Background
OCD is characterized by “intrusive and unwanted thoughts, images, or urges that cause distress or anxiety and repetitive thoughts or actions that the person feels driven to perform.”
Obsessions (repetitive/persistent, intrusive, unwanted thoughts/images/urges that cause distress/anxiety) → Compulsions (recurring thoughts/actions/rituals done to suppress the obsession).
Treatment
Psychotherapy. CBT: Exposure and response prevention (ERP) is a type of CBT that is effective at treating OCD. It involves repeated and prolonged exposure of the patient to the stimuli that elicit fear/anxiety (such as dirt) coupled with helping them learn healthy ways to deal with the anxiety and abstain from the compulsive behaviors.
Pharmacotherapy: SSRIs (used at high doses that in MDD), TCAs (Clomipramine).
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“Obsessions are repetitive and persistent thoughts (e.g., of contamination), images (e.g., of violent scenes), or urges (e.g., to stab someone). Obsessions are intrusive, unwanted thoughts that cause distress or anxiety. The person attempts to ignore or suppress these obsessions with another thought or action (i.e., a compulsion). Compulsions (or rituals) are repetitive behaviors (e.g., washing) or mental acts (e.g., counting) that the person feels driven to perform in response to an obsession. Compulsions are meant to neutralize or reduce the person’s discomfort or to prevent a dreaded event.” NEJM 2014
Reference
N Engl J Med 2014; 371:646-653. Obsessive–Compulsive Disorder. http://www.nejm.org/doi/full/10.1056/NEJMcp1402176