Do you suffer from OCD ?

Thousands of people around the world suffer from OCD (or Obsessive Compulsive Disorder), an anxiety disorder in which an individual suffers from unwanted repetitive thoughts and behaviours. It occurs in a spectrum from mild to severe, but if severe and left untreated, can destroy a person's capacity to function at work, school or even at home

Symptoms

Two major symptoms of OCD are obsessions and compulsive rituals. They often centre on one or more of the following issues:
- A person with OCD may constantly worry about having dirty hands or clothing, or catching or spreading germs. In some cases, it extends to sexual activity.

- They worry that the front door isn't locked, the oven isn't turned off, or a cigarette hasn't been snuffed out.

- They fear losing control and harming others.

- They are obsessed with order and precision, may feel very anxious if even the smallest detail is out of place.


Most people with OCD resort to repetitive behaviours called compulsions like the following:

- Repeatedly washing hands/or taking baths.

- Repeating routine actions a number of times until it feels right. For instance, checking if lights are switched off or appliances are unplugged.

- Excessive checking of door locks, the fridge or stoves.

- Repeatedly making lists, counting or arranging.

- Unnecessary re-reading and re-writing or excessive praying and performing rituals.



Stress from unemployment, relationship difficulties, problems at school, illness or childbirth can be strong triggers. Being a victim of sexual abuse as a child, can increase the chance of developing OCD as an adult



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Obsessive Compulsive Disorder ( OCD) Cycle

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OCD Model

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What causes OCD

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Common Obsessions

Contamination  45%

Pthologic Doubt  35%

Aggression  32%

Sex 20%

Religious  17%

Symmetry / exactness  14%

Hoarding   3%


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Common Compulsions

Washing & Cleaning  41%

Checking  38%

Repeating  16%

Ordering  16%

Counting  5%

Hoarding  3%


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OCD FACTS

20yrs ago , OCD was considered a rare disorder affecting only 0.5% people.

Now : 2-3% total population  , 1% children

According to WHO , OCD is one of the 10 leading causes of disability

Over 12 million Indian have it in one form or another

58% seeking treatment come from urban background.

Average time lag between onset and a proper diagnosis is 17 yrs

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Woman dies after showering 20 hours a day

An elderly British couple have been arrested on suspicion of the manslaughter of their daughter who was so blighted by obsessive compulsive disorder she spent up to 20 hours a day in the shower. Samantha Hancox, 40, was found dead in an armchair at the home she had hardly left in 18 years for fear of coming into contact with germs. Her parents Ken and Marion Hancox dialled 999 but were later questioned for seven hours after being arrested and taken to a police station to be fingerprinted. A post mortem examination revealed their daughter, their only child, died of dehydration and a skin infection. Mr Hancox, 76, who has bone cancer, and his 77-year-old wife are on bail while further investigations take place into the death. They told yesterday how their daughter, a former law student, suffered from acute obsessive compulsive disorder (OCD) which left her a virtual recluse with a crippling phobia about germs. As the condition took hold, Hancox would wear socks on her hands which she scrubbed constantly. In her final years only her parents were allowed into the house to try to keep it germ-free.
The couple from Tipton, Sandwell, West Midlands, criticised the lack of help they were given from mental health and social services teams as they laid bare the severity of their daughter’s illness. Mrs Hancox, who is disabled and cannot walk, said: “Everything had to be wrapped up. When Ken went out shopping he had to change his clothes before he could come back in or walk around in his underwear. Sometimes she would even want us to burn the clothes. There was a fog in the house from her showering.”
She added: “How could they arrest us? We didn’t kill her, it was the OCD. She was our daughter and we loved her.
“We tried to get help. All these psychiatrists kept coming and all they did was assess her and went away. Occasionally she was admitted to hospital briefly, but nothing was ever done to really help her. We even wrote to Tony Blair when he was prime minister.” She said her daughter wanted to see a psychotherapist but was told the local primary care trust did not offer that service to patients. In her last five years Hancox’s state of mind had deteriorated so much that she refused to let any medical professional visit her at home, and was too scared to leave the house herself. Her parents, former factory workers, said their daughter began worrying about germs at 10 when her grandmother, Molly, died after being admitted to hospital. An aunt had died not long before from food poisoning.
At 14, she dropped out of school and was tutored at home. Three years later her phobia led her to leave college before completing a law course.
Her parents said in her last 18 years she left the house only once other than for a hospital appointment.


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Hoarding is a compulsive disorder

A study conducted in 2008 by Johns Hopkins Medical School revealed that hoarding may be more prevalent than previously thought. Researchers concluded that one in 20 people may suffer from some form of hoarding.

It’s human nature to collect and save possessions that bring back pleasant memories. Researchers say that children as young as two years of age begin to hold onto treasures of one sort or another. And some of us are more prone to collecting than others. That makes me feel a lot better about my old shoes.

Hoarding can be a disease, but it’s a matter of degree. As one wise sage remarked, “Too much of anything is worse than none at all.” So to be classified as a bone-fide hoarder, you must cross the line from merely hoarding old shoes to an unlimited, unchecked, uncontrollable desire to save vast amounts of things. For some, this means holding onto newspapers, old clothes or keeping outdated food products. And in other instances, it can be having dozens of cats or other animals in the home.

Why do people hoard? Dr. Jack Samuels, a psychologist who specializes in personality disorders at Johns Hopkins Medical School, reports that hoarders are often “overwhelmed by their possessions and unable to make decisions about how to organize or cull them.” In some instances, hoarding is triggered by the death of a loved one, causing the inability to discard clothing and other items of a deceased partner.




So when is it time to seek help? Certainly not when the only problem is simply keeping a few pairs of old shoes. But, if you can no longer get into bed due to the pile of old World War II newspapers, it’s time to either get help or seek a divorce.



But treating hoarders is more difficult than prescribing a pill for hypertension. For one thing, many hoarders deny the severity of their problem. In fact, some become angry when criticized that they’re tormenting other members of the family.



Hoarding is a compulsive disorder, but it is not the same as obsessive compulsive disease (OCD). OCD patients have a compulsion to perform repetitive rituals that they know are totally senseless, but cannot stop performing them. Drugs such as Prozac can be helpful in taming OCD rituals. But studies show that Prozac has no effect on the compulsion to hoard

The most effective way to curb this condition is by home visits of behavioural therapists who can teach hoarders how to organize their lives. But never expect that one quick visit to convince a hoarder to stop “cold turkey”. It’s impossible to quickly eliminate the feeling that, “I might need these possessions someday."




Dr.Sanjay Mongia
http://www.ocd.net.in/

Compulsions

Compulsions are defined by:


1. Repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly.



2. The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive

 
 
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Obsessions

Obsessions are defined by:


1. Recurrent and persistent thoughts, impulses, or images that are experienced at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress.

2. The thoughts, impulses, or images are not simply excessive worries about real-life problems.

3. The person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action.

4. The person recognizes that the obsessive thoughts, impulses, or images are a product of his or her own mind, and are not based in reality.

5. The tendency to haggle over small details that the viewer is unable to fix or change in any way. This begins a mental pre-occupation with that which is inevitable
 
 
 
Dr.Sanjay Mongia
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Can Strep Throat Cause Obsessive-Compulsive Disorder ?

For years, researchers have wondered about a connection between children getting strep throat and later showing symptoms of obsessive-compulsive disorder (OCD).


Obsessive-compulsive disorder is a frequently debilitating condition affecting millions of People in which those afflicted think repetitive thoughts they don’t want to or perform compulsive, ritualistic behaviors they wish they didn’t have to—like washing their hands many, many times (sometimes until they bleed) or repeatedly checking a light switch to make sure it is off (even if they have to do so for an hour).

The thinking has been that strep throat bacteria trigger the production of antibodies that end up not only targeting strep, but “mistakenly” acting on an enzyme in the brain, which is involved in making brain chemical messengers. In so doing, the antibodies to the strep throat infection pathologically alter the balance of these chemical messengers.


Now, Israeli researchers have taken the theory one step further. A team at Tel Aviv University has created a lab model of how the process works. They take rats and expose them to strep bacteria and compare them to another group of rats who are not exposed to the bacteria. The ones exposed to the bacteria do indeed develop antibodies to the strep and high levels of those antibodies are, in fact, found bound to particular receptors in their brains. What’s more, these strep-exposed mice show compulsive behaviors like repeatedly and senselessly grooming themselves. Sounds a lot like repeatedly and senselessly washing one’s hands, right?



So, it is increasingly looking as though being infected by strep (as in, getting strep throat that isn’t very promptly treated) may be one significant reason people develop OCD. This is a stunning possibility, not only because of its implication for folks with that single condition, but because other conditions mimic OCD in many of their features—including autism.


For now, I would recommend routinely testing children for strep throat. Certainly, that would mean testing them with throat cultures whenever they have sore throats. Yes, whenever. Every time. But I also advise having throat cultures done a few times during the winter months just to do it. Many children exposed to strep (and infected by it) do not complain of a sore throat.
This is one time when getting aggressive with antibiotics makes all the sense in the world. Because the possibility of saving a person from OCD is worth the trouble and will actually save lots of suffering (not to mention, lots of money), in the long run


Dr.Sanjay Mongia
http://www.ocd.net.in/

OCD linked to common childhood illness

A new study at the Tel Aviv University suggests that strep throat – a common infection in children - can lead to brain dysfunction and OCD.

Prof. Daphna Joel and her team of researchers have scientifically demonstrated that strep throat can lead to problems with a child's heart, joints or brain if left untreated. And when the brain is involved, motor and mental functioning may be compromised, leading to syndromes such as attention deficit disorder and obsessive-compulsive disorder (OCD).


The team developed a new animal model to show how exposure to strep affects the brain and leads to a number of physical and mental ailments.  Comparing them to a strep-free control group, Prof. Joel measured a distinct difference in behavior in the strep-exposed animals.  The results showed that those exposed developed balance and coordination difficulties, as well as compulsive behaviors such as increased and repetitive grooming.

This breakthrough finding could lead to new modes of diagnosis of the disease and provide a new platform for drug developers seeking to treat or cure OCD.

OCD is characterized by recurrent intense obsessions and/or compulsions that may cause severe discomfort, anxiety and stress, and interfere with day-to-day functioning.

Prof. Joel stressed how important it is for parents who notice signs of strep throat to ensure that their children get treated with the appropriate antibiotics in a timely fashion.



Dr.Sanjay Mongia
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Brain chemical linked to obsessive compulsive disorder found

Scientists from Weill Cornell Medical College, New York, have identified a brain chemical linked to obsessive compulsive disorder (OCD).

In the study conducted using laboratory mice, researchers found that animals lacking the molecule, known as Slitrk5, exhibit behaviours similar to the human form of the condition including excessive self-grooming and increased anxiety.



However, these symptoms can be eased by fluoxetine, a drug commonly prescribed to treat OCD sufferers who demonstrate bizarre behaviour which can be upsetting both to them and their families, friends and colleagues.

Geneticist Professor Shahin Rafii and colleagues said in addition to identifying a new chemical involved in OCD, the mice may be useful as an animal model of the condition and in investigations for new therapies.

"Obsessive-compulsive disorder (OCD) is a common psychiatric disorder defined by the presence of obsessive thoughts and repetitive compulsive actions, and it often encompasses anxiety and depressive symptoms," telegraph.co.uk quoted Raffii as saying.
The researchers added: "This model can be used to further dissect the role of Slitrk5 in molecular pathways underlying the pathogenesis of obsessive-compulsive behaviours."




Dr.Sanjay Mongia
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Causes of OCD

In the early 1910s, Sigmund Freud attributed obsessive–compulsive behavior to unconscious conflicts which manifested as symptoms. Freud describes the clinical history of a typical case of "touching phobia" as starting in early childhood, when the person has a strong desire to touch an item. In response, the person develops an "external prohibition" against this type of touching. The cognitive–behavioral model suggests that compulsive behaviour is carried out to remove anxiety-provoking intrusive thoughts. Unfortunately this only brings about temporary relief as the thought re-emerges. Each time the behaviour occurs it is negatively reinforced by the relief from anxiety, thereby explaining why the dysfunctional activity increases and generalizes (extends to other, related stimuli) over a period of time.

OCD has been linked to abnormalities with the neurotransmitter serotonin , although it could be either a cause or an effect of these abnormalities. Serotonin is thought to have a role in regulating anxiety. To send chemical messages from one neuron to another, serotonin must bind to the receptor sites located on the neighboring nerve cell. It is hypothesized that the serotonin receptors of OCD sufferers may be relatively understimulated. This suggestion is consistent with the observation that many OCD patients benefit from the use of selective serotonin reuptake inhibitors (SSRIs), a class of antidepressant medications that allow for more serotonin to be readily available to other nerve cells.

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Gamma Knife Surgery for Obsessive Compulsive Disorder

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Gamma Knife Surgery for OCD

Gamma Knife surgery represents one of the most advanced means available to manage brain tumors , arteriovenous malformations , pain or Movement disorders ( Parkinsons’s Disease , Tremors ) & OCD. The procedure is unique because, with the Gamma Knife, no surgical incision is performed to expose the target.The Gamma Knife isn't really a knife at all, but Radiosurgery - a non-invasive neurosurgical procedure that uses powerful doses of radiation to target and treat diseased brain tissue while leaving surrounding tissue intact. Gamma Knife treatment offers new hope for patients with OCD.
Read more about it at http://www.gammaknifeonline.in
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OCD Treatment

Obsessive compulsive disorder is a highly disabling pathological condition which in the most severe and drug-resistant form can severely impair social, cognitive and interpersonal functioning. Deep-brain stimulation has been demonstrated to be an effective and safe interventional procedure in such refractory forms in selected cases. The first Italian experience in the treatment of this pathology by means of nucleus accumbens stimulation  has been published .


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Neurosurgical Treatment of Obsessive Compulsive Disorder

While many methods have been utilized in the Neurosurgical treatment of OCD , four procedures have evolved as the safest and most effective. These are all performed bilaterally and under stereotactic conditions to allow for precise lesioning of target structures. They include:


1.) Anterior cingulotomy.

2.) Subcaudate tractotomy.

3.) Limbic leucotomy.

4.) Anterior capsulotomy.

Although Talairach was the first to describe anterior capsulotomy, Leksell popularized the procedure for patients with a variety of psychiatric disorders. The aim was to interrupt presumed fronto-thalamic connections in the anterior limb of the internal capsule where they pass between the head of the caudate nucleus and the putamen. Clinical indications for Capsulotomy initially included schizophrenia, depression, chronic anxiety states and obsessional neurosis. Lesions are created by Gamma knife technique .


Obsessive Compulsive Disorder