the need to get rid of them through special rituals.

The patient at this stage may not be aware of the illogicality and compulsiveness of his behavior.

Over time, the deviation begins to worsen and flows into an active progressive form when the patient:

• cannot adequately perceive their own actions;
• feels intense anxiety;
• does not cope with phobias and panic attacks;
• needs hospitalization and medical treatment.

Main reasons

In spite of a large number of studies, it is impossible to unambiguously determine main reason formation of obsessive-compulsive disorder. This process can occur both due to psychological and sociological, and biological reasons, which can be classified in tabular form:

Biological causes of the disease	Psychological and social causes diseases
Diseases and functional and anatomical features of the brain	Violations of the human psyche due to the occurrence of neurosis
Features of the functioning of the autonomic nervous system	Increased susceptibility to individual psychogenic influences due to the strengthening of individual character traits or personality
Metabolic disorders, most often accompanied by a change in the level of the hormones serotonin and dopamine	The negative influence of the family on the formation of a healthy psyche of the child (overprotection, physical and emotional abuse, manipulation)
Genetic factors	The problem in the perception of sexuality and the occurrence of sexual deviations (deviations)
Complications after infectious diseases	Factors of production most often associated with long work accompanied by nervous overload

Biological

Among the biological causes of obsessive-compulsive disorder, scientists identify genetic factors. The study of the occurrence of the disorder using the study of adult twins led to the conclusion of scientists about the moderate heredity of the disease.

The state of mental disorder is not generated by any particular gene, but scientists have identified a link between the formation of the disorder and the functioning of the SLC1A1 and hSERT genes.

In people suffering from the disorder, one can observe a mutation of these genes, which are responsible for the transmission of impulses in neurons and the collection of the hormone serotonin in nerve fibers.

There are cases of early onset of the disease in a child due to complications after infectious diseases suffered in childhood.

The first study examining the biological link between the disorder and the body's autoimmune response concluded that the disorder occurs in children who have a streptococcal infection that causes inflammation of clusters of nerve cells.

The second study was looking for the cause of a mental disorder in the action of prophylactic antibiotics taken to treat infectious diseases. Also, the state of the disorder may be the result of other reactions of the body to infectious agents.

As for the neurological causes of the disease, using brain imaging and brain activity, scientists have been able to establish a biological link between obsessive-compulsive disorder and the work of parts of the patient's brain.

The symptoms of the manifestation of a mental disorder included the activity of parts of the brain that regulate:

• human behavior;
• emotional manifestations of the patient;
• bodily reactions of the individual.

Excitation of certain parts of the brain creates a desire in a person to perform some kind of action, for example, to wash their hands after contact with something unpleasant.

This reaction is normal and the urge that has arisen after one procedure is reduced. Patients with the disorder have trouble stopping these urges, so they are forced to carry out the ritual of washing their hands more often than normal, receiving only temporary satisfaction of the need.

Social and psychological

From the point of view of behavioral theory in psychology, obsessive-compulsive disorder is explained on the basis of a behavioral approach. Here the disease is perceived as a repetition of reactions, the reproduction of which facilitates their subsequent implementation in the future.

Patients expend a lot of energy constantly trying to avoid situations where panic fear might arise. As protective reactions, patients perform repetitive actions that can be performed both physically (washing hands, checking electrical appliances), and mentally (prayers).

Their implementation temporarily reduces anxiety, but at the same time increases the likelihood of repeating compulsive actions again in the near future.

People with an unstable psyche most often fall into such a state, who are subjected to frequent stress or are experiencing difficult life periods:

From the point of view of cognitive psychology, the disorder is explained as the inability of the patient to understand himself, a violation of the connection of a person with his own thoughts. People with obsessive-compulsive disorder are often unaware of the deceptive value they place on their fear.

Patients, out of fear of their own thoughts, try to get rid of them as soon as possible, using defensive reactions. The reason for the intrusiveness of thoughts lies in their false interpretation, giving them great significance and catastrophic meaning.

Such a distorted perception appears as a result of attitudes formed in childhood:

1. Basal anxiety arising from a breach of the sense of security in childhood(ridicule, parental overprotection, manipulation).
2. perfectionism, consisting in the desire to achieve the ideal, rejection of one's own mistakes.
3. exaggerated feeling human responsibility for the impact on society and the safety of the environment.
4. Hyper control mental processes, conviction in the materialization of thoughts, their negative impact on oneself and others.

Also, obsessive-compulsive disorder can be caused by traumas received in childhood or a more conscious age and constant stress.

In most cases of the formation of the disease, patients succumbed to the negative influence of the environment:

• subjected to ridicule and humiliation;
• entered into conflicts;
• worried about the death of loved ones;
• could not solve problems in relationships with people.

Symptoms

Impulsive (obsessive) compulsive disorder is characterized by certain manifestations and symptoms. The main feature of mental deviation can be called a strong exacerbation in crowded places.

This is due to the high likelihood of panic attacks arising out of fear:

• pollution;
• pickpocketing;
• unexpected and loud sounds;
• strange and unknown smells.

The main symptoms of the disease can be divided into certain types:

Obsessions are thoughts of a negative nature, which can be represented as:

• words;
• individual phrases;
• full dialogues;
• offers.

Such thoughts are obsessive and cause very unpleasant emotions in the individual.

The images that repeat in a person's thoughts are most often represented by scenes of violence, perversions and other negative situations. Intrusive memories are moments that pop up in the memory of life events where the individual felt shame, anger, regret, or remorse.

The impulses of obsessive-compulsive disorder are urges to take actions of a negative nature (to enter into a conflict or use physical force against others).

The patient fears that such impulses may be realized, which causes him to feel shame and regret. Obsessive thoughts are characterized by the patient's constant disputes with himself, in which he considers everyday situations and gives arguments (counterarguments) for their solution.

Obsessional doubtfulness in committed actions concerns certain actions and doubts about their correctness or incorrectness. Often such a symptom is associated with a fear of violating certain prescriptions and harming others.

Aggressive obsessions - obsessive ideas associated with prohibited actions, often of a sexual nature (violence, sexual perversion). Often such thoughts are combined with hatred for loved ones or popular personalities.

Phobias and fears that are most common during an exacerbation of obsessive-compulsive disorder include:

Often, phobias can contribute to the appearance of compulsions - protective reactions that reduce anxiety. Rituals include both the repetition of thought processes and the manifestation of physical actions.

Often among the symptoms of the disorder, motor disorders can be noted, in the event of which the patient is not aware of the obsession and groundlessness of the reproduced movements.

Symptoms of deviation include:

• nervous tics;
• certain gestures and movements;
• reproduction of pathological repetitive actions (biting a cube, spitting).

Diagnostic methods

A mental disorder can be diagnosed using several tools and ways to identify the disease.

With obsessive compulsive disorder, you will find a difference

When designating research methods for impulsive (obsessive) compulsive syndrome, first of all, diagnostic criteria for deviation are distinguished:

1. Recurrent occurrence of obsessive thoughts in the patient, accompanied by the manifestation of compulsions for two weeks.

2. Thoughts and actions of the patient have special features:

• they, according to the patient, are considered his own thoughts not imposed by external circumstances;
• they are repeated for a long time and cause negative emotions in the patient;
• a person tries to resist obsessive thoughts and actions.

3. Patients feel that the resulting obsessions and compulsions limit their lives, interfere with productivity.

4. The formation of the disorder is not associated with such diseases as schizophrenia, personality disorders.

Often, a screening questionnaire for obsessive disorders is used to identify the disease. It consists of questions to which the patient can answer yes or no. As a result of passing the test, the individual's tendency to obsessive disorder is revealed by the predominance of positive answers over negative ones.

Equally important for the diagnosis of the disease are the consequences of the symptoms of the disorder:

Among the methods for diagnosing obsessive-compulsive disorder, the analysis of the patient's body using computed and positron emission tomography is of great importance. As a result of the examination, the patient may experience signs of internal atrophy of the brain (death of brain cells and its neuronal connections) and increased cerebral blood supply.

Can a person help himself?

If symptoms of obsessive-compulsive disorder occur, the patient must carefully analyze his condition and contact a qualified specialist.

If the patient is temporarily unable to visit a doctor, then it is worth trying Relieve symptoms on your own with the following suggestions:

Methods of psychotherapy

Psychotherapy is the most effective way treatment of obsessive-compulsive disorder. Unlike the drug method of suppressing symptoms, therapy helps to independently understand one's problem and weaken the disease for a sufficiently long time, depending on the mental state of the patient.

Cognitive-behavioral therapy is recognized as the most appropriate treatment for obsessive-compulsive disorder. At the very beginning of the sessions, the patient gets acquainted with general concepts and the principles of therapy, and after a while the study of the patient's problem is divided into several blocks:

• the essence of the situation that causes a negative mental reaction;
• the content of obsessive thoughts and ritual actions of the patient;
• intermediate and deep beliefs of the patient;
• the fallacy of deep-seated beliefs, the search for life situations that provoked the appearance of obsessions in the patient;
• the essence of the patient's compensatory (protective) strategies.

After analyzing the patient's condition, a psychotherapy plan is formed, during which the person suffering from the disorder learns:

• use certain self-control techniques;
• analyze your own state;
• watch your symptoms.

Special attention is paid to working with the patient's automatic thoughts. The therapy consists of four stages:

Psychotherapy develops awareness and understanding of one's own state in the patient, does not negative impact on the patient's body and generally demonstrates a very beneficial effect on the treatment of obsessive-compulsive disorder.

Drug Treatment: Drug Lists

Impulsive (obsessive) compulsive disorder often requires medication through the use of certain medications. Carrying out therapy requires a strictly individual approach that takes into account the patient's symptoms, his age and the presence of other diseases.

The following medicines are used only on the prescription of a doctor and taking into account special factors:

Treatment at home

It is impossible to precisely define a universal method of getting rid of the disease, because for each patient suffering from a disorder, it is necessary individual approach and special treatments.

There are no specific instructions for self-recovery of obsessive-compulsive disorder at home, but it is possible to highlight general tips that can help relieve manifestation of symptoms of the disease and avoid the deterioration of mental health:

Rehabilitation

Obsessive-compulsive disorder is characterized by an irregularly changing nature, therefore, regardless of the type of treatment, any patient can feel improvement over time.

After supportive conversations, instilling self-confidence and hope for recovery, and psychotherapy, where techniques are developed to protect against obsessive thoughts and fears, the patient feels much better.

After the recovery phase, social rehabilitation begins, which includes certain training programs for the abilities necessary for comfortable self-feeling in society.

Such programs include:

• development of communication skills with other people;
• training in the rules of communication in the professional field;
• formation of understanding of the features of everyday communication;
• development of correct behavior in everyday situations.

The rehabilitation process is aimed at forming the stability of the psyche and building the personal boundaries of the patient, gaining faith in his own strength.

Complications

Not all patients manage to recover from obsessive-compulsive disorder and undergo full rehabilitation.

Experience has shown that patients with a disease who are in the recovery stage are prone to relapse (resumption and exacerbation of the disease), therefore, only as a result of successful therapy and independent work above yourself it is possible to get rid of the symptoms of the disorder for a long time.

The most likely complications of obsessive-compulsive disorder include:

Recovery prognosis

Impulsive (obsessive) compulsive disorder is a disease that most often occurs in a chronic form. Full recovery for such a mental disorder is quite rare.

With a mild form of the disease, the results of the treatment begin to be observed no earlier than 1 year of regular therapy and the possible use of medications. Even five years after the diagnosis of the disorder, the patient may feel anxiety and some of the symptoms of the disease in his Everyday life.

The severe form of the disease is more resistant to treatment, so patients with this degree of disorder are prone to relapse, the resumption of the disease after an apparent complete recovery. This is possible due to stressful situations and overwork of the patient.

Statistics show that in the vast majority of patients, improvements in mental state appear after a year of treatment. Through behavioral therapy, a significant reduction in symptoms of 70% is achieved.

In severe cases of the disease, a negative prognosis of the disorder is possible, which manifests itself in the appearance of:

• negativism (behavior when a person speaks out or behaves demonstratively opposite to what is expected);
• obsessive ideas;
• severe depression;
• social isolation.

Modern medicine does not single out a single method of treatment for impulsive (obsessive) compulsive disorder, which would be guaranteed to relieve the patient of negative symptoms forever. In order to regain mental health, the patient needs to see a doctor in a timely manner and be ready to overcome internal resistance on the way to a successful recovery.

Article formatting: Vladimir the Great

Video about OCD syndrome

The doctor will tell you about obsessive-compulsive disorder:

Obsessive psychological disorders have been known for centuries: in the 4th century BC. e. this disease was referred to as melancholy, and in the Middle Ages, the disease was considered an obsession.

The disease was studied and tried to systematize for a long time. He was periodically attributed to paranoia, psychopathy, manifestations of schizophrenia and manic-depressive psychosis. Currently obsessive-compulsive disorder (OCD) considered one of the varieties of psychosis.

Facts about obsessive-compulsive disorder:

Obsession can be episodic or observed throughout the day. In some patients, anxiety and suspiciousness are perceived as a specific character trait, while in others, unreasonable fears interfere with personal and social life and also have a negative impact on loved ones.

CAUSES

The etiology of OCD has not been elucidated, and there are several hypotheses in this regard. The reasons may be biological, psychological or socio-social in nature.

Biological reasons:

• birth trauma;
• pathology of the autonomic nervous system;
• features of signal transmission to the brain;
• metabolic disorders with changes in the metabolism necessary for the normal functioning of neurons (decrease in serotonin levels, increase in dopamine concentration);
• traumatic brain injury in history;
• organic brain damage (after meningitis);
• chronic alcoholism and drug addiction;
• hereditary predisposition;
• complicated infectious processes.

Socio-public and psychological factors:

• children's psychological trauma;
• psychological family trauma;
• strict religious upbringing;
• overprotective parenting;
• professional activity under stress;
• life-threatening shock.

CLASSIFICATION

Classification of OCD according to the features of its course:

• a single attack (observed throughout the day, week or longer than a year);
• relapsing course with periods of no signs of the disease;
• continuous progressive course of pathology.

Classification according to ICD-10:

• mainly obsessions in the form of intrusive thoughts and reflections;
• predominantly compulsions - actions in the form of rituals;
• mixed form;
• other OKRs.

SYMPTOMS of obsessive-compulsive disorder

The first signs of OCD appear between the ages of 10 and 30. As a rule, by the age of thirty, the patient has a pronounced clinical picture of the disease.

The main symptoms of OCD are:

• The appearance of painful and intrusive thoughts. Usually they are in the nature of sexual perversion, blasphemy, thoughts of death, fear of reprisals, illness and loss of material wealth. From such thoughts, a person with OCD is horrified, realizes all their groundlessness, but is not able to overcome his fear.
• Anxiety. The OCD patient has a constant internal struggle, which is accompanied by a feeling of anxiety.
• repetitive movements and actions can manifest themselves in the endless counting of the steps of the stairs, the frequent washing of hands, the arrangement of objects symmetrically to each other or in some order. Sometimes patients with the disorder can come up with their own intricate system for storing personal belongings and constantly follow it. Compulsive checks are associated with repeated return home in order to detect the light, gas, check whether entrance doors. The patient conducts a kind of ritual to prevent unlikely events and to get rid of obsessive thoughts, but they do not leave him. If the ritual fails to complete, the person starts over.
• Obsessive slowness in which a person performs daily activities extremely slowly.
• Strengthening the severity of the disorder in crowded places. The patient has a fear of infection, disgust, nervousness from the fear of losing his things. In this regard, patients with obsessive-compulsive disorder try to avoid the crowd as much as possible.
• Decreased self-esteem. The disorder is especially susceptible to suspicious people who are used to keeping their lives under control, but are unable to cope with their fears.

DIAGNOSTICS

Diagnosis requires a psychodiagnostic conversation with a psychiatrist. A specialist can differentiate OCD from schizophrenia and Tourette syndrome. special attention deserves an unusual combination of obsessive thoughts. For example, simultaneous obsessions of a sexual and religious nature, as well as eccentric rituals.

The doctor takes into account the presence of obsessions and compulsions. Intrusive thoughts are of medical importance if they are repetitive, persistent, and persistent. They should cause a feeling of anxiety and suffering. Compulsions are considered in the medical aspect if, when they are performed, the patient experiences fatigue in response to obsessions.

Obsessive thoughts and movements should take at least one hour a day, while accompanied by difficulties in communicating with loved ones and others.

To determine the severity of the disease and its dynamics, in order to standardize data use the Yale-Brown scale.

TREATMENT

According to psychiatrists, a person needs to seek medical care in the case when the disease interferes with his daily life and communication with others.

Treatment options for OCD:

• Cognitive Behavioral Psychotherapy allows the patient to resist intrusive thoughts by changing or simplifying rituals. When talking with a patient, the doctor clearly divides the fears into justified and caused by the disease. At the same time, concrete examples from life are given. healthy people, better than those that cause respect in the patient and serve as authority. Psychotherapy helps to correct some of the symptoms of the disorder, but does not completely eliminate obsessive-compulsive disorder.
• Medical treatment. Taking psychotropic drugs is an effective and reliable method of treating obsessive-compulsive disorder. Treatment is selected strictly individually, taking into account the characteristics of the disease, the age and gender of the patient, as well as the presence of concomitant diseases.

Medical treatments for OCD:

• serotonergic antidepressants;
• anxiolytics;
• beta blockers;
• triazole benzodiazepines;
• MAO inhibitors;
• atypical antipsychotics;
• antidepressants of the SSRI class.

Cases of complete recovery are recorded quite rarely, but with the help of medications it is possible to reduce the severity of symptoms and stabilize the patient's condition.

Many people suffering from this type of disorder do not notice their problem. And if they still guess about it, they understand the senselessness and absurdity of their actions, but do not see a threat in this pathological condition. In addition, they are convinced that they can cope with this disease on their own by sheer willpower.

The unanimous opinion of doctors is the impossibility of self-healing from OCD. Any attempt to cope on your own with such a disorder only exacerbate the situation.

For the treatment of mild forms, outpatient observation is suitable, in this case, the recession begins no earlier than a year after the start of therapy. More complex shapes obsessive-compulsive disorder, associated with fear of infection, pollution, sharp objects, complex rituals and versatile ideas, are particularly resistant to treatment.

The main goal of therapy should be establishing a trusting relationship with the patient, suppression of a sense of fear before taking psychotropic drugs, as well as instilling confidence in the possibility of recovery. The participation of loved ones and relatives greatly increases the likelihood of healing.

COMPLICATIONS

Possible complications of OCD:

• depression;
• anxiety;
• isolation;
• suicidal behavior;
• abuse of tranquilizers and sleeping pills;
• conflict in personal life and professional activities;
• alcoholism;
• eating disorders;
• low quality of life.

PREVENTION

Primary prevention measures for OCD:

• prevention of psychological trauma in personal life and professional activity;
• proper upbringing of a child early childhood do not give rise to thoughts about one's own inferiority, superiority over others, do not provoke feelings of guilt and deep fear;
• prevention of conflicts within the family.

Methods for secondary prevention of OCD:

• regular medical examination;
• conversations with the aim of changing a person's attitude to situations that traumatize the psyche;
• phototherapy, increasing the illumination of the room (the sun's rays stimulate the production of serotonin);
• general strengthening measures;
• the diet provides for good nutrition with a predominance of foods containing tryptophan (an amino acid for the synthesis of serotonin);
• timely treatment of concomitant diseases;
• prevention of any kind of drug addiction.

PROGNOSIS FOR RECOVERY

Obsessive-compulsive disorder is a chronic disease for which full recovery and episodic seen in rare cases.

In the treatment of mild forms of the disease in an outpatient setting, the regression of symptoms is observed no earlier than 1-5 years after the detection of the disease. Often the patient has some signs of the disease that do not interfere with his daily life.

More severe cases of the disease are resistant to treatment and prone to recurrence. OCD is aggravated by overwork, lack of sleep, and stress factors.

According to statistics, in 2/3 of patients, improvement during treatment occurs within 6-12 months. In 60-80% of them, it is accompanied by clinical recovery. Severe cases of obsessive-compulsive disorder are extremely resistant to treatment.

Improvement in the condition of some patients is associated with taking medications, therefore, after their withdrawal, the likelihood of relapse increases significantly.

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Obsessive-compulsive disorder is a mental illness of a person, otherwise called obsessive-compulsive disorder. For example, a pathological desire to wash hands two hundred times in one day due to thoughts of countless bacteria, or to count pages the book you read in an effort to know exactly how much time to spend on one sheet, or repeatedly returning home before work in doubt whether the iron or gas is turned off.

That is, a person suffering from obsessive-compulsive disorder is tormented by obsessive thoughts that dictate the need for tedious, repetitive movements, which leads to stress and depression. This condition undoubtedly reduces the quality of life and requires treatment.

Description of the disease

The official medical term "obsessive-compulsive syndrome" is based on two Latin roots: "obsession", which means "engulfment or siege by obsessed ideas", and "compulsion", that is, "compulsory action".

Sometimes there are disorders of a local nature:

• a purely obsessive disorder, experienced only emotionally, and not physically;
• apart from compulsive disorder, when restless actions are not caused by clear fears.

Obsessive compulsive disorder occurs in about three out of a hundred cases in adults and about two out of five hundred in children. The pathology of the psyche can manifest itself in different ways:

• occur sporadically;
• progress from year to year;
• be chronic.

The first signs are usually observed no earlier than 10 years and rarely necessitate immediate treatment. The initial obsessive-compulsive neurosis is presented in the form of various phobias and strange obsessive states, the irrationality of which a person is able to understand independently.

By the age of 30, the patient may already have a pronounced clinical picture, with a refusal to perceive their fears adequately. In advanced cases, a person, as a rule, has to be hospitalized and treated for more than effective methods than conventional psychotherapy sessions.

Causes

To date, the exact etiological factors for the occurrence of obsessive-compulsive syndrome are unknown. There are only a few theories and assumptions.

Among the biological causes, the following factors are considered possible:

• pathology of the autonomic nervous system;
• feature of the transmission of electronic impulses in the brain;
• violation of the metabolism of serotonin or other substances necessary for the normal functioning of neurons;
• previous traumatic brain injury;
• infectious diseases with complications;
• genetic inheritance.

In addition to biological factors, obsessive-compulsive disorder can have many psychological or social causes:

• psychotraumatic family relationships;
• strictly religious education;
• work in stressful working conditions;
• experienced fear due to a real threat to life.

Panic fear may be rooted in personal experience or be imposed by society. For example, watching crime news provokes anxiety about being attacked by robbers on the street or fear of car theft.

A person tries to overcome the obsessions that have arisen by repeated “control” actions: looking over his shoulder every ten steps, pulling the car door handle several times, etc. But such compulsions give relief for a short time. If you do not start a fight with them in the form of psychotherapeutic treatment, obsessive-compulsive syndrome threatens to completely overwhelm the human psyche and turn into paranoia.

Symptoms in adults

Symptoms of obsessive-compulsive disorder in adults add up to approximately the same clinical picture:

1. First of all, neurosis manifests itself in obsessive painful thoughts:

• about perversions of a sexual nature;
• about death, physical harm or violence;
• blasphemous or sacrilegious ideas;
• fears of disease, virus infection;
• anxiety about the loss of material values, etc.

Such painful thoughts terrify a person with obsessive-compulsive disorder. He understands their groundlessness, but cannot cope with the irrational fear or superstition that all this will one day come true.

2. The syndrome in adults also has external symptoms, expressed in repetitive movements or actions:

• recalculation of the number of steps on the stairs;
• very frequent hand washing;
• rechecking several times in a row turned off taps and closed doors;
• restoring a symmetrical order on the table every half hour;
• arranging books on a shelf in a certain order, etc.

All these actions are a kind of ritual for "getting rid" of the obsessive state.

3. Obsessive-compulsive disorder tends to intensify in crowded places. In a crowd, the patient may experience periodic panic attacks:

• fear of infection due to the slightest someone else's sneeze;
• fear of touching the "dirty" clothes of other passers-by;
• nervousness due to "strange" smells, sounds, sights;
• fear of losing personal belongings or becoming a victim of pickpockets.

In connection with such obsessive disorders, a person with obsessive-compulsive neurosis tries to avoid crowded places.

4. Since obsessive-compulsive disorder is more susceptible to people who are suspicious and have the habit of controlling everything in their lives, the syndrome is often accompanied by a very strong decrease in self-esteem. This happens because a person understands the irrationality of the changes taking place with him and powerlessness in front of his own fears.

Symptoms in children

Obsessive-compulsive disorder is less common in children than in adults. But has a similar obsessive state:

• the fear of getting lost in the crowd makes the already grown-up children hold their parents by the hand and constantly check whether the hoop is tightly linked;
• fear of being in orphanage(if adults threatened at least once with such a “punishment”) makes the child want to very often ask his mother if he is loved;
• panic at school due to a lost notebook leads to a frantic recounting of all school subjects while folding a portfolio, and waking up in a cold sweat at night and again rushing to this lesson;
• obsessive complexes, which are intensified by the "persecution" of classmates because of dirty cuffs, can torment so much that the child completely refuses to go to school.

Obsessive-compulsive disorder in children is accompanied by sullenness, unsociableness, frequent nightmares and poor appetite. Contacting a child psychologist will help to get rid of the syndrome faster and prevent its development.

What to do

Obsessive-compulsive personality disorder can occur episodically in any person, even a completely mentally healthy person. It is very important to recognize the beginning symptoms at the very first stages and start treatment with a psychologist, or at least try to help yourself by analyzing your own behavior and developing a certain protection against the syndrome:

Step 1. Learn what obsessive-compulsive disorder is.

Read several times the causes, symptoms and treatments. Write down on a piece of paper the signs that you observe. Leave space next to each disorder for a detailed description and a plan describing how to get rid of it.

Step 2. Ask for an assessment from the outside.

If you suspect obsessive compulsive disorder, it is best, of course, to consult a specialist doctor who will help you start effective treatment. If it is very difficult to make the first visit, you can ask relatives or a friend to confirm the already discharged symptoms of the disorder or add some others that the person himself does not notice.

Step 3. Look your fears in the eye.

A person with obsessive-compulsive disorder is usually able to understand that all fears are just a figment of his imagination. If every time a new desire arises to wash hands or check a locked door, remind yourself of this fact and interrupt the next “ritual” with a simple effort of will, getting rid of an obsessive neurosis will become easier and easier.

Step 4 Praise yourself.

You need to celebrate the steps to success, even the smallest ones, and praise yourself for the work done. When the sufferer of the syndrome has at least once felt that he is stronger than his obsessive states, that he is able to control them, the treatment of neurosis will go faster.

If it is difficult for a person to find sufficient strength in himself to get rid of obsessive-compulsive neurosis, he should turn to a psychologist.

Methods of psychotherapy

Treatment in the form of psychotherapeutic sessions for obsessive-compulsive syndrome is considered the most effective. Today, specialist psychologists have in their medical arsenal several effective methods to get rid of such obsessive-compulsive disorder:

1. Cognitive behavioral therapy for the disorder. Founded by psychiatrist Jeffrey Schwartz, the idea is to resist the syndrome by minimizing compulsions and then eliminating them completely. A step-by-step method of absolute awareness of one's disorder and its causes leads the patient to decisive steps that help to get rid of neurosis for good.

2. The technique of "stopping thoughts." Behavioral therapy theorist Joseph Wolp formalized the idea of ​​applying the "outside view of the problem." A person suffering from a neurosis is invited to recall one of the vivid situations when his obsessive states manifest themselves. At this point, the patient is told loudly “Stop!” and analyze the situation using a number of questions:

• Is there a high probability that this could happen?
• How much does thought interfere with living a normal life?
• How strong is the internal discomfort?
• Would life be easier and happier without this obsession and neurosis?

Questions may vary. There may be many more. Their main task in the treatment of obsessive-compulsive disorder is to "photograph" the situation, to consider it, as in a slow motion frame, to see it from all angles.

After such an exercise, it becomes easier for a person to face fears and control them. The next time the obsessive-compulsive disorder begins to haunt him outside the walls of the psychologist's office, the internal exclamation "Stop!" will work, and the situation will take on a completely different shape.

The above methods of psychotherapy are far from the only ones. The choice remains with the psychologist, after questioning the patient and determining the degree of obsessive-compulsive syndrome on the Yale-Brown scale, which was specially designed to identify the depth of neurosis.

Medication treatment

Treatment of some difficult cases obsessive-compulsive syndrome is not complete without medical intervention. Especially when metabolic disorders were discovered that are necessary for the work of neurons. The main drugs for the treatment of neurosis are SSRIs (serotonin reuptake inhibitors):

• fluvoxamine or escitalopram;
• tricyclic antidepressants;
• paroxetine, etc.

Modern Scientific research in the field of neurology have discovered therapeutic potential in agents that release the neurotransmitter glutamate and help, if not get rid of neurosis, then significantly mitigate it:

• memantine or riluzole;
• lamotrigine or gabapentin;
• N-acetylcysteine, etc.

But conventional antidepressants are prescribed as a means of symptomatic effects, for example, to eliminate neurosis, stress arising from persistent obsessive-compulsive states or mental disorders.