What is Obsessive Compulsive Disorder?
Obsessive Compulsive Disorder is a an anxiety disorder characterised by either obsessions or compulsions but most typically both.
An obsession is defined as an unwanted intrusive thought, image or urge which repeatedly enters an individual's mind. Intrusive thoughts in themselves are a normal occurrence. However, the difference between a normal intrusive thought and an obsession is the meaning that is attached to the content.. Someone suffering from OCD will tend to believe that intrusive thoughts are dangerous, immoral and that they are able to prevent harm occurring either to their self or a vulnerable person.
Compulsions are repetitive behaviours or mental acts that an individual feels compelled to perform in order to reduce anxiety, prevent catastrophe or avoid harm.
OCD is a complex disorder and takes many forms. Examples are as follows:
- Contamination from dirt, germs, viruses, bodily fluids, faces, chemicals, sticky substances or dangerous materials
- Fear of harm
- Excessive concern with order and symmetry
- Obsessions with the body or physical symptoms
- Religious, sacrilegious or blasphemous thoughts
- Thoughts of a sexual nature
- An urge to hoard useless or worn out possessions
- Thoughts of aggression or violence
- Cleaning, washing
- Repeating acts
- Mental compulsions (e.g. special words or prayers repeated in a set manner)
- Ordering, symmetry or exactness
How many people suffer from OCD ?
Worldwide studies indicate that between 2-3% of the adult population suffer from OCD with little variance from country to country. It often co-exist with other disorders such as depression, alcohol and substance abuse or an eating disorder. The average age of onset is in late adolescence for males and early twenties for females.
What is the evidence that CBT is an effective treatment of OCD?
Behavioural therapy has over 30 years of published research to support a widely held consensus as an effective treatment for OCD. Cognitive therapy approaches have been developed more recently with the aim of improving efficacy for individuals who find the behavioural approaches difficult. Current approaches tend to combine elements of the cognitive and behavioural therapeutic approaches.
How many sessions does NICE recommend?
For individuals experiencing mild symptoms of OCD at least 10 sessions of CBT is recommended. Where symptoms are more severe the number of sessions required may need to be increased and a pharmaceutical considered.
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