Obsessions are repetitive thought impulses that the person finds disturbing, reactionary, distressing, and have a high impact on the person's mood.
Compulsion is a reaction to an obsession. or motor or mental actions performed according to strict rules. The person knows that his behavior is excessive and meaningless. This behavior is done to reduce the impact of obsessions or to prevent what they fear will happen. However, there is either no realistic relationship between the behavior performed for this purpose or it is seen as extremely exaggerated. While a thought that forcibly enters the mind, causes discomfort and distress, fits the definition of obsession, another thought that aims to neutralize such a thought and reduce the distress fits the definition of compulsion.
According to DSM-IV. What are the diagnostic criteria?
-
There are obsessions or compulsions.
-
· This disorder Recurrent and persistent thoughts, impulses, or fantasies that are sometimes involuntary and inappropriate during the It is not excessive sadness felt about real life problems.
-
· The person tries to ignore these thoughts, impulses or fantasies, or to suppress them, or to neutralize them with another thought or action.
-
· The person sees his obsessional thoughts, impulses or fantasies as a product of his own mind.
Compulsions are also present.
< br /> · These are repetitive behaviors that the person cannot stop himself from doing, either as a reaction to an obsession or in accordance with rules that must be strictly applied. For example; shaking hands, praying, constantly saying certain words, etc. · Behaviors and mental actions are aimed at getting rid of distress, reducing existing distress, or protecting from an event or situation that creates fear; However, these behaviors or mental acts are either not realistically related to what they are designed to neutralize or protect, or are clearly too extreme.
-
At some point during the course of this disorder, the person accepts that the obsessions or compulsions are excessive or meaningless. Note: this does not apply to children.
-
The obsessions and compulsions cause significant distress, waste time, or interfere with the person's normal daily activities, occupational functioning, or normal social activities or relationships. It significantly deteriorates.
WHAT IS THE AGE OF OPERATION?
On average, the disorder begins around the age of 21. The disorder occurs a little earlier in men (around the age of 19) and a little later in women. In 65% of patients (aged 22 years) the disorder occurs before the age of 25, but in about 15% after the age of 35. Cases diagnosed with OCD at the age of two have been reported. It is reported by most patients that before the disorder becomes established, there are obsessive-compulsive symptoms that do not significantly impair functionality and do not cause significant discomfort. The age at which such symptoms start is around 13, and it starts at a slightly earlier age in men.
WHAT ARE THE FACTORS?
Genetic factors
Research shows that OCD has symptoms that suggest it is genetically inherited. Family studies show that the prevalence of OCD among the biological relatives of a patient with OCD is 5-10 times higher than in the general population. However, this finding cannot be interpreted in favor of genetic factors alone. Because children may have learned these behaviors by imitating their parents. However, the symptoms of the patients and the symptoms of other members of the family are usually different from each other.
Psychodynamic factors
According to the psychoanalytic view, obsessions are derivatives of repressed impulses. Sometimes the impulse qualities are preserved, but deformed. Sexual and aggressive obsessions generally have this feature. Compulsions can be derivatives of impulses or superego commands against these impulses. Some symptoms of OCD reflect a conflict between derivatives of impulses and the forces opposing them. (obse (sif suspicion symptoms)
Behavioral factors
According to behavioral theory, obsessions are conditioned stimuli. Innocent stimuli incidentally present in an anxiety-provoking situation may later create anxiety. Compulsions are avoidance behaviors. The person discovers that a certain action reduces anxiety and keeps repeating this action.
DIAGNOSIS
OCD is very rich in symptoms, and this diversity in symptoms suggests that the disorder is heterogeneous. According to the data, approximately 40% of the patients have only obsessions, 30% have only compulsions, and the remaining 30% have both obsessions and compulsions. In clinical series, both obsession and compulsion are more than 75%. This shows that patients in the last group are more likely to seek help.
In order of frequency, obsessions are;
-
Contamination is 50%
-
Doubt 40%
-
Somatic 30%
-
Symmetry 30%
-
Aggressive 30%
-
Sexual 25%
-
Religious 10%
More than 70% of the cases are between two or more types of obsessions.
Compulsions in order of frequency:
-
Checking 60%
-
Washing 50%
-
Counting 35%
-
Don't ask, don't tell or pray 35%
-
Symmetry is 30%
-
Hoarding 20%
More than one type of compulsion is found in about 60% of cases.
COMPULSATIONS ACCOMPANYING OBSESSIONS
-
The obsession with contamination is usually accompanied by the compulsion to wash and clean.
-
The obsession with doubt is usually accompanied by the compulsion to check.
-
Aggressive and sexual obsessions are usually accompanied by compulsions to ask questions and explain.
-
The obsession with symmetry and order is usually accompanied by a counting compulsion.
-
Somatic obsessions are often accompanied by a checking compulsion.
TREATMENT
OCD treatment consists of explaining the symptoms to the patient and, if necessary, explaining this to the patient. It should be emphasized that this does not mean that it will happen. At the same time, the patient's relatives should be informed and their cooperation in the treatment should be ensured. They should display an uncompromising but caring and sympathetic attitude towards the patient.
OCD usually fluctuates; It is a chronic, often lifelong disorder. Drug treatment is more helpful in controlling the symptoms. Additionally, although medications are effective on obsessions, they do not change avoidance behaviors. For these last ones, behavioral therapies should also be applied. At the beginning, some patients may not consent to behavioral therapies due to the anxiety they will have to endure. Most of these patients accept behavioral therapy after being relieved with medication. Some patients may not accept drug treatment because they are afraid of the side effects of the drugs. As the effects of behavioral methods are seen in this group, the majority of people accept the use of medication.
Behavior therapy gives more successful results in patients with prominent compulsions. The cooperation of the patient and often the family is required.
Read: 0
