I. Overview of obsessive-compulsive disorder: Before talking about obsessive-compulsive disorder, let’s first talk about obsessive-compulsive phenomena, which almost all of us may have experienced: for example, sometimes there is a song that keeps ringing in your head, or after going out of the house, you always worry about whether or not the door of the house is forgotten to be locked? Did you leave the gas on? You may even go home to check. Children, teenagers can also appear obsessive-compulsive phenomenon, such as children walking on the road, walk four steps must jump a step to continue to walk forward, etc., it can be said that everyone may have obsessive-compulsive phenomenon, generally speaking, the degree of this obsessive-compulsive phenomenon is mild, short duration, does not cause serious anxiety and other emotional disorders, it is a normal performance. What is obsessive-compulsive disorder? Obsessive-compulsive disorder (OCD) is a group of neurological disorders with obsessive-compulsive symptoms (mainly including obsessive thoughts and compulsive behaviors) as the main clinical manifestations. Obsessive-compulsive disorder (OCD) is not uncommon in the clinic, the United States survey shows that the lifetime prevalence of OCD is about 2-3%, and there are literature reports that the lifetime prevalence of OCD is 0.8-3%; in 1982, China had done a survey of 12 regions, the results show that the prevalence of OCD is 0.3 per 1,000, in fact, this figure is much lower than the actual prevalence. From clinical experience, the number of cases of OCD is much less than that of depression. Combined with my own clinical practice, I estimate that the prevalence rate of OCD in China is about 5-10 per thousand, with about 5-10 million people, and 80% of the cases of OCD develop before the age of 25 years old, with an average age of onset of 19-29 years old, and there are more males than females. Obsessive-compulsive disorder (OCD) is a difficulty and a priority in clinical work, why? Because although from the classification of mental diseases, obsessive-compulsive disorder is a kind of neurosis, belongs to the light mental disease, can be put obsessive-compulsive disorder but in fact, the treatment of obsessive-compulsive disorder may be more difficult than depression, anxiety disorders, disorder for mild obsessive-compulsive disorder and severe obsessive-compulsive disorder, mild obsessive-compulsive disorder is relatively easy to treat, the efficacy of the treatment is better; however, severe obsessive-compulsive disorder may be slower in the improvement of the symptom, the dose of medication in general, but also the treatment is more difficult. However, the symptoms of severe obsessive-compulsive disorder may improve more slowly, and the dose of medication is generally large. If not diagnosed and treated timely and correctly, severe obsessive-compulsive disorder will have a greater impact on the patient’s normal life and work, and bring greater pain and burden to the patient and his family. I have seen a patient wash his hands for 3-4 hours, his hands are washed; another patient to check repeatedly before going out, 3 hours can not get out of the door, for this reason, do not go out for the whole day. It can be said that patients with obsessive-compulsive disorder (OCD) are in great pain, and it is not uncommon for patients to be unable to work due to OCD, so we should attach great importance to the treatment of OCD. Why do we get OCD? The cause of the disease is still unclear, but a large number of studies have shown that anxiety disorders are related to genetic factors, personality traits, adverse events, stress factors, etc., especially closely related to the patient’s personality traits, such as: over-pursuit of perfection, indecisiveness, caution, stubbornness, etc., with these undesirable personality traits are prone to develop obsessive-compulsive disorder. From clinical experience, parents’ lack of family education: independence, sense of autonomy, self-confidence, boldness, as well as over-indulgence or excessive severity of the child, resulting in excessive dependence on others, independence, sense of autonomy, self-confidence, boldness, the lack of these qualities may be the most important cause of the development of obsessive-compulsive disorder, and also affect the treatment and the prognosis of the most critical factors. Research has shown that patients with OCD have dysfunctions in the neuro-endocrine system, resulting in an imbalance of neurotransmitters, which leads to the emergence of various obsessive-compulsive symptoms. The reason why our brain can realize various physiological functions is mainly through the transmission of different neurotransmitters, neurotransmitters are like letter carriers, different letter carriers transmit different information, playing a variety of different physiological functions. Research has found that patients with obsessive-compulsive disorder often have 5-HT (5-hydroxytryptamine), DA (dopamine), Sigma (sigma) receptors and central glutamatergic neuron dysfunction, and anti-obsessive-compulsive drugs can make the imbalance of neurotransmitters tend to normalize, so as to make obsessive-compulsive symptoms improve. Second, the performance of obsessive-compulsive disorder (OCD) Obsessive-compulsive symptoms generally include 1, obsessive-compulsive concepts: patients repeatedly think about some ideas, such as suspicion, memories, poor thoughts, etc.; 2, obsessive-compulsive behavior: patients repeatedly do some unnecessary behavior, such as repeated checking, repeated washing of hands, repeated counting, and ceremonial actions, and so on. Obsessive-compulsive and anxiety are like twins, and people with OCD often have significant anxiety symptoms. Obsessive-compulsive symptoms generally have the following characteristics: 1. The patient knows that the obsessive-compulsive symptoms are not right but cannot control them, because once the control does not go to do it, there will be nervousness, panic and other serious anxiety manifestations, in order to avoid anxiety, the patient has to think and do. This feature is called conscious self-compulsion and anti-compulsion. 2, the patient can realize that this kind of compulsive consciousness and impulses come from the self, not from the outside world, is their own thoughts. Newly diagnosed OCD patients usually have obvious conscious self-compulsions and counter-compulsions; if the patient has been suffering from the disease for a long time, he may have already adapted to the obsessive-compulsive symptoms, and thus the self-compulsions and counter-compulsions become less intense. This is the key point in diagnosing OCD. Because clinically, there are some atypical OCD patients who develop psychotic symptoms after a period of time, and the diagnosis may be mistaken for schizophrenia. Therefore, timely recognition of the characteristics of obsessive-compulsive symptoms and rational drug treatment can greatly help the prognosis of patients. There is also a broad category of obsessive-compulsive disorders called obsessive-compulsive spectrum disorders (OCDs), which have similar characteristics: they are characterized by recurrent ideas and/or behaviors, and the symptoms are recurrent and difficult to control. Including: obsessive-compulsive personality disorder, body dysmorphic disorder, hypochondriasis, depersonalization, eating disorders, impulse control disorders, impulse control disorders (hair-pulling fetishism), addictive behaviors (pathological gambling, compulsive sexual behavior compulsive shopping, Internet addiction) Third, the diagnosis of obsessive-compulsive disorder Diagnosis of a typical obsessive-compulsive disorder is not a very difficult thing to do, psychiatrists diagnose obsessive-compulsive disease on the basis of the following: family members to provide the patient’s The psychiatrist’s diagnosis of OCD is mainly based on the patient’s medical history provided by the family (time of illness, bad performance, etc.), psychiatric examination (results of the examination are obtained by talking with the patient), physical examination, scale measurement, laboratory auxiliary examination, and so on. The Yale Brown Obsessive-Compulsive Scale (YOBS) is the most commonly used clinical obsessive-compulsive scale, and the severity and degree of improvement of the disease can be determined by the number of points scored on the scale. However, atypical obsessive-compulsive disorder (OCD) is often encountered in the clinic. Through years of clinical experience, atypical OCD may be the early manifestation of schizophrenia, depression and other affective disorders, as well as OCD, which requires family members to closely observe the changes in the condition, consult the doctor in a timely manner, maintain close contact with the doctor, and make a timely diagnosis and timely treatment. Diagnostic Criteria: Obsessive-compulsive disorder (OCD) [F42 Obsessive-compulsive disorder] refers to a neurological disorder with predominantly obsessive-compulsive symptoms, which is characterized by the coexistence of conscious self-compulsion and counter-compulsion, which are in strong conflict and cause patients to feel anxiety and pain; patients experience that the concepts or impulses originate from the ego but are against their own will, and are uncontrollable although they try to resist them; patients are also aware of the abnormality of the obsessive-compulsive symptoms but are unable to get rid of them. The patient is also aware of the abnormality of obsessive-compulsive symptoms, but cannot get rid of them. Those with a prolonged course of the disease have reduced mental suffering with ritualistic behavior, but social functioning is severely impaired. Symptomatic criteria 1, meet the diagnostic criteria of neurosis, and predominantly obsessive-compulsive symptoms, at least one of the following: ① predominantly obsessive-compulsive thoughts, including obsessive concepts, memories or representations, obsessive-oppositional concepts, exhaustive thinking, fear of loss of self-control; ② predominantly obsessive-compulsive behaviors (actions), including repeated washing, checking, inspecting, or questioning, etc.; ③ a mixture of the above; 2, the patient said that obsessive-compulsive symptoms (2) The patient claims that the obsessive-compulsive symptoms originate from within himself/herself and are not imposed by others or external influences; (3) The obsessive-compulsive symptoms recur repeatedly, and the patient thinks they are meaningless and feels unhappy or even painful, so he/she tries his/her best to resist them, but it is not effective. Severity criteria: impaired social functioning. Disease duration criteria: meet the symptom criteria has been at least 3 months. Exclusion criteria: 1. Exclude secondary obsessive-compulsive symptoms of other mental disorders, such as schizophrenia, depression, or phobias, etc.; 2. Exclude secondary obsessive-compulsive symptoms of organic brain diseases, especially basal ganglia lesions.