psychiatric disorders
Obsessive Compulsive Disorder (OCD)
Key Points
Obsessions are intrusive, unwanted thoughts, images, or urges that usually cause marked distress or anxiety. Compulsions are excessive, repetitive rituals that people feel they must do to reduce the anxiety caused by their obsessive thoughts or to neutralize their obsessions. Obsessions and/or compulsions must be time-consuming (eg,>1 hour a day, often much more) or cause patients significant distress or impairment in functioning. Treat by gradually exposing patients to situations that trigger the anxiety-provoking obsessions and rituals while requiring them not to perform their rituals. The addition of cognitive approaches to exposure and response prevention may be helpful. Consider combining exposure and ritual prevention with medications (ie, an SSRI orclomipramine), particularly for severe cases. 