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Obsessive Compulsive Disorder NUR 114 Obsessive-Compulsive Disorder (2-3%) of population) Obsessive-compulsive disorder: • A mental disorder characterized by obsessions and compulsions. Obsession: • An unwanted thought or idea with which a person is preoccupied. • e.g., “I left the doors unlocked!” Compulsion: • The feeling that one is obliged to perform a behavior, even if one prefers not to do so. • Checking behaviors (keep checking the doors) Examples of obsessions: Concern for order and constancy Cleanliness (body or living space) Forbidden sexual thoughts Examples of compulsions: Hand washing Checking Collecting Repeating behaviors (in and out of a door) Arranging things Cleaning Obsessive-Compulsive Disorder Possible Causes: Genetic Origin: • Evidence is beginning to accumulate suggesting that OCD might have a genetic origin. Appears with Tourette’s syndrome Brain Damage (from trauma) • Basal ganglia, cingulate, frontal cortex Treatment Serotonin's involvement in impulse control via orbitofrontal cortex and basil ganglia (both receive SE input) • SSRIs are most effective • Serotonin antagonists worsen symptoms Obsessive-Compulsive Disorder Possible Causes: Tourette’s syndrome: • A neurological disorder characterized by tics and involuntary vocalizations and sometimes by compulsive uttering of obscenities and repetition of the utterances of others. • Treatment with antipsychotics (dopamine antagonists, D2) Obsessive-Compulsive Disorder Possible Causes: Cingulotomy: • The surgical destruction of the cingulum bundle, which connects the prefrontal cortex with the limbic system; helps to reduce intense anxiety and the symptoms of obsessive-compulsive disorder. • Only used on patients who are unresponsive to drug treatment.