Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Without treatment, the symptoms of OCD can progress to the point that the
sufferer's life becomes consumed, inhibiting their ability to keep a job and
maintain important relationships. Many people with OCD have thoughts of killing
themselves, and about 1% complete suicide.
In terms of the prognosis for the specific symptoms, it is rare for any to
progress to a physically debilitating level. However, problems like compulsive
hand washing can eventually cause skin to become dry and even to break down.
Repeated trichotillomania can result in unsightly scabs on the
person's scalp.
Where can I get more information about obsessive compulsive disorder?
Further information about OCD can be gained from the following resources.
Obsessive compulsive disorder (OCD) is an anxiety disorder characterized by
irresistible thoughts or images (obsessions) and/or rigid rituals/behaviors that
may be driven by obsessions (compulsions).
OCD occurs in about 2% of
populations worldwide across cultures and has been known to the field of
medicine for at least 100 years.
The average age of onset of OCD is 19 years,
and it usually begins by 30 years of age.
OCD sufferers are more likely
than those who do not have the disorder to also suffer from other anxiety
disorders.
While there is no known specific cause for OCD, presence of the
illness in other family members and an imbalance of the brain chemical serotonin
are thought to increase the likelihood of OCD developing.
OCD is diagnosed by
the practitioner looking for signs and symptoms of this and other emotional
problems, as well as ensuring that there is no medical condition that could be
contributing to development of OCD.
OCD tends to respond most to a combination
of behavior therapies (exposure and ritual prevention), group or individual
cognitive behavioral therapy, and medications.
Although not as effective in
treating OCD as clomipramine, SSRIs are the group of medications that are most
often used to treat this illness since the SSRIs tend to cause less side
effects.
SSRIs are thought to work by increasing the activity of serotonin in the brain.
When the combination of psychotherapy and SSRI treatment is not sufficiently effective, neuroleptic medications may be added to improve the person's outcome.
For some people with severe OCD symptoms, deep brain stimulation can be helpful, and the use of hallucinogen medication as a treatment modality continues to be researched.
Although the symptoms of OCD may last indefinitely, its prognosis is
best when the sufferer has milder symptoms that have been present for a short
time, and the person has no other emotional problems.
Without treatment, OCD
can worsen to the point that the sufferer has physical problems, becomes
emotionally unable to function, or experiences suicidal thoughts. About 1% of
OCD sufferers complete suicide.
REFERENCES:
American Psychiatric Association. Diagnostic Criteria from Diagnostic and
Statistical Manual, Fourth Edition, Treatment Revision 2000.
American Psychiatric Association. Treatment of patients with obsessive-compulsive disorder. Practice Guidelines 2007 July.
Amiaz, R., L. Fostick, A. Gershon, and J. Zohar. "Naltrexone Augmentation in OCD: A Double-Blind Placebo-Controlled Cross-over Study." European Neuropsychopharmacology
18.6 June 2008: 455-461.
Awareness Foundation for OCD and Related Disorders. Mental health and OCD
resources. 2007.
Bejerot, S., L. Ekselius, and L. von Knorring. "Comorbidity Between
Obsessive-Compulsive Disorder (OCD) and Personality Disorders." Acta Psychiatry
Scandinavia 97.6 (1998): 398-402.
Caspi, A., T. Vishne, Y. Sasson, et al. "Relationship Between Childhood Sexual
Abuse and Obsessive-Compulsive Disorder: Case Control Study." Israeli Journal of Psychiatry and Related Sciences
45.3 (2008): 177-182.
Chabane, N., R. Delorme, B. Millet, M.C. Mouren, M. Lebover, and D. Pauls. "Early-Onset
Obsessive-Compulsive Disorder: A Subgroup With a Specific Clinical and Familial
Pattern?" Journal of Child Psychology and Psychiatry 46.8 (2004): 881-887.
Cordioli, A.V., E. Heldt, D.B. Bochi, R. Maris, M.B. de Sousa, J.F. Tonello, et
al. "Cognitive-Behavioral Group Therapy in Obsessive-Compulsive
Disorder: A Randomized Clinical Trial." Psychotherapy and Psychosomatics
72 (2003): 211-216.
Foa, E.B., M.R. Liebowitz, M.J. Kozak, et al. "Randomized,
Placebo-Controlled Trial of Exposure and Ritual Prevention, Clomipramine and
Their Combination in the Treatment of Obsessive-Compulsive Disorder." Focus 5
Summer 2007: 368-380.
Geller, D.A., J. Biederman, S.E. Stewart, et al.
"Which SSRI? A Meta-Analysis of Pharmacotherapy Trials in Pediatric
Obsessive-Compulsive Disorder." American Journal of Psychiatry 160 (2003):
1919-1928.
Goodman, W.K., K.D. Footec, B.D. Greenberg, et al. "Deep Brain Stimulation for
Intractable Obsessive Compulsive Disorder: Pilot Study Using a Blinded, Staggered-Onset
Design." Biological Psychiatry 67.6 Mar. 2010: 535-542.
Heyman, I., D. Mataix-Cols, and N.A. Fineber. "Obsessive-Compulsive Disorder."
British Medical Journal 333 Aug. 2006: 424-429.
Horwath, E., and M. Weissman. "The Epidemiology and Cross-National Presentation of
Obsessive-Compulsive Disorder." Psychiatric Clinics of North America 23.3
(2003):
493-507.
Hu, X.Z., R.H. Lipsky, G. Zhu, et al. "Serotonin Transporter Promoter Gain-of-Function
Genotypes Are Linked to Obsessive-Compulsive Disorder." American Journal of Human
Genetics 78.5 May 2006: 815-826.
Journal of the American Medical Association. Obsessive compulsive disorder.
10/27/04; 292(16).
Kobak, K.A., J.H. Greist, J.W. Jefferson, et al. "Behavioral Versus
Pharmacological Treatments of Obsessive Compulsive Disorder." Focus 2 (2004):
462-474.
National Institute of Mental Health. The numbers count: Mental disorders in
America. June 26, 2008.
National Institute of Mental Health. Psychotherapy, medications best for youth
with obsessive compulsive disorder. Press Release. Oct. 28, 2004.
Pallanti, S. "Transcultural Observations of Obsessive-Compulsive Disorder."
American Journal of Psychiatry 165 (2008): 169-170.
Saxena, S. "Is Compulsive Hoarding a Genetically and Neurobiologically Discrete
Syndrome? Implications for Diagnostic Classification." American Journal of Psychiatry
164 Mar. 2007: 380-384.
Sessa, B. "Can Psychedelics Have a Role in Psychiatry Once Again?" The British Journal of Psychiatry
186 (2005): 457-458.
Simon, N.M., M.W. Otto, S.R. Wisniewski, M. Fossey, M., et al. "Anxiety Disorder Comorbidity in
Bipolar Disorder Patients: Data From the First 500 Participants in the Systematic
Treatment Enhancement Program for Bipolar Disorder (STEP-BD)." American Journal of Psychiatry
161 Dec. 2004: 2222-2229.
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
Panic attacks are sudden feelings of terror that strike without warning. These episodes can occur at any time, even during sleep. A person experiencing a panic attack may believe that he or she is having a heart attack or that death is imminent. The fear and terror that a person experiences during a panic attack are not in proportion to the true situation and may be unrelated to what is happening around them. Most people with panic attacks experience several of the following symptoms: racing heartbeat, faintness, dizzyness, numbness or tingling in the hands and fingers, chills, chest pains, difficulty breathing, and a feeling of loss or control. There are several treatments for panic attacks.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Anorexia is an eating disorder characterized by markedly reduced appetite or total aversion to food. Anorexia is a serious psychological disorder and is a condition that goes well beyond out-of-control dieting. With anorexia, the drive to become thinner is actually secondary to concerns about control and/or fears relating to one's body. There are psychological and behavioral symptoms as well as physical symptoms of anorexia including: depression, social withdrawal, fatigue, food obsession, heart and gastrointestinal complications, kidney function, flaky skin, brittle nails, and tooth loss (this list is not exhaustive).
Suicide is the process of intentionally ending one's own life. Approximately 1 million people worldwide commit suicide each year, and 10 million to 20 million attempt suicide annually.
Bipolar disorder (or manic depression) is a mental illness characterized by depression, mania, and severe mood swings. Treatment may incorporate mood stabilizer medications, antidepressants, and psychotherapy.
Huntington's disease is the result of degeneration of neurons in areas of the brain. Huntington's disease is an inherited disorder. Early symptoms include mood swings, apathy, depression, and anger uncharacteristic of the individual. Judgement, memory, and other cognitive functions may become impaired. Presymptomatic testing is available for individuals who have a family history of Huntington's disease. Treatment includes medication and therapy for symptoms.
Antisocial personality disorder (ASPD) has many symptoms, signs, and causes. Therapy is one treatment option for antisocial personality disorder. It is closely related to other personality disorders (PD), such as borderline personality disorder and narcissistic personality disorder.
ADHD afflicts approximately 3 percent to 5 percent of school-age children and an estimated 60 percent of those maintain the disorder into adulthood. Symptoms of adult ADHD include chronic lateness, anxiety, low self esteem, employment problems, difficulty controlling anger, impulsiveness, poor organization skills, procrastination, chronic boredom among others.
Bulimia is an eating disorder characterized by episodes of secretive excessive eating (bingeing) followed by inappropriate methods of weight control, such as self-induced vomiting (purging), abuse of laxatives and diuretics, or excessive exercise. Purging and nonpurging are the two types of bulimia. There are five basic criteria in the diagnosis of bulimia.
Mental illness is any disease or condition affecting the brain that influence the way a person thinks, feels, behaves, and/or relates to others. Mental illness is caused by heredity, biology, psychological trauma and environmental stressors.
Characteristics of binge eating disorder include eating more quickly than usual, eating until uncomfortably full, eating a lot of food despite not being hungry, eating alone due to embarrassment, and feeling disgusted by overeating. Depression may be a cause of binge eating disorder. Risks of binge eating include weight gain, diabetes, high blood pressure, high cholesterol, heart disease, and some cancers.
Prader-Willi syndrome is a condition characterized by severe floppiness (hypotonia), poor growth, delayed development, and poor feeding problems in early infancy later followed in infancy by excessive eating that may lead to extreme obesity. The genitals in both females and males are underdeveloped and most are infertile. Prader-Willi syndrome is related to chromosome 15.
Asperger syndrome (AS, Asperger's syndrome) is an autism spectrum disorder. Asperger syndrome is characterized by a degree of impairment in language and communication skills, and repetitive or restrictive thoughts or behaviors. The most common symptom of Asperger syndrome is the obsessive interest in a single object or topic. Other conditions that may co-exist with Asperger syndrome include: ADHD, tic disorders, depression, anxiety disorders, and OCD. Diagnosis of Asperger syndrome is complicated, and treatment is generally directed toward minimizing the symptoms of the syndrome and behavioral and educational interventions.
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