Recognising OCD

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OCD1

Obsessive-Compulsive Disorder is a common mental illness which can result in considerable distress and sometimes shame which can delay the diagnosis and the provision of effective management.

Obsessions are unwanted ideas, images or impulses that repeatedly enter a person’s mind. Common examples are:

  • Fear of causing harm to someone else
  • Fear of causing harm to self
  • Fear of contamination
  • Need for symmetry and exactness
  • Sexual and religious obsessions
  • Fear of behaving unacceptably
  • Fear of making a mistake

Compulsions are repetitive stereotyped behaviors or mental acts driven by rules that must be applied rigidly. They are often intended to neutralise anxiety provoked by the obsessions. Examples of behaviours include:

  • Cleaning
  • Hand washing
  • Checking
  • Ordering and arranging
  • Hoarding
  • Asking for reassurance

Examples of mental acts include:

  • Counting
  • Repeating words silently
  • Ruminations
  • Neutralising thoughts

Obsessions and compulsions share the following features:

  • Acknowledged as originating in the mind of the person
  • Repetitive and unpleasant; at least one recognised as excessive or unreasonable
  • At least one must be successfully resisted (although the resistance may be minimal)
  • Carrying out the obsessive thought or compulsive act is not intrinsically pleasurable

NICE has recommended 6 screening questions to help identify the condition which may be particularly useful for people who present with anxiety and depression which are known to commonly overlap with OCD. These questions are:

  • Do you wash or clean a lot?
  • Do you check things a lot?
  • Is there any thought that keeps bothering you that you want to get rid of but can’t?
  • Do your daily activities take a long time to finish?
  • Are you concerned about orderliness or symmetry?
  • Do these problems trouble you?

If OCD is an issue for you then consider the benefits of The Wait Control Process training programme. For further information please email or phone me.

Further information from: Obsessive-compulsive disorder and body dysmorphic disorder. NICE, 2005 Clinical Guideline 31. www.nice.org.uk

1Heyman I, Mataix-Cols D, Fineberg NA. Obsessive-compulsive disorder. BMJ 2006; 333:424-9

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