Obsessive-compulsive disorder

OCD is a chronic mental health condition characterized by disabling and distressing obsessions and compulsions.

OCD is associated with hyperactivity of the orbitofrontal cortex and caudate, abnormalities in functional or structural connections (anterior cingulate, thalamus, cortex, amygdala, parietal cortex), and deficits in cognitive abilities, including executive functioning, impulsivity in motor function, and cognitive inflexibility. Abnormal interactions in the cortico-striato-thalamo-cortical loop, including links to the amygdala, cause an imbalance between glutamatergically mediated excitatory and GABA-mediated inhibitory control mechanisms in the frontostriatal circuit, resulting in neurocognitive deficits, obsessions, and compulsions, which may be associated with other co-morbidities, such as tic disorders, anxiety disorders, and psychotic disorders.

The 12-month and lifetime prevalence of the OCD is estimated at 1.2% and 2.3%, respectively.

OCD is a multifactorial familial condition involving polygenic and environmental risk factors. Adverse perinatal events, psychological trauma, and neurological trauma may modify the expression of risk genes, triggering obsessive-compulsive behaviors. OCD often co-occurs with other psychiatric disorders, such as social anxiety disorder, panic disorder, specific phobias, major depressive disorder, bipolar disorder, PTSD, generalized anxiety disorder, anorexia nervosa, and bulimia nervosa.

OCD is a chronic disorder with recurrent obsessive thoughts and uncontrolled repetitive acts. Obsessions are intrusive, unwanted thoughts, images, or urges that cause significant anxiety or distress. Compulsions are repetitive behaviors or mental acts that an individual feels driven to perform in response to an obsession or according to rigid rules, aimed at reducing anxiety or preventing a feared event or situation.

The prognosis of OCD varies, with outcomes ranging from full recovery to chronic illness. Adequate treatment improves daily functioning, relationships, and overall QoL for most patients. The remission of OCD without treatment is only 20%.