A mental disorder, which is based on obsessive thoughts, ideas and actions that arise in addition to the mind and will of a person. Obsessive thoughts often have a content alien to the patient, however, despite all efforts, he cannot get rid of them on his own. The diagnostic algorithm includes a thorough interrogation of the patient, his psychological testing, exclusion of organic pathology of the central nervous system using neuroimaging methods. The treatment uses a combination of drug therapy (antidepressants, tranquilizers) with psychotherapy methods ("thought stopping" method, autogenic training, cognitive-behavioral therapy).

General information

Probably, obsessive-compulsive disorder is a multifactorial pathology in which a hereditary predisposition is realized under the influence of various triggers. It is noted that people with increased suspiciousness, hypertrophied concern about how their actions look and what others will think of them, persons with great conceit and its downside - self-deprecation, are predisposed to the development of obsessive-compulsive disorder.

Symptoms and course of neurosis

The basis of the clinical picture of obsessive-compulsive disorder is formed by obsessions - irresistibly obsessive thoughts (ideas, fears, doubts, drives, memories) that cannot be “thrown out of my head” or ignored. At the same time, patients are quite critical of themselves and their condition. However, despite repeated attempts to overcome it, they do not succeed. Along with obsessions, compulsions arise, with the help of which patients try to reduce anxiety, distract themselves from annoying thoughts. In some cases, patients engage in compulsive activities covertly or mentally. This is accompanied by some distraction and slowness in the performance of their official or household duties.

The severity of symptoms can vary from mild, practically not affecting the patient's quality of life and his ability to work, to significant, leading to disability. With a mild severity, the acquaintances of a patient with obsessive-compulsive disorder may not even be aware of his existing disease, referring the quirks of his behavior to character traits. In severe, advanced cases, patients refuse to leave their home or even their room, for example, to avoid contamination or contamination.

Obsessive-compulsive disorder can proceed according to one of 3 options: with constant persistence of symptoms for months and years; with a remitting course, including periods of exacerbation, often provoked by overwork, illness, stress, an unfriendly family or work environment; with a steady progression, expressed in the complication of the obsessive syndrome, the appearance and aggravation of changes in character and behavior.

Types of obsessive states

Obsessive fear (fear of failure) is an agonizing fear of not being able to properly perform an action. For example, go out in front of the audience, remember a learned poem, have sexual intercourse, fall asleep. This also includes erythrophobia - the fear of blushing in front of strangers.

Obsessive doubts - uncertainty about the correctness of performing various actions. Patients suffering from obsessive doubts are constantly worried whether they turned off the tap with water, turned off the iron, whether they indicated the correct address in the letter, etc. Pushed by uncontrolled anxiety, such patients repeatedly check the performed action, sometimes reaching complete exhaustion.

Obsessive phobias - have the widest variation: from the fear of contracting various diseases (syphilophobia, carcinophobia, heart phobia, cardiophobia), fear of heights (hypsophobia), enclosed spaces (claustrophobia) and too open areas (agoraphobia) to fear of their loved ones and yourself someone's attention. Common phobias among OCD patients are fear of pain (algophobia), fear of death (thanatophobia), and fear of insects (insectophobia).

Obsessive thoughts - persistently "creeping" into the head names, lines from songs or phrases, surnames, as well as various thoughts that are opposite to the patient's life ideas (for example, blasphemous thoughts in a believing patient). In some cases, obsessive philosophizing is noted - empty endless reflections, for example, about why trees grow taller than people or what will happen if two-headed cows appear.

Obsessive recollections - recollections of some events that arise against the patient's wishes, which, as a rule, have an unpleasant coloration. This also includes perseverations (obsessive representations) - vivid sound or visual images (melodies, phrases, pictures) reflecting a traumatic situation that occurred in the past.

Obsessive actions are repeated many times against the will of the sick movement. For example, closing eyes, licking lips, correcting hair, grimacing, winking, scratching the back of the head, rearranging objects, etc. Some clinicians separately single out obsessive drives - an uncontrollable desire to count or read something, rearrange words, etc. this group also includes trichotillomania (hair pulling), dermatillomania (damage to one's own skin), and onychophagia (compulsive nail biting).

Diagnostics

Obsessive-compulsive disorder is diagnosed based on patient complaints, neurological examination findings, psychiatric examination and psychological testing. It is not uncommon for patients with psychosomatic obsessions to be treated ineffectively by a gastroenterologist, therapist or cardiologist for somatic pathology before referral to a neurologist or psychiatrist.

Important for the diagnosis of OCD are obsessions and / or compulsions occurring every day, taking at least 1 hour a day and disrupting the patient's usual course of life. The patient's condition can be assessed using the Yale-Brown scale, psychological research of personality, pathopsychological testing. Unfortunately, in some cases, psychiatrists diagnose patients with OCD with schizophrenia, which entails inappropriate treatment, leading to the transition of neurosis to a progressive form.

Examination by a neurologist may reveal hyperhidrosis of the palms, signs of autonomic dysfunction, tremor of the fingers of outstretched arms, and a symmetrical increase in tendon reflexes. If there is a suspicion of cerebral pathology of organic origin (encephalitis, arachnoiditis, cerebral aneurysm), MRI, MSCT or CT of the brain are indicated.

Treatment

It is possible to effectively treat obsessive-compulsive disorder only by following the principles of an individual and integrated approach to therapy. It is advisable to combine drug and psychotherapeutic treatment, hypnotherapy.

The use of psychoanalytic methods in the treatment of obsessive-compulsive disorder is limited, since they can provoke outbursts of fear and anxiety, have a sexual connotation, and in many cases obsessive-compulsive disorder has a sexual accent.

Forecast and prevention

Complete recovery is rare. Adequate psychotherapy and medication support significantly reduce the manifestations of neurosis and improve the patient's quality of life. Under unfavorable external conditions (stress, serious illness, overwork), obsessive-compulsive disorder may arise again. However, in most cases, after 35-40 years, there is some smoothing of symptoms. In severe cases, obsessive-compulsive disorder affects the patient's ability to work, a third group of disability is possible.

Considering the character traits that predispose to the development of OCD, it can be noted that a simpler attitude towards oneself and one's needs, a life for the benefit of the people around, will be a good prevention of its development.

Obsessive-compulsive neurosis is a mental disorder that is accompanied by the appearance of obsessive ideas, burdened thoughts, a state of internal anxiety, and also allowing to reduce this anxiety.

Causes and stages of development

Obsessive neurosis develops due to biological and psychological factors. But each case is individual, and therefore the degree of influence of factors is different. The severity of manifestations is measured on the Yale-Brown scale. If we consider the psychological side of obsessive states, then compulsive behavior (which is not rational) may be due to genetic markers.

According to science, obsessive neurosis occurs as a result of metabolic disorders of the hormone of joy - serotonin. Doctors believe that serotonin is a level regulator by binding to nerve cells through receptors. In addition, scientists suggest that ecology may be the third factor, but the genetic link has not yet been established. By the way, the likelihood of a hereditary predisposition to obsessive-compulsive disorder is extremely high, based on the latest medical research.

Medicine knows 3 stages of the course of obsessive-compulsive neurosis:

  1. At stage 1, the manifestations of obsessive states can persist both for 2-3 months and for about 2 years.
  2. Remitting, characterized by a weakening of obsessions and impulses.
  3. This stage is characterized by a progressive form of the disease. At the same time, complete disposal of anxiety and disturbing thoughts is extremely rare. Closer to the age of 40, obsessive neurosis with its painful manifestations recedes.

In the 19th century. the term became popular, which was equated to the patient's obsession. Scientist Jean-Etienne D. Esquirol called this type of disorder a disease of doubt, since patients often hesitated between common sense and complete nonsense.

Obsessive-compulsive neurosis is less likely to suffer than neurasthenia or hysterical neurosis. But persons of both sexes suffer from this disorder equally. Diagnosis is simple: the patient is asked to stretch his arms forward to make sure his fingers tremble. In addition, with obsessive-compulsive neurosis, tendon reflexes are revived, hand hyperhidrosis and disorders in the functioning of the autonomic system.

Obsessive-compulsive disorder symptoms

Among the most characteristic signs of an obsessive state, the following can be distinguished:

  • repetitive behavior;
  • rituals;
  • regular checks of their own actions;
  • burdened thoughts that become cyclical;
  • craving for counting numbers;
  • preoccupation with thoughts of religion, fear, intimate details.

Most often, the people around the patient suffer from obsessive-compulsive neurosis, trite perplexed by what is happening. However, it should be noted that the patient reproaches himself for illogical and irrational behavior and actions, but is unable to fight the adversity.

People suffering from obsessive-compulsive disorder and its symptoms behave inappropriately in everyday life, their actions can be described as paranoid. Many patients admitted that they understand all the irrationality of their actions, which in the future leads to a restless state. The disease, according to doctors, can appear at any age. For example, patients claim that obsessive thoughts have manifested themselves and continue to destroy a person's consciousness throughout their lives.

Obsessive-compulsive neurosis in most cases manifests itself in people-perfectionists, pedantic personalities, often fixated on little things that others would never have noticed. But it is the obsession that becomes the ignition key for the future neurotic state.

Similar symptoms are seen in autistic patients. The disease often affects individuals with a high level of intellectual abilities. Such people are distinguished by excessive attention to detail, scrupulous phased planning of further actions, fear of taking a risky step, an increased level of responsibility, as well as indecision and slowness in making important decisions in life.

In addition to all of the above, patients with obsessive-compulsive disorder are characterized by all kinds of phobias:

  • carcinophobia - fear of the likelihood of contracting cancer;
  • lissophobia - fear of going crazy;
  • cardiophobia - fear of dying from heart disease;
  • oxyphobia - fear of sharp objects;
  • - fear of confined space;
  • - fear of open spaces, premises;
  • acrophobia - fear of heights;
  • fear of blushing in public.

All of the above phobias can be characterized as obsessive-phobic neurosis, which is difficult for a person to fight, since it arises against his will. The patient tries in every possible way to resist the awakening fears and desires, but ultimately do nothing about it. Fears or phobias can have both an objective basis and arise from illusions and made-up stories.

People often, attacks in broad daylight, lack of money, lack of jobs. In rare cases, phobias can lead the patient to commit suicide.

What is it? This is primarily the discrepancy between the perceived danger and the real threat. But it must be said that fear exists only in the mind of a person and is not always an objective phenomenon. The patient is not able to rationally assess the current situation and protect himself from the source of fear. The only way out for him is to surrender to the power of the phobia. But this is the answer to the question of how to overcome a phobia. You just need to face your fears face to face in order to finally find out whether it is really worth worrying about it.

With obsessive-compulsive disorder, patients are irritable, get tired quickly, and find it difficult to concentrate on any kind of activity. People complain about sleep problems. Symptoms in each patient manifest themselves in different ways, but they are united by a depressed mood with a feeling of inferiority in relation to others. In any situation, a neurotic patient feels hopelessness and hopelessness.

The neurosis can acquire a chronic form with periodic bursts of exacerbation.

Characteristic signs of the disease in children

Considering the course of the disease in children, scientists came to the conclusion that the process is reversible, that is, there is no disturbance in the perception of the surrounding reality. Parents often do not pay attention to the child's changed behavior, believing that a fleeting change in mood or behavior is just a prank. Signs of the disease in children:

  • periodically repetitive movements;
  • frowning of the forehead;
  • sniffing;
  • twitching shoulders;
  • clapping hands;
  • stomping.

Add to this list the feelings of dread that children experience, for example, fear of damaging furniture, staining a new jacket, or being left in an enclosed space.

When children become adolescents, the obsessive-compulsive neurosis itself changes. Teenagers are afraid to speak in front of a large crowd of people, suffer from the thought of dying prematurely from an illness. Their behavior becomes diametrically opposite. Actions can be sometimes immoral and blasphemous, an obsession can haunt for months. At the same time, it is impossible to translate into reality all experiences, but the state itself causes fear and anxiety. In such situations, parents should seek the help of a psychotherapist. For the treatment of obsessive-compulsive disorder, methods of play and fairy-tale therapy are used. Of course, the age of the child and the degree of the disease play an important role.

Symptoms of obsessive-compulsive disorder

For some people, it happens that they suddenly want to make the same movements periodically. At the same time, a person critically evaluates his own actions. Such constant movements are called compulsions in medicine. Typical signs of compulsions:

  • an irresistible desire to perform any action;
  • in most cases, patients are aware of the entire irrationality of behavior, but there is nothing they can do about it;
  • compulsions destroy a person's life, as irrationality tries to supplant the rational principle.

Among the most common obsessive movements in adults, the following should be highlighted:


Doctors have not come to an exact definition of the causes of obsessive compulsive disorder. But most often, the neurosis of obsessive-compulsive movements occurs due to the action of psychological factors (psychological trauma), biological (hereditary predisposition, trauma in the family), sociological (strict education based on religious beliefs).

Treatment and prevention of the disease

In order to determine how to treat, an experienced physician identifies the form and severity of the disease. Therapy is performed both comprehensively and individually, based on the characteristics of the patient's behavior. Mild obsessive-compulsive disorders are treated with psychotherapeutic methods. To cope with neurosis will help the usual training, which will bring a positive result, gradually suppressing obsessions and thoughts. But if a positive effect is not observed, then it is recommended to use hypnotic methods. The patient is prescribed sedatives and tonic drugs depending on the symptoms of obsessive-compulsive disorder and the stage of the disease.

To cure obsessive-compulsive disorder at the initial stage, when the patient also suffers from obsessive-phobic neurosis, is necessary with the use of tranquilizers and antidepressants. When choosing a dose of a medicine, the nature of obsessive-compulsive disorder is taken into account, how to get rid of a disorder most quickly. If after treatment the obsessive-compulsive disorder disappears, then it is advisable to carry out supportive therapy for another 6 months to a year. In addition, the correct regime of work, rest and sleep should be observed.

There are severe cases of obsessive-compulsive disorder, treatment at home for which is not possible, therefore, it is treated only in a hospital. For treatment, drugs such as antipsychotics, antidepressants and hypoglycemic doses of insulin are used. The recovery period directly depends on the patient himself, his desire to re-become a part of society and to set aside obsessive thoughts or ideas. Therefore, symptoms and treatment are interrelated in this case. When the patient cannot cope with isolated obsessions (fear of heights, fear of the dark, claustrophobia), it is necessary to resort to the method of self-hypnosis. The protracted course of obsessive-compulsive disorder is the reason for the transfer of such an employee to an easier job. Possible complications can become a reason for assigning a disability to such a patient.

Treatment of obsessive-compulsive disorder at home is carried out by non-drug folk methods, which are best suited for people who already expect danger from all sides. How to get rid of obsessive-compulsive disorder? Obsessive thoughts can either reduce food cravings or, conversely, increase appetite. In both cases, you should include in the diet foods containing vitamins B and E, as well as magnesium and calcium. It will be useful to use juices, water and herbal decoctions based on ginseng, oats, wild oats, hop cones, valerian, linden and chamomile. Well proven: self-massage, cognitive and aromatherapy, exercise.

Preventive measures to combat obsessive-compulsive disorder are reduced to the deliberate stop of obsessive thoughts, which blocks the manifestation of other symptoms. This technique is designed for those who are trying to answer the question of how to cure neurosis, and who are really able to resist obsessive thoughts.

Obsessive-compulsive disorder is a mental pathology in which obsessive thoughts and ideas arise in a person's mind against his will. The patient is not able to get rid of them on his own. It is required to consult a psychiatrist for diagnosis and treatment.

The causes of obsessive-compulsive disorder

There is no consensus on the causes of the onset of the disease. There are several versions explaining the occurrence of pathology.

The likelihood of the appearance of this neurosis is higher in people whose close relatives suffered from this disorder. In addition, the condition is often observed in children whose parents have suffered from alcoholic psychosis, tuberculous meningitis, or epileptic seizures.

The disease in 75% of cases is accompanied by other mental disorders. This condition is often diagnosed in people with manic-depressive psychosis.

The disorder can occur due to impaired functioning of neurotransmitters. If there are disruptions in the production of serotonin, norepinephrine, dopamine, a person has obsessive thoughts and ideas.

There is a theory linking the occurrence of a pathological condition with the ingestion of streptococci. If the produced antibodies destroy the basal ganglia along with pathogenic microorganisms, the human nervous system begins to malfunction.


The mechanism of development of obsessive neurosis

It is believed that the main cause of the onset of pathology is personality traits. The disease appears in people with high impressionability, low self-esteem, high anxiety. Often they are dependent on the opinions of others, do not have independence, and are easily suggestible.

Due to problems with communication in a team, difficult relationships with close relatives, psychological trauma, constant stress, a nervous breakdown, the thinking of such people becomes narrower, a thought arises on which they get hung up. Obsessive neurosis develops.

Symptoms

Repetitive actions are noted. A person is inclined to perform rituals, without which no action is performed. He constantly checks his own actions. Perhaps constant thinking about thoughts about sex, religion, counting numbers in the mind. A person notices obsessive thoughts, is often aware of the presence of pathology, and can make attempts to get rid of it on his own. However, it is not possible to recover without the help of a doctor.

In some cases, all obsessive actions occur in the thoughts of the patient, without physically manifesting. In this case, lethargy, absent-mindedness, and slowness in performing any tasks are possible.

The severity may vary. With a mild disorder, a person and others may not be aware of the presence of the disease, consider what is happening as individual characteristics.

In severe cases, a person is prone to phobias, due to which they may refuse to leave the room or experience panic about any other action. Decreased efficiency, difficulty concentrating. Unreasonable aggression often appears. Behavior becomes inappropriate.

Obsessive neurosis in children is manifested by moodiness, tearfulness, disobedience. The child can lose weight dramatically. The ability to focus is impaired. Fears appear, repetitive movements. The child does not communicate well with other children, prefers to be alone. Headache complaints are possible. The pathology is often accompanied by involuntary urination.


Treatment of obsessive-compulsive disorder

To select a therapy, you must first contact a neurologist for diagnostics. You also need to visit a psychiatrist. The doctor will diagnose and select the appropriate therapy. Self-medication should not be done.

Complex therapy. With obsessive-compulsive disorder, treatment at home is possible in the case of mild pathology. Severe forms are treated in a clinic. The patient will have to seek help from a psychotherapist, take special medications.

Psychotherapy

Cognitive behavioral therapy is used. First, the therapist identifies phobias, obsessive thoughts that the patient has. Then new attitudes are developed that allow a person to cope with fear. The patient can, under the supervision of a psychologist, face a fearful situation in order to understand that it does not pose a threat.

The method of stopping thoughts helps. First, a list of the obsessive thoughts that are present must be made, after which the patient is taught to switch to other thoughts.

Other techniques are also used. A person needs to undergo a course of individual therapy, during which his problems will be worked out. Hypnosis can be used. For the treatment of minors, play techniques and art therapy are often used.


Drug treatment

Only a doctor can pick up pills. You cannot prescribe medication for yourself on your own. The specialist will prescribe the appropriate drug, dosage, duration and dosage regimen.

Antidepressants are used. The third generation drugs that inhibit the reuptake of serotonin are considered effective. These drugs include Fluoxetine, Sertraline, Citalopram. If there is high anxiety, tranquilizers are used. In the chronic form of pathology, atypical psychotropic drugs are prescribed. In severe cases, treatment in a hospital setting may be required.


Adjunctive treatments

Physical activity helps with obsessive neurosis: special training, gymnastics, exercises. Yoga can be used, special meditation techniques, breathing exercises are used. A set of exercises should be selected together with a doctor.

Herbal medicine helps. Decoctions of linden, ginseng, chamomile, valerian, hop cones are effective.

Aromatherapy is used. You need to use soothing scents: lavender, chamomile, geranium, pine needles.

The diet should be supplemented with foods containing vitamins E and B group, calcium, magnesium. These substances have a beneficial effect on the functioning of the nervous system.


Forecast and prevention of the state of neurosis

A person rarely recovers completely. Correct therapy can reduce the severity of symptoms, improve the patient's quality of life.

To prevent re-development, stressful situations must be avoided. You need to sleep at least 8 hours, eat healthy foods. Regular walks in the fresh air are helpful. Close relatives should create a favorable environment at home, support the patient. It is important to communicate with him, pay attention to him.

Obsessive-compulsive syndrome, obsessive-compulsive disorder (OCD) is a psychoneurotic disorder manifested by the patient's obsessive thoughts and actions. The concept of "obsession" is translated from Latin as a siege or blockade, and "compulsion" - compulsion. Healthy people have no problem dismissing unpleasant or frightening thoughts, images, or impulses. People with OCD cannot do this. They constantly ponder such thoughts and get rid of them only after performing certain actions. Gradually, obsessive thoughts begin to conflict with the patient's subconscious. They become a source of depression and anxiety, and rituals and repetitive movements cease to have the expected effect.

In the very name of pathology lies the answer to the question: what is OCD? Obsession is the medical term for obsessive ideas, disturbing or frightening thoughts, while compulsion is a coercive action or ritual. Perhaps the development of local disorders - only obsessive with a predominance of emotional experiences, or only compulsive, manifested by restless actions. The disease is a reversible neurotic process: after psychotherapeutic and drug treatment, its symptoms completely disappear.

Obsessive-compulsive disorder occurs at all socioeconomic levels. Under the age of 65, men are predominantly ill. At a more advanced age, the disease is diagnosed in women. The first signs of pathology appear in patients by the age of ten. Various phobias and obsessive states arise that do not require immediate treatment and are adequately perceived by a person. In thirty-year-old patients, a pronounced clinic of the syndrome develops. At the same time, they stop perceiving their fears. They need qualified medical care in a hospital setting.

People with OCD are tormented by the thought of countless bacteria and wash their hands a hundred times a day. They are not sure if the iron is turned off, and they return home from the street several times to check it. Patients are confident that they are capable of harming loved ones. To prevent this from happening, they hide dangerous objects and avoid casual communication. Patients will check several times to see if he forgot to put all the necessary things in his pocket or bag. Most of them carefully keep order in the room. When things are out of place, emotional stress arises. Such processes lead to a decrease in working capacity and poor perception of new information. The personal life of such patients usually does not work out: they either do not create families, or their families quickly disintegrate.

Painful obsessive thoughts and similar actions lead to depression, reduce the quality of life of patients and require special treatment.

Etiology and pathogenesis

The causes of obsessive-compulsive disorder are currently not fully understood. There are several hypotheses regarding the origin of this disease.

The provoking factors include biological, psychological and social.

Biological factors in the development of the syndrome:

  • acute infectious diseases - meningitis, encephalitis,
  • autoimmune diseases - group A hemolytic streptococcus causes inflammation of the basal ganglia,
  • hereditary predisposition,
  • alcohol and drug addiction,
  • neurological diseases,
  • metabolic disorders of neurotransmitters - serotonin, dopamine, norepinephrine.

Psychological or social factors of pathology:

  1. special religious beliefs,
  2. tensions in the family and at work,
  3. excessive parental control in all areas of a child's life,
  4. severe stress, psycho-emotional outburst, shock,
  5. long-term use of psychostimulants,
  6. experienced fear due to the loss of a loved one,
  7. avoidant behavior and misinterpretation of their thoughts,
  8. psychological trauma or depression after childbirth.

Panic and fear can be imposed by society. When the news reports of a robber attack on the street, it raises anxiety, which can be dealt with by special actions - constant looking around the street. These compulsions help patients only at the initial stage of mental disorders. In the absence of psychotherapeutic treatment, the syndrome suppresses the human psyche and turns into paranoia.

Pathogenetic links of the syndrome:

  • the emergence of thoughts that frighten and torment the sick,
  • concentration on this thought contrary to desire,
  • mental stress and increasing anxiety,
  • performing stereotyped actions that bring only short-term relief,
  • return of obsessive thoughts.

These are the stages of one cyclical process leading to the development of neurosis. Patients become addicted to ritual activities that have a narcotic effect on them. The more patients think about the current situation, the more they become convinced of their inferiority. This leads to an increase in anxiety and a worsening of the general condition.

Obsessive-compulsive syndrome can be inherited through a generation. This disease is considered moderately hereditary. In this case, the gene that causes this condition has not been identified. In some cases, it is not the neurosis itself that is inherited, but a genetic predisposition to it. Clinical signs of pathology arise under the influence of negative conditions. Correct upbringing and a favorable atmosphere in the family will help to avoid the development of the disease.

Symptoms

Clinical signs of pathology in adults:

  1. Thoughts of sexual perversion, death, violence, haunting memories, fear of harming someone, getting sick or getting infected, anxiety about material loss, blasphemy and sacrilege, fixation on cleanliness, pedantry. In relation to moral and ethical principles, unbearable and irresistible drives are contradictory and unacceptable. Patients are aware of this, often resist and are very worried. A sense of fear gradually arises.
  2. Anxiety following obsessive, repetitive thoughts. Such thoughts cause panic and horror in the patient. He realizes the groundlessness of his ideas, but is unable to control superstition or fear.
  3. Stereotypical actions - counting steps on the stairs, frequent hand washing, “correct” arrangement of books, rechecking of switched off electrical appliances or closed taps, symmetrical order of objects on the table, repetition of words, counting. These actions are a ritual that supposedly gets rid of obsessive thoughts. For some patients, reading a prayer, clicking joints, biting lips helps to relieve stress. Compulsions are a complex and intricate system, when destroyed, the patient carries it out again. The ritual is slow. The patient seems to be wasting time, fearing that this system will not help, and internal fears will intensify.
  4. Panic attacks and nervousness in the crowd are associated with the risk of contact with the "dirty" clothes of the people around, the presence of "strange" smells and sounds, "sidelong" glances, the possibility of losing your belongings. Patients avoid crowded places.
  5. Obsessive-compulsive syndrome is accompanied by apathy, depression, tics, dermatitis or alopecia of unknown origin, excessive concern with one's appearance. In the absence of treatment, patients develop alcoholism, isolation, rapid fatigue, thoughts of suicide, mood swings, quality of life decreases, conflicts increase, disorders of the gastrointestinal tract, irritability, concentration of attention decreases, hypnotics and sedatives are abused.

In children, signs of pathology are less pronounced and occur somewhat less frequently. Sick children are afraid of getting lost in the crowd and constantly hold the adults by the hand, clasping their fingers tightly. They often ask their parents if they are loved because they are afraid to end up in a shelter. Having lost a notebook once at school, they experience severe stress, forcing them to recount school supplies in their portfolio several times a day. The dismissive attitude of classmates leads to the formation of complexes in the child and skipping lessons. Sick children are usually gloomy, unsociable, suffer from frequent nightmares and complain of poor appetite. A child psychologist will help to stop the further development of the syndrome and get rid of the child.

OCD in pregnant women has its own characteristics. It develops in the last trimester of pregnancy or 2-3 months after childbirth. The obsessive thoughts of the mother are the fear of harming her baby: it seems to her that she is dropping the baby; she is visited by thoughts of sexual attraction to him; she has difficulty making decisions about vaccinations and feeding choices. To get rid of obsessive and frightening thoughts, a woman hides objects with which she can harm the child; constantly washes bottles and washes diapers; guards the baby's sleep, fearing that he will stop breathing; examines him for certain symptoms of the disease. Relatives of women with similar symptoms should talk her into seeing a doctor for treatment.

Video: an analysis of the manifestations of OCD using the example of Sheldon Cooper

Diagnostic measures

The diagnosis and treatment of the syndrome is carried out by specialists in the field of psychiatry. Specific signs of pathology are obsessions - obsessive thoughts with persistent, regular and annoying repetitions. They cause anxiety, anxiety, fear and suffering in the patient, are practically not suppressed or ignored by other thoughts, are psychologically incompatible and irrational.

For physicians, compulsions are important, which cause overwork and suffering in patients. Patients understand that compulsions are not interconnected and excessive. For specialists, it is important that the manifestations of the syndrome last more than an hour a day, complicate the life of patients in society, interfere with work and study, and disrupt their physical and social activity.

Many people with the syndrome often do not understand or perceive their problem. Psychiatrists advise patients to undergo a complete diagnosis and then begin treatment. This is especially true when obsessive thoughts get in the way of life. After a psychodiagnostic conversation and differentiation of pathology from similar mental disorders, specialists prescribe a course of treatment.

Treatment

Treatment of obsessive-compulsive syndrome should be started as soon as symptoms appear. Complex therapy is carried out, which consists in psychiatric and medication.

Psychotherapy

Psychotherapeutic sessions for obsessive-compulsive syndrome are considered more effective than drug treatment. Psychotherapy gradually cures neurosis.

The following methods help to get rid of such ailment:

  • Cognitive Behavioral Therapy is a resistance to a syndrome in which compulsions are minimized or eliminated altogether. During treatment, patients become aware of their disorder, which helps them to get rid of it forever.
  • "Stop thought" is a psychotherapeutic technique, which consists in stopping memories of the most vivid situations, manifested by an obsessive state. Patients are asked a series of questions. To answer them, patients must view the situation from all angles, as in slow motion. This technique makes it easier to face and control fears.
  • Exposure and warning method - conditions are created for the patient that provoke discomfort and cause obsessions. Before this, the patient is counseled on how to resist compulsive rituals. This form of therapy achieves sustained clinical improvement.

The effect of psychotherapy lasts much longer than medication. Patients are shown correction of behavior under stress, training in various relaxing techniques, a healthy lifestyle, proper nutrition, the fight against tobacco smoking and alcoholism, hardening, water procedures, breathing exercises.

Currently, group, rational, psychoeducational, aversive, family and some other types of psychotherapy are used to treat the disease. Non-drug therapy is preferable to drug therapy, since the syndrome lends itself well to correction without drugs. Psychotherapy has no side effects on the body and has a more persistent healing effect.

Drug treatment

Treatment of a mild form of the syndrome is carried out on an outpatient basis. Patients are given a course of psychotherapy. Doctors find out the causes of the pathology and try to establish trusting relationships with patients. Complicated forms are treated with medications and psychological correction sessions.

Patients are prescribed the following groups of drugs:

  1. antidepressants - "Amitriptyline", "Doxepin", "Amisol",
  2. antipsychotics - "Aminazin", "Sonapax",
  3. normotimic drugs - "Cyclodol", "Depakin Chrono",
  4. tranquilizers - "Phenozepam", "Clonazepam".

It is impossible to cope with the syndrome on your own without the help of a specialist. Any attempts to control your mind and defeat the disease lead to a worsening of the condition. In this case, the patient's psyche is destroyed even more.

Obsessive-compulsive disorder is not a mental illness because it does not lead to personality change and disorder. It is a neurotic disorder that is reversible with proper treatment. Mild forms of the syndrome respond well to therapy, and after 6-12 months its main symptoms disappear. Residual phenomena of pathology are expressed in a mild form and do not interfere with the normal life of patients. Severe cases of the disease are treated for an average of 5 years. Approximately 70% of patients notice an improvement in their condition and are clinically cured. Since the disease is chronic, relapses and exacerbations occur after drug withdrawal or under the influence of new stresses. Cases of complete cure are very rare, but possible.

Preventive actions

Prevention of the syndrome consists in preventing stress, conflict situations, creating a favorable environment in the family, eliminating mental trauma at work. It is necessary to educate the child correctly, not to generate feelings of fear in him, not to instill in him thoughts of his inferiority.

Secondary psychoprophylaxis is aimed at preventing relapse. It consists in regular medical examination of patients, conversations with them, suggestions, timely therapy of the syndrome. For prophylactic purposes, phototherapy is carried out, since light promotes the production of serotonin; restorative treatment; vitamin therapy. Experts recommend that patients get enough sleep, diet, rejection of bad habits, timely treatment of concomitant somatic diseases.

Forecast

Obsessive-compulsive syndrome is characterized by chronicity of the process. Complete recovery of pathology is quite rare. Relapses usually occur. In the course of treatment, symptoms gradually disappear, and social adaptation begins.

Without treatment, the symptoms of the syndrome progress, impair the patient's ability to work and the ability to be in society. Some patients commit suicide. But in most cases, OCD has a favorable course.

OCD is essentially a neurosis that does not lead to temporary disability. If necessary, patients are transferred to lighter work. The advanced cases of the syndrome are considered by VTEC specialists, who define the III group of disability. Patients are issued a certificate for facilitated work, excluding night shifts, business trips, irregular working hours, direct exposure to harmful factors on the body.

Adequate treatment guarantees patients stabilization of symptoms and relief of vivid manifestations of the syndrome. Timely diagnosis of the disease and treatment increase patients' chances of success.

Video: about obsessive-compulsive disorder



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Obsessive-compulsive disorder is an anxiety disorder characterized by burdened thoughts, fear, apprehension, anxiety, repetitive actions to reduce this anxiety, and a combination of obsessive obsessions and ideas.

Obsessive-compulsive disorder includes three forms of the course: the first, in which the symptoms persist for months or several years; the second remitting form, characterized by repeated episodes of weakening of the signs of the disease; the third steadily progressive form of the course. Complete recovery is rare. Closer to 35-40 years of age, painful manifestations are smoothed out.

In the 19th century, the term neurosis was widely used, which was referred to as obsessions. In 1827, Dominic Eskirol described one of the forms of obsessive-compulsive disorder, which he called the disease of doubt. He defined this disease between a disorder of intelligence and will. In 1858 I. M. Balinsky singled out a common feature among obsessions - alienation to consciousness. Further, I.P. Pavlov noted in his works the similarity of obsessions with delirium, since they are based on the pathological inertness of arousal, as well as the lability of inhibition.

Obsessive-compulsive disorder occurs less frequently than neurasthenia or hysterical neurosis. The incidence of the disease in men and women is almost the same. The disease is diagnosed by neurological manifestations: with outstretched hands, trembling of the fingers occurs, hyperhidrosis of the hands, revitalization of tendon and periosteal reflexes, and vegetative-vascular disorders are observed.

The causes of obsessive-compulsive disorder

Numerous psychological as well as biological factors lead to the causes of the development of obsessive-compulsive disorder. The severity of symptoms is assessed using the Yale-Brown scale.

Obsessive-compulsive disorder often occurs in individuals of the thinking type. The weakening of the body due to somatic and infectious diseases in combination with phobias provokes the appearance of neurosis, and people have obsessive thoughts, doubts, memories, actions, drives.

Obsessive-compulsive disorder symptoms

Symptoms of the disease include repetitive actions, rituals, cyclicality of diverse thoughts, constant checking of their actions, preoccupation with intimate thoughts, thoughts of violence, as well as religion, fear or desire to count numbers.

Symptoms of obsessive-compulsive disorder often frighten the immediate environment of patients, and the patients themselves are critical of themselves, but are not able to change their behavior or attitude to what is happening.

The actions of people suffering from obsessive-compulsive disorder are assessed as inadequate, affecting mental activity, and seem paranoid. The patients themselves admit that their actions are irrational, which further causes concern about this. The disease can appear at any age. A third of the patients claim that obsessive-compulsive disorder arose in childhood and now continues throughout their entire conscious life.

The term obsessive-compulsive disorder is applied to a meticulous person with perfectionistic traits, overly enthusiastic or fixated on something. The same symptoms are inherent in obsessive-compulsive disorder, autism. The disease can occur in patients with high intelligence. All patients are united by excessive attention to detail, careful planning, risk avoidance, a heightened sense of responsibility, as well as indecision with slow decision-making.

For a person suffering from this disease, all kinds of phobias are characteristic. These include carcinophobia (fear of getting cancer), lissophobia (obsessive fear of insanity), cardiophobia (fear of dying from heart disease), oxyphobia (fear of sharp objects), claustrophobia (fear of enclosed spaces), agoraphobia (fear of open spaces), acrophobia (fear heights), fear of pollution, fear of blushing and so on. For all these phenomena, the desire for obsessive states that arise contrary to the desire of a person is irresistible and strong. The sick person treats them critically, they are alien to him, he seeks to overcome them on his own, but this does not work. Patients suffer both from their fears, which have objective grounds, and act as a result of far-fetchedness, illusions. People are afraid of attacks on the street, fatal diseases, fear of unemployment, poverty, etc. Rarely, but the excruciating fear pushes to suicide.

What is fear? Fear is a manifestation of a reaction to an imbalance between an imagined danger and perceived possibilities. Fear is expressed mentally; it is not objective. The sick person cannot move away from his phobia and surrenders to the power of fear. Fear torments you and you don't know what to do with it? The answer is on the surface. Do what you fear and the fear will subside.

Obsessive-compulsive disorder manifests itself in increased irritability, sleep disturbances, fatigue, and difficulty concentrating. Symptoms are expressed with varying intensity, and the patient's mood is often low and with a tinge of hopelessness, as well as a sense of his own inferiority.

Obsessive-compulsive disorder is capable of a chronic course with periods of exacerbations. Features of the course of obsessive-compulsive disorder are manifested in three types. The first involves a single episode of illness that lasts weeks or years. The second consists of relapses, including periods of full health. The third includes a continuous course, accompanied by a periodic increase in symptoms.

Obsessive-compulsive disorder in children

The disease in children has a reversible mental nature, in which the perception of the world is not distorted. Often, parents do not pay attention to obsessive-compulsive disorder in children, thinking that this state will go away on its own. The disease manifests itself in children as repetitive movements, tics, twitching of the shoulders, wrinkling of the forehead, grinning, sniffing, coughing, tapping, clapping. Often these symptoms are supplemented by a feeling of fear that babies experience before the opportunity to stain their clothes, they are afraid of closed spaces, prickly objects.

During adolescence, fears change. This is being replaced by the fear of getting sick, of dying, the fear of speaking and answering at the blackboard. Sometimes children are disturbed by contrasting obsessions. They are characterized by immorality, blasphemy of thoughts, obsession with desires. The realization of such experiences is not carried out, and the sensations themselves deliver fear and anxiety. In these situations, parents should seek help from a psychotherapist. In the treatment of childhood obsessive-compulsive disorder, the method of play, fairy-tale therapy, is successfully used. Age and severity of the disease play an important role in prescribing treatment.

Obsessive-compulsive disorder treatment

Treatment is carried out only by an experienced doctor, after determining the type of disease. Therapy includes a complex, as well as a strictly individual approach, which is carried out taking into account both the clinical picture of the disease and the personal characteristics of the patient. Mild cases are treated with psychotherapeutic or restorative methods.

A good effect can be achieved with a simple workout that suppresses obsession. Provided that this does not give success, use the suggestion of hypnosis. Shown are sedatives, as well as tonic drugs, depending on the stage of the disease, as well as the characteristics of the clinical picture.

The initial stage of the course of obsessional neurosis in combination with phobias and anxiety is treated with tranquilizers of mild antidepressant action. All doses of drugs are selected individually for the state of neurotic disorders. If the obsessive-compulsive disorder after treatment weakens or disappears, then maintenance therapy is indicated for a duration of 6 months to one year. Psychotherapy for the patient is necessary along with the observance of a rest and sleep regimen.

Severe cases of neurosis, which occur with neurotic depression, are treated in hospitals. Medical institutions use antidepressants, hypoglycemic doses of insulin, antipsychotics in treatment. The recovery period is accompanied by the involvement of a person in the life of the team, as well as a shift in attention from obsessions to real life. If persistent, as well as isolated obsessions (fear of open space, fear of heights, fear of the dark) are preserved, the suppression of fear by the method of self-hypnosis is shown.

Obsessive-compulsive disorders with protracted courses require transferring patients to easier work. In case of complications, VKK refers the patient to VTEK. The commission can give III group of disability, as well as give recommendations that relate to working conditions, type of work.

How is obsessive-compulsive disorder treated?

Help for obsessive-compulsive disorders is carried out by folk non-drug methods. These methods include hyperventilation - intense breathing.

Obsessive-compulsive disorder leads either to suppression of appetite, or to its increase. In this case, it is very important to enrich your diet with foods containing vitamins B, E, magnesium, calcium. Indicated for use are juice, water, herbal teas (ginseng, wild oats, oats, linden, hop cones, valerian, chamomile). Self-massage (stroking techniques) is effective, as well as cognitive therapy, physical education, cranial osteopathy, aromatherapy.

Doctor of the PsychoMed Medical and Psychological Center

The information provided in this article is intended for informational purposes only and cannot replace professional advice and qualified medical assistance. At the slightest suspicion of the presence of obsessive-compulsive disorder, be sure to consult your doctor!