obsessive-compulsive disorder (OCD)

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[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]

Introduction

A condition that is characterized by the presence of obsessions &/or compulsions.

Etiology

Epidemiology

  • affects 1-2% of the general population
  • 2.5% lifetime prevalence
  • 1st symptoms begin in childhood or adolescence
  • equally common in males & females

Pathology

Genetics

Clinical manifestations

  • obsessions
    • recurrent, intrusive thoughts usually irrational worries that often necessitate behaviors to prevent untoward consequences
    • fears of contamination from dirt requiring the individual to wear gloves at all times
    • frightening impulses of hurting someone
    • sexual imagery
  • compulsions
    • recurrent behaviors beyond the normal range that the individual feels compelled to undertake, usually to preserve personal safety, to avoid embarrassment, or to perform adequately
    • checking multiple times to see that the gas is turned off before leaving home
    • repeated hand washing resulting in hand dermatitis[2]
    • mentally repeating words or counting
  • symptoms are time-consuming & disabling
  • in children, a preceeding pharyngitis may be noted[5]
  • patient must realize the obsessions &/or compulsions are unreasonable[2]

Differential diagnosis

Management

More general terms

More specific terms

Additional terms

References

  1. ↑ Stedman's Medical Dictionary 27th ed, Williams & Wilkins, Baltimore, 1999
  2. ↑ 2.0 2.1 2.2 2.3 Medical Knowledge Self Assessment Program (MKSAP) 11, 16, 17, 18. American College of Physicians, Philadelphia 1998, 2012, 2015, 2018.
    Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
  3. ↑ 3.0 3.1 Prescriber's Letter 7(11):65 2000
  4. ↑ UCLA Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
  5. ↑ 5.0 5.1 5.2 5.3 Journal Watch 22(10):75, 2002 Murphy MI & Pichichero ME Prospective identification and treatment of children with pediatric autoimmune neuropsychiatric disorder associated with group A streptococcal infection (PANDAS). Arch Pediatr Adolesc Med 156:356, 2002 PMID: https://www.ncbi.nlm.nih.gov/pubmed/11929370
  6. ↑ 6.0 6.1 Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
  7. ↑ 7.0 7.1 Maher AR et al. Efficacy and comparative effectiveness of atypical antipsychotic medications for off-label uses in adults. JAMA 2011 Sep 28; 306:1359 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21954480
  8. ↑ 8.0 8.1 Andersson E et al. Internet-based cognitive behaviour therapy for obsessive- compulsive disorder: A randomized controlled trial. Psychol Med 2012 Feb 21 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22348650 <Internet> http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8496709
  9. ↑ Franklin ME, Foa EB. Treatment of obsessive compulsive disorder. Annu Rev Clin Psychol. 2011;7:229-43 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21443448
  10. ↑ 10.0 10.1 10.2 Grant JE Obsessive-Compulsive Disorder N Engl J Med 2014; 371:646-653. August 14, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25119610 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMcp1402176
  11. ↑ Stein DJ, Hollander E. Dermatology and conditions related to obsessive-compulsive disorder. J Am Acad Dermatol. 1992 Feb;26(2 Pt 1):237-42. PMID: https://www.ncbi.nlm.nih.gov/pubmed/1552059
  12. ↑ 12.0 12.1 Skapinakis P et al. Pharmacological and psychotherapeutic interventions for management of obsessive-compulsive disorder in adults: A systematic review and network meta-analysis. Lancet Psychiatry 2016 Jun 15 PMID: https://www.ncbi.nlm.nih.gov/pubmed/27318812 Free Article
  13. ↑ 13.0 13.1 Wong J, Motulsky A, Abrahamowicz M et al. Off-label indications for antidepressants in primary care: Descriptive study of prescriptions from an indication based electronic prescribing system. BMJ 2017;356:j603 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28228380 Free PMC Article <Internet> http://www.bmj.com/content/356/bmj.j603
  14. ↑ 14.0 14.1 14.2 Locher C, Koechlin H, Zion SR et al Efficacy and Safety of Selective Serotonin Reuptake Inhibitors, Serotonin-Norepinephrine Reuptake Inhibitors, and Placebo for Common Psychiatric Disorders Among Children and Adolescents. A Systematic Review and Meta-analysis. JAMA Psychiatry. Published online August 30, 2017. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28854296 <Internet> http://jamanetwork.com/journals/jamapsychiatry/fullarticle/2652447
    Merry SN, Hetrick SE, Stasiak K. Effectiveness and Safety of Antidepressants for Children and Adolescents. Implications for Clinical Practice. JAMA Psychiatry. Published online August 30, 2017. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28854300 <Internet> http://jamanetwork.com/journals/jamapsychiatry/fullarticle/2652446
  15. ↑ 15.0 15.1 FDA News Release. August 17, 2018 FDA permits marketing of transcranial magnetic stimulation for treatment of obsessive compulsive disorder. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm617244.htm
  16. ↑ Obsessive Compulsive Disorder National Institute for Health and Clinical Excellence (NICE) http://www.nice.org.uk/page.aspx?o=cg031

Patient information

obsessive compulsive disorder patient information

Database

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