OCD

OCD, or obsessive-compulsive disorder, is a common mental health condition characterized by the presence of obsessions, compulsions, or both. Obsessions are intrusive, distressing thoughts, urges, or images that repeatedly occur. Compulsions are repetitive behaviors or mental acts that a person feels driven to perform in response to an obsession, often aimed at preventing distress or a feared event, though the connection is usually not realistic or is excessive.

Most people with OCD recognize that their obsessions are a product of their own mind, though insight can vary. The symptoms are time-consuming and cause significant distress or impairment in social, occupational, or other important areas of functioning.

Estimates of lifetime prevalence are around 1-3%. Onset typically occurs in adolescence or early adulthood, with roughly equal distribution between men and women. The course is usually chronic but fluctuates in intensity; many individuals improve with treatment, though some experience persistent symptoms.

Causes are multifactorial, including genetic vulnerability, neurobiological factors involving fronto-striatal circuits and serotonin, and environmental stressors. OCD is diagnosed based on clinical assessment; there are no biological tests that definitively diagnose the condition.

Treatment usually combines psychotherapy and medication. Cognitive-behavioral therapy, especially exposure and response prevention, is a first-line psychosocial treatment. Selective serotonin reuptake inhibitors (SSRIs) at higher-than-typical antidepressant doses are commonly used, with clomipramine as an alternative when SSRIs are ineffective or not tolerated. For some patients, a combination of CBT and medication or augmentation with other therapies may be necessary. In severe cases, specialist referral or consideration of neuromodulation strategies may be appropriate.

With proper treatment, many individuals experience substantial symptom reduction and improved functioning, though complete remission is less common.