Is ocd a neurological disorder

Signs of central nervous system dysfunction in obsessive-compulsive disorder

. 1990 Jan;47(1):27-32.

doi: 10.1001/archpsyc.1990.01810130029005.

E Hollander¹, E Schiffman, B Cohen, M A Rivera-Stein, W Rosen, J M Gorman, A J Fyer, L Papp, M R Liebowitz

Affiliations

Affiliation

¹ Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY 10032.

PMID: 2294853
DOI: 10.1001/archpsyc.1990.01810130029005

E Hollander et al. Arch Gen Psychiatry. 1990 Jan.

. 1990 Jan;47(1):27-32.

doi: 10.1001/archpsyc.1990.01810130029005.

Authors

E Hollander¹, E Schiffman, B Cohen, M A Rivera-Stein, W Rosen, J M Gorman, A J Fyer, L Papp, M R Liebowitz

Affiliation

¹ Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY 10032.

PMID: 2294853
DOI: 10.1001/archpsyc.1990.01810130029005

Abstract

Obsessive-compulsive disorder (OCD) has been linked to altered neurological function following head trauma, encephalitis, abnormal birth events, and Gilles de la Tourette's syndrome. Abnormalities in computed tomographic scans, electroencephalograms, positron emission tomographic scans, and evoked potentials have been described in this disorder, but are neither consistent nor pathognomonic of OCD. Neurological soft signs are nonlocalizing signs of deviant performance on a motor or sensory test where no other sign of a neurological lesion is present. We studied 41 medication-free patients with OCD who met DSM-III-R criteria, as well as 20 normal controls, matched for age, sex, and handedness, on 20 individual tasks that involved fine motor coordination, involuntary movements, and sensory and visuospatial function. There were significantly more signs of central nervous system dysfunction in the OCD group, as shown by abnormalities in fine motor coordination, involuntary and mirror movements, and visuospatial function. An excess of findings on the left side of the body and abnormalities of cube drawing may suggest right hemispheric dysfunction in a subgroup of patients with OCD. Soft signs correlated with a severity of obsessions. There was also a correlation between abnormalities in visual memory and recognition on neuropsychological testing and total soft signs. These findings provided additional evidence for a neurological deficit in some patients with OCD. However, further comparisons with other psychiatric populations are needed to determine whether these findings are unique to OCD or are a property of other psychiatric disorders as well.

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Projection-specific deficits in synaptic transmission in adult Sapap3-knockout mice.
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Obsessive-compulsive disorder in children and adolescents. A review of the literature.
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Signs of Central Nervous System Dysfunction in Obsessive-Compulsive Disorder | JAMA Psychiatry

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Article

January 1990

Eric Hollander, MD^{; Erica Schiffman, MD^{; Barry Cohen, MS^{; et al Maria A. Rivera-Stein^{; Wilma Rosen, PhD^{; Jack M. Gorman, MD^{; Abby J. Fyer, MD^{; Laszlo Papp, MD^{; Michael R. Liebowitz, MD}}}}}}}}

Author Affiliations

From the Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY.

Arch Gen Psychiatry. 1990;47(1):27-32. doi:10.1001/archpsyc.1990.01810130029005

Full Text

Abstract

• Obsessive-compulsive disorder (OCD) has been linked to altered neurological function following head trauma, encephalitis, abnormal birth events, and Gilles de la Tourette's syndrome. Abnormalities in computed tomographic scans, electroencephalograms, positron emission tomographic scans, and evoked potentials have been described in this disorder, but are neither consistent nor pathognomonic of OCD. Neurological soft signs are nonlocalizing signs of deviant performance on a motor or sensory test where no other sign of a neurological lesion is present. We studied 41 medication-free patients with OCD who met DSM-III-R criteria, as well as 20 normal controls, matched for age, sex, and handedness, on 20 individual tasks that involved fine motor coordination, involuntary movements, and sensory and visuospatial function. There were significantly more signs of central nervous system dysfunction in the OCD group, as shown by abnormalities in fine motor coordination, involuntary and mirror movements, and visuospatial function. An excess of findings on the left side of the body and abnormalities of cube drawing may suggest right hemispheric dysfunction in a subgroup of patients with OCD. Soft signs correlated with a severity of obsessions. There was also a correlation between abnormalities in visual memory and recognition on neuropsychological testing and total soft signs. These findings provided additional evidence for a neurological deficit in some patients with OCD. However, further comparisons with other psychiatric populations are needed to determine whether these findings are unique to OCD or are a property of other psychiatric disorders as well.

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Obsessive-compulsive disorder - what is it.

Symptoms and basic principles of treatment for OCD

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Obsessive-compulsive disorder (OCD) is a condition characterized by obsessions and compulsions (recurring behaviors or rituals).

Obsessions are repetitive thoughts, images or urges that a person at the initial stage of the disease himself evaluates as obsessive or unfounded; later they cause him anxiety or guilt. The most common obsession concerns infections (the threat of infection) and tends to wash hands unnecessarily frequently. nine0003

Obsessions can also come from the fear of causing misfortune, injury, or accident, such as leaving the house unlocked or forgetting to turn off the gas. People with OCD feel compelled to reexamine themselves repeatedly. Intrusive thoughts related to violence, murder, blasphemy, or sex are also driven by the fear of harm.

Obsessive actions or rituals (compulsions) are actions that people are forced to purposefully repeat in order to try to reduce their psychological discomfort or avoid it. Most common compulsions: nine0003

frequent checks to prevent potential hazards;
excessive brushing or washing of hands;
re-search for confirmation;
re-counting or touching to reduce the risk of disaster;
organizing or ordering objects or activities;
repeatedly asking questions or talking about one's actions;
storage of useless or worn-out property. nine0014

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Obsessive-compulsive disorder (OCD): what is it, symptoms, treatment, doctor's advice

Updated on August 08, 2022, 03:45 PM

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OCD affects both men and women regardless of age. Some people develop symptoms during adolescence, although they are usually diagnosed in adults. Obsessive-compulsive disorder can significantly interfere with a fulfilling life, but treatment can help keep it under control.

Let's figure out together with experts what are the causes of OCD, what therapeutic and drug methods are used by doctors, and how to behave relatives of a person who has been diagnosed with this disorder. nine0003

Contents

What it is
Signs and symptoms
Causes
Diagnosis
How to treat
Advice for relatives
Forums
What is obsessive-compulsive disorder?

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Obsessive-compulsive disorder is a common chronic and long-term condition in which a person has uncontrollable repetitive, obsessive thoughts (ideas) and/or actions (behaviors) [1]. OCD is diagnosed in 1.3% of the world's population [2]. nine0003
Many people confuse OCD with nail biting or negative thinking. Both can be a sign of the disease, but other diagnostic criteria must be taken into account. The obsession is often that a person considers certain numbers or colors to be "good" or "bad". It happens that the habit with OCD is washing your hands repeatedly after touching something that is considered dirty, infected, dangerous. Although the person does not want to think or do it, he is unable to stop [3]. nine0003
Vladimir BelovMedical psychologist, child psychologist, consultant suicidologist, leading specialist of the Semeynaya clinic network

“Obsessive Compulsive Disorder is a neuropsychological disorder that always includes two components:
- obsessions - persistent thoughts or impulses, intrusive and unacceptable, causing anxiety;
- compulsions are rituals that are built into the thoughts of a person, he considers it necessary to perform them in response to an obsession. nine0014
The most common connection between these components is that compulsions are actions whose purpose is to neutralize or reduce the distress caused by obsessions. Rituals include such processes as endless washing of hands, double-checking one's own actions or the state of some objects. For some people, these are specific prayers, rituals when going to work, when returning to an apartment, while waiting for transport.

Signs and symptoms of obsessive-compulsive disorder

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Obsessions - involuntary thoughts and ideas: "I shook hands with a person and now I can get infected with something." This rumination in itself is perfectly normal, but the person with OCD will wash their hands again and again, unable to get rid of it. This is already a compulsion - an obsessive behavior, an individual unstoppable ritual. In the short term, it reduces anxiety, but the thought returns and the action must be repeated. A person feels that he must do it, while he cannot stop. Everyone has recurring habits or thoughts that recur frequently. But in the case of OCD they are:
- present daily;
- are uncontrollable;
- are not enjoyable;
- affect work and social life.
It's not unusual to wonder if the curling iron is unplugged. It’s worth worrying if this thought haunts you every day, makes you return home halfway from work and check (more than once, even if you just made sure that the device is not turned on). Obsessive-compulsive disorder comes in many forms, but most cases fall into at least one of the four main categories. The symptoms of OCD are rooted in the person's obsessive behavior. For example, he:
1. Checks if the door is locked, if the iron and oven are switched off.
2. Unreasonably suspects undiagnosed health conditions such as pregnancy or schizophrenia.
3. Afraid of germs, things that can be dirty, constantly cleaning.
4. Strives for excessive symmetry and order, feels the need to arrange things in a certain way: by size, colors or alphabet.
5. Cannot drive obsessive thoughts and ideas away from himself. Some of them can be violent or disturbing. nine0014
Anastasia AfanasyevaPsychiatrist, psychotherapist, clinical director of the psychological platform Alter

“Intrusive thoughts can occur as part of a variety of disorders, from psychosis to anxiety. To understand what disease these thoughts can be associated with, experts look at how a person treats them. For example, a person in psychosis may not even have a shadow of doubt and discomfort from the fact that the obsessive thought “you can harm your child” is spinning in his head. A person with OCD cannot have this, he will be frightened by such thoughts, and he will try to do everything to prevent this from happening, for example, remove all sharp objects away from him or not approach the child. Discomfort and the feeling that these thoughts are "inadequate", "wrong" will be an important identifying factor that this is OCD. nine0003
People without disorders can also have obsessive thoughts, but normally we quickly cope with them and they do not disturb life, forcing us to rebuild it for ourselves: the thought appeared - the person brushed it off and moved on.

Causes of OCD

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Doctors do not give a specific explanation of the causes of the onset and development of OCD. It is most often diagnosed in adolescence and adulthood, with women 1.6 times more likely than men [4]. The factors for the development of the disease include:
1. Genetics. If you have OCD in your next of kin—father, mother, brother, and sister—the chances are high that you have it too.
2. Structure and function of the brain. In the brain of OCD sufferers, increased activity is recorded in the region of the cortico-striatal-thalamo-cortical loop [5].
3. Environment. High levels of stress, increased anxiety can also be a trigger for the development of obsessive-compulsive disorder.
4. Concomitant diseases. OCD is often diagnosed in parallel with eating disorders and depression [6]. nine0014
5. Traumatic events. The disorder can be the result of difficult circumstances experienced: psychological and sexual abuse, physical trauma, loss of loved ones.
6. Infections. Occasionally, OCD is found in children who have had a streptococcal infection. This is called pediatric autoimmune neuropsychiatric disorders.
There is a hypothesis that disturbing deviations developed and persisted in the course of evolution [7]. When people did not have access to modern advances in medicine and hygiene, those who had less contact with a possible source of infection and were constantly on the alert, assessing possible risks and double-checking the safety of food and housing, survived. nine0003
Obsessive Compulsive Disorder Diagnostics

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All people from time to time find themselves in stressful situations, many people find it helpful to put things in order at home or in the closet, everyone at least once caught himself thinking that he had not turned off the coffee maker in a hurry to a meeting. It doesn't mean you have OCD. Only a doctor can make an accurate diagnosis. Contact a specialist if the above symptoms directly affect your relationship with yourself and others, steal time, do not allow you to relax and enjoy life. nine0003
In society, the attitude towards OCD is often superficial and not serious. It is often perceived as a funny feature of a person. But the worsening symptoms cannot be controlled by willpower alone. OCD can be expressed in varying degrees of obsession, and for many it really does not interfere (and may help maintain cleanliness and keep processes under control), but for others it poses a real threat to normal life [8].

There are specialized tests for obsessive-compulsive disorder. Try to answer several questions in the format "often", "rarely", "never", "always":
- Do you experience obsessive thoughts about possible tragic events, death, serious illnesses, fires, accidents?
- Are you concerned about the possibility of contamination with germs and chemicals?
- Do you unnecessarily re-read emails or text messages before or after sending them?
- Are you obsessed with keeping everything in order (cataloging books, perfect stacks of clothes in your closet, pencils arranged by size on your desk)? nine0014
- Do you repeat routines, such as opening a door, putting on your shoes, or getting into bed over and over, until you feel like you've done it "right"?
- Do you have recurring inappropriate thoughts (often of a religious, violent, or sexual nature) that seem intrusive and out of control?
- Do you feel the need to constantly seek confirmation of what you have said or done?
- Do you follow ritualized washing, cleaning or grooming habits (eg washing your hands five times in a row)? nine0014
- Do you avoid certain colors or numbers because you consider them "unlucky"?
- Do you check your trash before you throw it away to make sure it's clean?
- Do you worry about doing something out of a mindless impulse, like pushing a stranger or hitting a loved one?
- Do you check oven handles, door locks and car brakes over and over again in a short period of time? nine0014
If most of the described thoughts and situations appear suspiciously often in your daily life, you should consult a general practitioner. He will conduct a physical examination and order blood tests to make sure that the symptoms are not caused by something else. If OCD is suspected, work with a therapist or psychiatrist to talk about life circumstances, feelings, thoughts, and habits.

How to treat obsessive-compulsive disorder

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There is no specific drug that can completely eliminate the symptoms of OCD. But medication support and additional psychological techniques for working on oneself help to work through this problem and keep it under control.

Psychotherapy

Cognitive Behavioral Therapy allows you to change your thinking patterns. Anastasia Afanasyeva believes that one of the most important techniques when working with OCD is distancing, exposing and challenging thoughts: “Distancing is a group of techniques in which we teach a person with OCD to notice intrusive thoughts, realize their ineffectiveness and switch from thinking about them to current ones. affairs. It is important here not to try to start controlling and “not thinking” these thoughts, as this is unrealistic and causes even more anxiety. Instead, for example, we can imagine that thoughts are like an annoying radio broadcast that cannot be turned off, but is not worth listening to. nine0003
Exposure is the conscious exposure to uncomfortable situations in order to gradually learn to endure stress and stop using rituals that reduce anxiety in the moment, such as double-checking, washing hands, avoiding sharp objects.

Challenging and checking the reality of thoughts helps to understand that often a thought is just a thought and not every thought that comes to mind is worth believing. To assess how true this idea is, you can write it down on a piece of paper and give facts for and against its correctness. nine0003
Relaxation

Anxiety and obsessive thoughts are inevitably associated with tension in the body. Available meditation techniques, as well as massage and yoga classes, help to consciously look at the circumstances and cope with stress.

Anastasia Afanasyeva:

“In general, working with anxiety disorders always involves homework, as people learn to cope with their anxiety not only in the psychologist's office, but also in situations that arise in everyday life. Mostly it's working with thoughts and changing behavioral strategies that support OCD or reduce anxiety for only a short time. nine0003
The most common treatment for OCD involves individual sessions with a psychotherapist. There are practically no therapy protocols with proven efficacy for groups.”

Medicines

When taking drugs, you can achieve a stable remission. The timing of drug treatment will be determined by the attending physician. Do not stop taking antidepressants at the first sign of improvement.

Vladimir Belov:

“First of all, we need both a psychiatrist and a medical psychologist/psychotherapist. Because, on the one hand, cognitive-behavioral therapy is used, which is quite effective and has a lot of scientific evidence: exposure and prevention of reactions and rituals. This program goes on for several months and is combined with drugs. First of all, these are antidepressants - selective serotonin reuptake inhibitors and atypical antipsychotic drugs. Much depends on the condition of the patient and the severity of the process in which he is. nine0003
What to do for relatives of an OCD patient

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People who live near a person with OCD often find themselves in difficult conditions. They want to help by interrupting the compulsive manifestations of a loved one, which can create an even more stressful situation for him. But it is also not worth closing your eyes to the disease. Psychologists advise updating it, pronouncing the problem. Develop the emotional intelligence of a loved one: let's understand that he can safely talk to you about any of his feelings. Emphasize that you are always ready to listen and help: “I am with you, we will deal with this problem together.” nine0003
Anastasia Afanasyeva:

“If someone close to you suffers from OCD, one of the important tasks that you face is to stay out of the anxiety maintenance cycle. For example, one should not encourage the desire for excessive cleanliness, endless washing of clothes, washing hands, constant fruitless visits to doctors, one should not participate in rechecking any facts. You need to understand that this does not help a loved one cope with anxiety, but reinforces a non-working pattern of behavior and serves as proof that such behavior and thoughts are justified. nine0003
Forums, support groups for people with OCD

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The best option is to contact a trusted doctor and treat according to his recommendations. In addition to medicines and work with a specialist, the fulfillment of independent tasks plays an important role. It is important for people with OCD to talk about the problem and see the support of others. Like-minded forums often help. You can join thematic groups on social networks or contact volunteers:
1. Anxiety and Depression Association of America (ADAA) - mental health resources, including conferences of the International OCD Foundation. There are online support groups for those with the disorder.
2. OCD Peers - Virtual support groups (6-10 members) using a HIPAA compliant platform. Video conferences with group mentor, open discussions and agenda. All groups are paid.
3. 7 cups - on the platform you can find a volunteer who will be in touch and ready to listen to the problem. This is not a qualified professional, but sometimes speaking out to an attentive listener is just as important as working through a problem with a licensed psychotherapist. nine0014
4. Support Groups is a free resource with several hundred support groups on a variety of topics, including those for OCD sufferers. Groups are moderated to avoid bullying and inappropriate user reactions.
5. HealthUnlocked - literally "health unlocked" - a resource with forums to support people with various diseases. The ROC topic is moderated not only by the portal administrators, but also by representatives of the International ROC Foundation.
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Is ocd a neurological disorder

Signs of central nervous system dysfunction in obsessive-compulsive disorder

Affiliation

Authors

Affiliation

Abstract

Similar articles

Cited by

Publication types

MeSH terms

Grant support

Signs of Central Nervous System Dysfunction in Obsessive-Compulsive Disorder | JAMA Psychiatry

Obsessive-compulsive disorder - what is it.

Our doctors

Reviews

Obsessive-compulsive disorder (OCD): what is it, symptoms, treatment, doctor's advice

What is obsessive-compulsive disorder?

Signs and symptoms of obsessive-compulsive disorder

Causes of OCD

Obsessive Compulsive Disorder Diagnostics

How to treat obsessive-compulsive disorder

Psychotherapy

Relaxation

Medicines

What to do for relatives of an OCD patient

Forums, support groups for people with OCD