OBSESSIVE-COMPULSIVE DISORDER (OCD)

Obsessive-compulsive disorder (OCD) is a mental disorder that occurs when a person becomes trapped in obsessive thoughts (obsessions) and repetitive behaviors (compulsions), affecting life activities.

Who May Have Obsessive-Compulsive Disorder (OCD)?

Obsessive-compulsive disorder (OCD) is a mental health disorder that occurs when a person becomes trapped in obsessive thoughts (obsessions) and repetitive behaviors (compulsions). These thoughts and behaviors are not only obstacles to the person’s daily function but may also adversely affect their well-being, depending on their obsessive behaviors.

OCD can occur in anyone regardless of age or gender. According to the International OCD Foundation, 1 in every 100 adults and 1 in every 200 children and adolescents suffers from this disorder. OCD usually begins between 10 and 12 years old and late adolescence. If not detected and intervened promptly, OCD can become chronic with complex symptoms and progression.

Signs Of OCD

People with OCD have recurrent, unwanted, and intrusive thoughts, ideas, or feelings (obsessions). To escape those thoughts, they feel driven to do something repeatedly (compulsions). Behaviors (such as washing/cleaning hands, checking things) and mental behaviors (such as counting) or redundant activities can significantly interfere with the person's daily activities and social interactions.

Obsessions

People with OCD have recurring and persistent thoughts, impulses, or symbols at certain times; they feel intruded and unwanted, so anxiety or severe distress may occur. They try to ignore or suppress the above thoughts, impulses, or symbols or neutralize them with other thoughts or actions.

Some common obsessive thoughts include: Fear of contamination; perfectionism; Fear of danger happening to yourself/others; Fear of losing control of one's actions; Unwanted thoughts, usually violent or sexual; and Obsession with religion and morality (scrupulosity).

Compulsions

People with OCD feel driven to repeatedly perform the above behaviors in response to an obsessive or rigidly applied set of rules. Such compulsion prevents or reduces anxiety about a feared event or situation, whether real or perceived. However, these acts have no real connection to the established purpose or are carried out excessively.

Note: Young children may not be able to express the purpose of these behavioral or mental behaviors.

Some common compulsive behaviors include: Cleaning, bathing, or doing anything to keep clean regularly; Checking too many times regularly (like checking to see if the door is locked, or checking if the stove is off); Repeating actions; Having compulsive mental behaviors (such as counting, praying); Frequently seek reassurance (like asking “Are you sure I'll be okay?”); Avoid situations that remind you of obsessive thoughts.

Many people without OCD may also have obsessive thoughts or repetitive behaviors, but these usually do not disrupt daily life. Those with OCD, on the other hand, have thoughts that appear persistently, as well as behaviors that must be performed rigidly. Failure to do so often causes the individual with this disorder a great level of stress and fear of serious consequences (to themselves or loved ones) if the behavior is not performed. Even though many people with OCD know or suspect their obsessive thoughts are unrealistic, they still have difficulty getting rid of the obsessive thoughts or stopping the compulsive behaviors.

WARNING: The symptoms listed are for reference only. If you suspect that you have obsessive-compulsive disorder, see a psychologist for an accurate diagnosis.

How To Diagnose OCD?

A diagnosis of OCD requires the presence of obsessive thoughts and/or compulsive behaviors that are time-consuming (more than one hour per day), cause significant distress, and impair work or social activities. Specifically, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), diagnostic criteria for obsessive-compulsive disorder include:

A. Presence of obsessions, compulsions, or both;

B. The obsessions or compulsions are time-consuming or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.;

C. The obsessive-compulsive symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition;

D. The disturbance is not better explained by the symptoms of another mental disorder (e.g., excessive worries, as in generalized anxiety disorder; ritualized eating behavior, as in eating disorders and so on).

Each person with OCD has a different level of awareness of the accuracy of the beliefs contained in their obsessive-compulsive symptoms:

• Some people understand the unreasonableness of obsessive behaviors relatively well (for example, they understand that their house will not burn down if they do not check the stove 30 times);

• Some people have a lower level of awareness of the irrationality of obsessive behavior (for example, they believe that their house could burn down if they don't check the stove 30 times);

• Some people are completely unaware of the absurdity of obsessive behavior (for example, they completely believe that their house will definitely burn down if they don't check the stove 30 times).

This level of awareness will change over time; The lower the level of awareness of the absurdity of obsessive behavior, the more serious the obsessive-compulsive disorder.

WARNING: The symptoms listed are for reference only. If you suspect that you have obsessive-compulsive disorder, see a psychologist at a reputable psychological/psychiatric assessment and treatment facility for an accurate diagnosis.

Causes Of OCD

Biological Causes

Family studies and twin studies both show that obsessive-compulsive disorder is heritable and the early or late onset of OCD is also closely related to genetics. The problem of abnormal levels of activity in certain cortical structures, or other words brain damage, can also trigger obsessions in people with OCD. In addition, some symptoms of this disorder are related to abnormalities in neurotransmitters in the brain.

Psycho-Social Causes

Family characteristics, such as controlling, overly critical, unencouraging, and discouraging parenting styles, have been linked to the development of OCD. Individuals raised in negative environments may also develop maladaptive thoughts about personal responsibility. They may believe that they are responsible for preventing harm to themselves and those around them; they also tend to overestimate risk and responsibility. Besides, people with OCD who face hostility or criticism from those around them will have more severe symptoms than others.

Disorders Related To OCD

Some disorders that are closely related to OCD include:

• Hoarding disorder (HD): People with this disorder will collect and keep many items, cluttering the house, causing the space not to be used for its intended purpose, and causing difficulties or problems in daily living.

• Body dysmorphic disorder (BDD): People with this disorder are very preoccupied with one or more aspects of their appearance and will engage in repetitive behaviors to fix, hide, or control aspects that they do not like about their bodies. 

• Other body-focused repetitive behaviors (BFRBs): People with these behaviors will engage in repetitive self-damaging acts that affect their body, such as scratching their skin and pulling out their hair, biting their lips or cheeks. While there exists an effort to decrease the frequency of such harmful behaviors, they may still significantly impair the person’s daily functioning. 

Can OCD Be Treated?

People with OCD can be treated at psychotherapy centers or medical facilities. Some popular treatments today include medication, psychotherapy, or a combination of both. 

Medication

Antidepressants that regulate neurotransmitter uptake levels (SSRIs) are commonly used to treat OCD. In cases where SSRIs do not improve symptoms of obsessive-compulsive disorder, your doctor may prescribe antipsychotic or anti-anxiety medications. However, these drugs can have many side effects, and there is still a risk of OCD relapse after drug treatment. Individuals with OCD need to be extremely cautious when using medication and should only use medication with the advice and prescription of a clinician.

Psychotherapy

One of the most effective methods of treating OCD is using Cognitive Behavioral Therapy (CBT). More specifically, a special type of CBT called Exposure and Response Prevention (ERP) helps people with OCD face (exposure) fearful situations or images focusing on their obsessions; at the same time, guides them to avoid carrying out coercive acts. When in fearful situations without any terrible consequences, the individual will realize that their fearful thoughts are just thoughts and that they can deal with them without repetitive behaviors. Through this, their anxiety will gradually decrease over time.

If you feel you are having symptoms of obsessive-compulsive disorder, go to a medical facility for timely examination and diagnosis, or contact the Vietnam - France Psychology Institute via Hotline: 0979.158.463 for specific advice. Early intervention is key to improving health and quality of life.

Tham khảo:

[1] Rối loạn ám ảnh cưỡng chế (OCD) là gì?. https://iocdf.org/wp-content/uploads/2023/02/IOCDF-What-Is-OCD-Brochure-Vietnamese.pdf

[2] What Is Obsessive-Compulsive Disorder?. https://iocdf.org/wp-content/uploads/2023/02/IOCDF-What-Is-OCD-Brochure-Vietnamese.pdf

[3] Tâm bệnh học. Đặng Hoàng Minh (chủ biên)

[4] Diagnostic and statistical manual of mental disorders _ DSM-5. https://repository.poltekkes-kaltim.ac.id/657/1/Diagnostic%20and%20statistical%20manual%20of%20mental%20disorders%20_%20DSM-5%20(%20PDFDrive.com%20).pdf

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