OCD in Adult Woman

OCD in Adult Woman

Introduction

Obsessive-compulsive disorder (OCD) is one of the more common of the serious psychiatric conditions. OCD has varying degrees of severity and it is characterized by obsessions or compulsions but commonly both. Obsessions are unwanted intrusive thoughts, images or urges that occur repeatedly and the person cannot get out of their mind. Compulsions are repetitive behaviours or mental acts that the person feels driven to carry out. They can be overt (noticeable to others), eg. Constantly washing their hands; or they can be covert, e.g. A mental act that cannot be observed, such as repeating a certain phrase in one's mind. Body Dysmorphic Disorder (BDD), a condition related to OCD characterized by severe preoccupation with a perceived physical defect (Aull 2005).

Body Image

Body image problems can cause significant distress and can lead to further problems such as anxiety, eating disorders and social phobia. It has long been recognized that negative body image problems are a factor in the onset and maintenance of many eating disorders. In many ways, BDD is quite similar to OCD; BDD also has obsessive characteristics, in the case of BDD the person is obsessed with an imagined defect in his/her appearance. The treatment of BDD is very similar to OCD (Banks & Kaschak 2003).

Compulsions

Compulsions can include behaviors such as cleaning, hand washing, checking, ordering and arranging, hoarding and asking for reassurance. Compulsions can also include mental acts such as counting, repeating words silently and constant worries about past events (Steele & Steele 2008).

Prognosis

For most adult patients who come to treatment, OCD appears to be a chronic condition. In their series of 560 patients in 1988, Rasmussen and Eisen reported that 85% had a continuous course with waxing and waning symptoms, 10% a deteriorative course and only 2% an episodic course marked by full remissions lasting six months or more. An Italian series by Lensi et al. in 1996 reported more patients with episodic or deteriorative courses in which 26% were episodic, 9% were deteriorative, and 64% were chronic. The conclusions drawn from studies that predate current diagnostic criteria, effective treatments and current patterns of health care utilization should not be applied to today's patients (Norcross 2003).

The prognosis of children and adolescents who present for treatment appears to be good for half or more. Leonard et al. reported in 1993, that a little more than half of 54 children and adolescents were only mildly affected when evaluated two- to seven- years after vigorous treatment with medications, and less often with behavior therapy. Only six patients (11%) were symptom free, however, and only three of these were taking no medication. A 9 -to 14 -year follow-up study reported that 8 of 14 adolescents who had received medication treatment were medication free and did not meet OCD criteria; the other six had experienced a chronic, or a relapsing and then chronic course, reported Bolton, Luckie and Steinberg in 1995. Finally, Thomsen and Mikkelsen reported in 1995 that a ...