Psychiatric Comorbidity and Quality of Life in Patients With Obsessive Compulsive Disorder(Case Control Study )

Obsessive-compulsive disorder (OCD) is a mental and behavioral disorder[7] in which a person has certain thoughts repeatedly (called "obsessions") and/or feels the need to perform certain routines repeatedly (called "compulsions") to an extent that generates distress or impairs general functioning.[1][2] The person is unable to control either the thoughts or activities for more than a short period of time.[1] Common compulsions include excessive hand washing, the counting of things, and checking to see if a door is locked.[1] These activities occur to such a degree that the person's daily life is negatively affected,[1] often taking up more than an hour a day.[2] Most adults realize that the behaviors do not make sense.[1] The condition is associated with tics, anxiety disorder, and an increased risk of suicide.[2][3] The cause is unknown.[1] There appear to be some genetic components, with both identical twins more often affected than both non-identical twins.[2] Risk factors include a history of child abuse or other stress-inducing event.[2] Some cases have been documented to occur following infections.[2] The diagnosis is based on the symptoms and requires ruling out other drug-related or medical causes.[2] Rating scales such as the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) can be used to assess the severity.[8] Other disorders with similar symptoms include anxiety disorder, major depressive disorder, eating disorders, tic disorders, and obsessive-compulsive personality disorder.[2]

Treatment may involve psychotherapy, such as cognitive behavioral therapy (CBT), and antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) or clomipramine.[4][5] CBT for OCD involves increasing exposure to fears and obsessions while preventing the compulsive behavior that would normally accompany the obsessions.[4] Contrary to this, metacognitive therapy encourages the ritual behaviors in order to alter the relationship to one's thoughts about them.[9] While clomipramine appears to work as well as do SSRIs, it has greater side effects and thus is typically reserved as a second-line treatment.[4] Atypical antipsychotics may be useful when used in addition to an SSRI in treatment-resistant cases but are also associated with an increased risk of side effects.[5][10] Without treatment, the condition often lasts decades.[2]