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Diagnosis and treatment of OCD

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Written By: Admin | Updated : June 9, 2014 2:40 PM IST

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OCD-Diagnosis

Diagnosis of OCD

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM), to be diagnosed with OCD, a person must have obsessions, compulsions, or both. The thoughts, impulses, or images that are obsessions are of a degree or type that lies outside the normal range of worries about conventional problems. A person may attempt to ignore or suppress such obsessions, or to neutralize them with some other thought or action, and will tend to recognize the obsessions as distinctive or irrational.

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Compulsions become clinically significant when a person feels driven to perform them in response to an obsession, or according to rules that must be applied rigidly, and when the person consequently feels or causes significant distress. Therefore, while many people who do not suffer from OCD may perform actions often associated with OCD (such as ensuring the angles at which the curtains must be drawn or ensuring correct punctuation marks all the time), the distinction with clinically significant OCD lies in the fact that the person who suffers from OCD mustperform these actions; otherwise they will experience significant psychological distress.

Treatment for OCD

Cognitive-behavioural therapy

Cognitive-behavioural therapy for obsessive-compulsive disorder (OCD) highlights treatments through:

  1. Exposure and response preventionor ERP: This involves repeated exposure to the source of your obsession. Then you are asked to refrain from the compulsive behaviour you'd usually perform to reduce your anxiety. For example, if you are a compulsive hand washer, you might be asked to touch your shoe and then be prevented from washing your hands. As you sit with the anxiety, the urge to wash your hands will gradually begin to go away on its own. In this way, you learn and understand that you don't need the ritual to get rid of your anxiety that you have some control over your obsessive thoughts and compulsive behaviours.
  2. Cognitive therapy: It focuses on the catastrophic thoughts and exaggerated sense of responsibility you feel. A big part of cognitive therapy for OCD is teaching you healthy and effective ways of responding to obsessive thoughts, without resorting to compulsive behaviour.

More recent behavioural work has focused on associative splitting. It is a new technique aimed at reducing obsessive thoughts. The method draws upon the 'fan effect' of associative priming. The sprouting of new associations diminishes the strength of existing ones. As OCD patients show marked biases or restrictions in OCD-related semantic networks (e.g., cancer is only associated with 'illness' or 'death', fire is only associated with 'danger' or 'destruction'), they are encouraged to imagine neutral or positive associations to OCD-related cognitions (cancer = zodiac sign, animal, crab; fire = fireflies, fireworks, candlelight-dinner).

Read more about causes, symptoms, diagnosis and treatment of OCD.

Four steps to deal with OCD and prognosis

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