Obsessive-Compulsive Disorder (OCD): Symptoms, Triggers & Treatment | Mass General Brigham

Mass General Brigham
20 Oct 202108:20
EducationalLearning
32 Likes 10 Comments

TLDRDr. Sabina Wilhelm, a leading expert in psychology and OCD, explains Obsessive-Compulsive Disorder (OCD) as a psychiatric condition characterized by distressing obsessions and compulsive behaviors aimed at reducing anxiety. She details common obsessions and compulsions, potential triggers, and the disorder's prevalence, onset, and chronic nature. Wilhelm discusses the genetic, biological, psychological, and environmental factors that may contribute to OCD's development. She outlines two primary treatments: cognitive-behavioral therapy with exposure and response prevention, and pharmacotherapy with serotonin reuptake inhibitors. She emphasizes the importance of relapse prevention and distinguishes OCD from common perfectionism or cleanliness preferences. Diagnosing OCD involves a mental health professional's interview, and Wilhelm highlights comorbidities and related disorders. She concludes with a message of hope and the availability of effective treatments.

Takeaways
  • 🧠 Obsessive-Compulsive Disorder (OCD) is a psychiatric disorder characterized by obsessions and compulsions that cause significant anxiety and distress.
  • 🔄 Common obsessions include fears of contamination, losing something, making mistakes, and concerns with symmetry or exactness, along with recurrent inappropriate thoughts related to violence, sex, or religion.
  • 🛁 Typical compulsions involve repetitive behaviors like washing, cleaning, checking, and repeating actions, or mental rituals such as praying or reviewing to prevent a feared event.
  • 🔑 Triggers for OCD can be diverse and include everyday objects or situations that lead to obsessions and compulsions.
  • 📈 OCD is relatively common, affecting 1-2% of the general population, with two onset peaks in childhood and early adulthood.
  • 🧬 The exact cause of OCD is unknown but is believed to involve a combination of genetic, biological, psychological, and environmental factors.
  • 🧬 Genetics play a role, as OCD tends to run in families, and certain brain areas are hyperactive in individuals with the disorder.
  • 🧘 Personality traits like perfectionism and environmental factors such as stress or trauma may predispose some individuals to OCD.
  • 💊 There are two primary treatments for OCD: cognitive-behavioral therapy (CBT) with exposure and response prevention, and pharmacotherapy with serotonin reuptake inhibitors.
  • 🤝 CBT involves psychoeducation, cognitive exercises, behavioral exposure, response prevention, and relapse prevention strategies.
  • 🔄 Relapse after successful CBT treatment is possible, but re-engaging with treatment strategies or seeking additional therapy can help get back on track.
  • 🤔 OCD is distinct from simply wanting to perform well or being a 'neat freak'; it involves actual suffering from obsessions and compulsions.
  • 🩺 OCD is diagnosed through a diagnostic interview with a mental health professional, and there is no biological test for the disorder.
  • 🔗 Common comorbidities with OCD include depressive disorders, anxiety disorders, eating disorders, and other related disorders like body dysmorphic disorder, trichotillomania, and hoarding disorder.
Q & A

  • What is Dr. Sabina Wilhelm's professional role?

    -Dr. Sabina Wilhelm is the Chief of Psychology and Director at the Center for OCD and Related Disorders at Mass General Hospital, and she is also a professor at Harvard Medical School.

  • What is Obsessive Compulsive Disorder (OCD)?

    -Obsessive Compulsive Disorder is a psychiatric disorder characterized by obsessions, which are recurrent thoughts or images that cause anxiety and distress, and compulsions, which are repetitive behaviors or mental acts performed to reduce the anxiety caused by obsessions.

  • What are the common obsessions associated with OCD?

    -Common obsessions include fears of contamination, losing something, making a mistake, concerns with symmetry or exactness, and recurrent inappropriate violent, sexual, or religious thoughts.

  • What are some common compulsions seen in individuals with OCD?

    -Common compulsions include repetitive hand washing, cleaning, checking, repeating actions until they feel right, praying silently to prevent a feared event, or reviewing actions to ensure they were done correctly.

  • What are triggers and symptoms in the context of OCD?

    -Triggers are events or situations that precede the onset of OCD symptoms, which are the obsessions and compulsions. For example, touching a doorknob might trigger the obsession of getting sick, leading to the compulsion of washing hands repeatedly.

  • How common is OCD and when does it typically start?

    -OCD is quite common, affecting about one to two percent of the general population. It has two peaks of onset: in childhood and early adulthood, with most individuals developing OCD before the age of 25.

  • What are the potential causes of OCD?

    -The exact causes of OCD are not known, but it is believed to involve a combination of genetic, biological, psychological, and environmental factors. This includes family history, hyperactivity in certain brain areas, neurotransmitter imbalances, personality traits like perfectionism, and stressful life events or psychological trauma.

  • What are the two gold standard treatments for OCD?

    -The two gold standard treatments for OCD are cognitive-behavioral therapy (CBT), specifically involving exposure and response prevention, and pharmacotherapy, typically with serotonin reuptake inhibitors.

  • How effective is cognitive-behavioral therapy for OCD and what is the relapse rate?

    -Cognitive-behavioral therapy is effective for about 60 to 80 percent of patients with OCD. About 20 percent of people relapse after initially successful CBT, but this can often be managed by revisiting treatment strategies or having booster sessions with a therapist.

  • How is OCD different from simply wanting to do a good job or perform well?

    -While many people may use the term 'OCD' colloquially to describe a preference for cleanliness or organization, true OCD involves significant distress and suffering from obsessions and compulsions that go beyond simply wanting to do a good job or perform well.

  • How is OCD diagnosed and what are some common comorbidities?

    -OCD is diagnosed through a diagnostic interview with a mental health service provider who asks about obsessions and compulsions. There is no brain scan or blood test for OCD. Common comorbidities include depressive disorders, anxiety disorders, eating disorders, and other conditions like body dysmorphic disorder, trichotillomania, excoriation disorder, and hoarding disorder.

Outlines
00:00
🧠 Understanding Obsessive-Compulsive Disorder (OCD)

Dr. Sabina Wilhelm, a leading authority in psychology, introduces obsessive-compulsive disorder (OCD) as a psychiatric disorder characterized by obsessions and compulsions causing significant distress and anxiety. She explains that common obsessions include fears of contamination, losing something, making mistakes, and inappropriate thoughts related to violence, sex, or religion. Compulsions often involve repetitive behaviors like washing, checking, or mental rituals such as praying or reviewing actions. Triggers for OCD can be varied and numerous, including everyday objects or events, and the disorder typically starts in childhood or early adulthood, persisting chronically without treatment. The exact cause of OCD remains unknown but is believed to involve a combination of genetic, biological, psychological, and environmental factors.

05:00
🛠️ Treatments and Diagnosis of OCD

The script outlines two primary treatments for OCD: cognitive-behavioral therapy (CBT) with exposure and response prevention, and pharmacotherapy using serotonin reuptake inhibitors. CBT involves psychoeducation, cognitive exercises to alter perspectives on thoughts, and behavioral exercises that encourage facing anxiety-provoking situations without performing compulsions, followed by relapse prevention strategies. The therapy is typically short-term, with a high success rate, although about 20% of patients may relapse. The distinction between OCD and the common desire for cleanliness or organization is clarified, with the enjoyment of such activities being a key differentiator. OCD is diagnosed through a mental health professional's interview, without the need for brain scans or blood tests. The script also mentions common comorbidities with OCD, such as depressive and anxiety disorders, and related conditions like body dysmorphic disorder, trichotillomania, excoriation disorder, and hoarding disorder. Dr. Wilhelm concludes by offering hope and information resources through the International OCD Foundation.

Mindmap
Keywords
💡Obsessive Compulsive Disorder (OCD)
Obsessive Compulsive Disorder, or OCD, is a psychiatric disorder characterized by the presence of obsessions and compulsions. In the video, Dr. Sabina Wilhelm explains that individuals with OCD experience recurrent, distressing thoughts (obsessions) and engage in repetitive behaviors (compulsions) to alleviate the anxiety caused by these thoughts. The disorder is a central theme of the video, as it discusses its symptoms, causes, and treatments.
💡Obsessions
Obsessions refer to the recurrent, unwanted thoughts or images that cause significant anxiety and distress. In the context of the video, Dr. Wilhelm describes common obsessions as fears of contamination, losing something, making mistakes, and having inappropriate violent, sexual, or religious thoughts. These obsessions are a driving force behind the compulsive behaviors seen in OCD.
💡Compulsions
Compulsions are repetitive behaviors or mental acts that an individual feels compelled to perform in response to an obsession. The video explains that compulsions, such as excessive hand washing, cleaning, checking, or repeating actions, are attempts to reduce the anxiety caused by obsessions. They are a key aspect of OCD and often interfere significantly with a person's daily life.
💡Triggers
Triggers in the context of OCD are stimuli or situations that initiate or exacerbate obsessions and compulsions. The video mentions examples such as touching a doorknob triggering a fear of contamination, which then leads to the compulsion of washing hands repeatedly. Triggers are important to understand as they can help in identifying the onset of OCD symptoms.
💡Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy is one of the two gold standard treatments for OCD mentioned in the video. CBT involves exposure to the source of anxiety and response prevention, which means the individual is prevented from carrying out the compulsive behavior. The therapy aims to change thought patterns and behaviors, and the video highlights its effectiveness with a significant percentage of patients responding positively.
💡Pharmacotherapy
Pharmacotherapy refers to the use of medication to treat a disorder, and in the case of OCD, it often involves serotonin reuptake inhibitors. The video explains that this form of treatment is an important part of managing OCD symptoms, alongside psychotherapy.
💡Genetics
Genetics plays a role in the development of OCD, as suggested by the video. It mentions that if a family member has OCD, an individual is more likely to develop it as well. This indicates a hereditary component to the disorder, which is one of the factors that researchers consider when studying the causes of OCD.
💡Neurotransmitters
Neurotransmitters are chemical messengers in the brain that facilitate communication between nerve cells. The video points out that individuals with OCD may have an imbalance in certain neurotransmitters, which could contribute to the disorder's symptoms. This highlights the biological aspect of OCD.
💡Perfectionism
Perfectionism is a personality trait characterized by striving for flawlessness and setting excessively high standards. In the video, it is suggested that high levels of perfectionism might predispose someone to develop OCD. This trait is discussed as a potential psychological factor contributing to the development of the disorder.
💡Relapse Prevention
Relapse prevention is a strategy taught in CBT to help individuals maintain the gains made during treatment and avoid returning to previous unhealthy behaviors or thought patterns. The video explains that learning relapse prevention exercises is an important part of CBT for OCD, as it helps patients manage their condition over the long term.
💡Diagnostic Interview
A diagnostic interview is a method used by mental health professionals to assess an individual's symptoms and determine the presence of a disorder. The video clarifies that OCD is diagnosed through such interviews, where questions about obsessions and compulsions are asked, rather than through brain scans or blood tests.
Highlights

Dr. Sabina Wilhelm is the chief of psychology and director at the Center for OCD and Related Disorders at Mass General Hospital, and a professor at Harvard Medical School.

Obsessive Compulsive Disorder (OCD) is a psychiatric disorder characterized by obsessions and compulsions.

Obsessions are recurrent thoughts or images that cause anxiety and distress.

Compulsions are actions or mental acts performed to reduce anxiety caused by obsessions.

Common obsessions include fears of contamination, losing something, making mistakes, and concerns with symmetry or exactness.

Common compulsions involve repetitive washing, cleaning, checking, and repeating actions or mental rituals.

Triggers for OCD can be various stimuli or situations that lead to obsessions and compulsions.

OCD affects about 1-2% of the general population and has two peaks of onset: in childhood and early adulthood.

OCD is typically chronic, waxing and waning, and does not go away without treatment.

The exact cause of OCD is unknown, but it is believed to involve a combination of genetic, biological, psychological, and environmental factors.

Cognitive Behavioral Therapy (CBT) with exposure and response prevention is a gold standard treatment for OCD.

Pharmacotherapy with serotonin reuptake inhibitors is another effective treatment for OCD.

CBT involves psychoeducation, cognitive exercises, behavioral exercises, and relapse prevention.

CBT is a short-term treatment, usually taking about 16 to 20 sessions to complete.

About 60-80% of patients respond to CBT for OCD.

Approximately 20% of people relapse after successful CBT, but can be managed with booster sessions or revisiting treatment strategies.

OCD is different from simply wanting to do a good job or perform well; it involves actual suffering from obsessions and compulsions.

OCD is diagnosed through a diagnostic interview with a mental health service provider, with no brain scan or blood test available for diagnosis.

Common comorbidities with OCD include depressive disorders, anxiety disorders, eating disorders, and other related disorders.

Disorders that resemble OCD include body dysmorphic disorder, trichotillomania, excoriation disorder, and hoarding disorder.

There is hope for individuals with OCD as effective treatments are available.

The International OCD Foundation provides more information and resources for those affected by OCD.

Transcripts

Browse More Related Video

Obsessive compulsive disorder (OCD) - causes, symptoms & pathology

OCD: Signs & Symptoms of Obsessive Compulsive Disorder | Stanford

OCD explained for beginners - how I wish I was taught

Obsessive Compulsive Disorder (OCD), Causes, SIgns and Symptoms, Diagnosis and Treatment.

Obsessive-Compulsive Disorder (OCD) Mnemonics (Memorable Psychiatry Lecture)

Anxiety or Obsessive Compulsive Disorder?

Rate This

5.0 / 5 (0 votes)

Thanks for rating:

Related Tags
OCD AwarenessMental HealthPsychiatry InsightsAnxiety DisordersCompulsionsObsessive ThoughtsCognitive TherapySerotonin InhibitorsGenetic FactorsBehavioral Treatment