Clinical manifestations of obsessive-compulsive disorder and treatment methods

  Obsessive-compulsive disorder (OCD) is a psychological disorder characterized by recurring ideas, emotions or behaviors that one knows are unnecessary but cannot get rid of. The age of onset is mostly between 16-30 years old, with more males than females. These patients often have compulsive personality defects before the disease. They are characterized by timidity, indecisiveness, caution, meticulousness and orderliness in handling matters. Interaction with others is serious and stereotypical, lacking flexibility and adaptability.  Although there are various forms of OCD, they can be divided into two main categories: obsessive-compulsive thinking and obsessive-compulsive behavior.  Compulsive thinking: compulsive doubts and memories, compulsive exhaustive thinking. For example, some patients always think, “Why don’t people have two horns on their heads?” Some patients are always worried about whether the door is closed after leaving the house; some patients often think about whether the address is wrong after sending a letter. Patients know that such thoughts are meaningless, but they have to think about it, so it is very painful and anxious compulsive behavior: compulsive repeated hand washing, such as each hand washing must be washed for about 20 minutes, before they are willing to stop.  Compulsive counting, such as someone must use 30 small sheets of toilet paper every time they have a bowel movement. Compulsive ritual actions, such as a patient who must stretch the left sleeve three times and the right sleeve three times each time he or she dresses before being willing to put the clothes on.  In daily life, certain people also experience some compulsive phenomena. For example, some people are afraid of dirty repeatedly wash their hands; some people always like to count the street lights when walking. But these people’s actions and thinking do not affect life and work, and will not be restrained by the anxiety, after a period of time will disappear, still belong to the category of normal psychology. In contrast, these obsessive-compulsive phenomena in OCD patients seriously affect their work and study and daily life, and are maintained for a longer period of time, for which the patients often suffer from anxiety.  The treatment of OCD should be comprehensive under the guidance of a psychiatrist.  1, psychotherapy: mainly take the explanatory psychotherapy. The purpose is to raise the patient’s awareness of the disease, to make the patient realize that OCD is a functional disease, not an organic disease, even if after treatment, no improvement in a short period of time, will not deteriorate, and will not change into other more serious diseases, to make the patient establish confidence to overcome the disease.  2.Behavior therapy: For patients with compulsive behavior, behavior therapy should be used. Among them, systematic desensitization therapy is the most effective. For example, for patients who always appear to want to jump downward when ascending a tall building, you can take the patient to the second floor. If there is no compulsive intention, then, take the patient to the third floor, four floors. After repeated training and practice, you can often achieve success.  3, medication: For patients with obsessive-compulsive thinking, medication should be used. Mainly including fluvoxamine, paroxetine, sertraline, fluoxetine and other SSRI drugs as the first choice; chlorpromazine is a more effective anti-OCD drugs, but the side effects are greater, as the second-line drugs. For refractory OCD, risperidone, aripiprazole, quetiapine and olanzapine are often used in combination as booster agents to improve the efficacy. Anxiety and insomnia can be treated with a combination of diazepines.