Obsessive compulsive. Characteristic signs of OCD that should be considered when making a diagnosis

An obsessive-compulsive personality must be distinguished from a person with OCD, i.e. which one obsessive-compulsive disorder(neurosis obsessive states).

Because in the first, somewhat obsessive and ritualistic thinking and behavior may look like an anxious and suspicious trait of character and temperament, and not particularly interfere with himself and those around him, close people.

The second one is excessive obsessive symptoms OCD, for example, fear of getting infected and frequent hand washing, can significantly interfere with a person, both personally and public life. Which can also negatively affect the immediate environment.

However, it should be remembered that the first can easily become the second.

Obsessive-compulsive personality

• Their keywords: "Control" and "Must"
• Perfectionism (striving for perfection)
• Consider themselves responsible for themselves and others
• They see others as frivolous, irresponsible and incompetent.
• Beliefs: “I have to manage the situation”, “I have to do everything right”, “I know what is best...”, “You have to do it my way”, “People and yourself need to be criticized in order to prevent mistakes”...
• Catastrophic thoughts that the situation will get out of control
• They control the behavior of others through excessive management, or disapproval and punishment (including the use of force and enslavement).
• They are prone to regret, disappointment, and punishment of themselves and others.
• They often experience anxiety and can become depressed if they fail

Obsessive-compulsive disorder - symptoms

• Repetitive obsessive thoughts and compulsive actions that interfere with normal life
• Repetitive obsessive, ritualistic behavior (or imagination) to relieve anxiety and distress caused by intrusive thoughts
• A person with OCD may or may not recognize the meaninglessness of their thoughts and behavior.
• Thoughts and rituals take up a lot of time and interfere with normal functioning, causing psychological discomfort, including among those closest to you.
• Impossibility of independent, volitional control and resistance to automatic thoughts and ritual behavior

Associated OCD symptoms:
Depressive disorder, alarming and panic disorder, social phobias, disorders eating behavior(anorexia, bulimia)…

Listed associated symptoms may be similar to OCD, so they carry out differential diagnosis, distinguishing other personality disorders.

Obsessive disorder

Persistent (frequent) intrusive thoughts are ideas, images, beliefs and thoughts that cause anxiety and distress and constitute obsessive personality disorder.

The most common obsessive thoughts are fears of infection, pollution or poisoning, harming others, doubts about closing the door, turning off household appliances...etc.

Compulsive disorder

Obsessive actions, or ritual behavior (ritual can also be mental) is a stereotypical behavior with the help of which a person with a compulsive disorder tries to ease anxiety or relieve distress.

The most common ritual behaviors are washing hands and/or objects, counting out loud or silently, and checking that one's actions are correct...etc.

Obsessive-compulsive disorder - treatment

Typically, when OCD is severe and the person has little motivation to get rid of it, they use drug treatment, in the form of taking antidepressants and serotonin reuptake inhibitors, non-selective serotonergic drugs and placebo tablets. (the effect is usually short-lived, and besides, pharmacology is not harmless)

For OCD sufferers for a long time, and are usually highly motivated to heal, the best option would be non-drug psychotherapeutic intervention (medication, in some difficult cases, can be used at the beginning of psychotherapy).

However, those who want to get rid of obsessive-compulsive disorder and the accompanying emotional and psychological problems should know that psychotherapeutic intervention is labor-intensive, slow and expensive.

But those who have the desire, after a month of intensive psychotherapy, will be able to improve their condition to normal. In the future, to avoid relapses and to consolidate the results, supportive therapeutic meetings may be necessary.

Obsessive-compulsive disorder (OCD) – mental illness, manifested by obsessive thoughts, doubts and accompanied by constant double-checking of completed actions.

Obsessive-compulsive disorder is not as serious a pathology as schizophrenia or depression, but this mental disorder can significantly disrupt a person’s quality of life, contribute to a decrease in self-esteem and even deterioration social status sick.

Causes

Obsessive-compulsive disorder can develop due to the interaction of a number of factors. First of all, it is a hereditary predisposition. A person can inherit certain personality traits and patterns of behavior in traumatic conditions.

The development of this mental disorder can be caused by sudden mental trauma (life-threatening situation, death loved one, disaster) or prolonged exposure to stressful conditions, when a person’s psyche is “exhausted.” Examples of such a situation are an uninteresting job that a person hates, from which he cannot quit (he lives in a small village where another job cannot be found).

Symptoms of the disease

The first manifestations of obsessive-compulsive disorder appear in adolescence or early mature age. At this time, obsessions arise, which are regarded by patients as something absurd and illogical.

The main obsessions characteristic of OCD are obsessive thoughts and compulsive actions.

Now let's take a closer look at each separate symptom.

Obsessive thoughts

Obsessive thoughts- painful thoughts, images and desires that arise against a person’s will, come to his mind again and again, and which he tries to resist. Such thoughts themselves “swarm” in the head, do not give a person peace, he would be glad to switch to something else, but again and again obsessive thoughts arise in his mind.

We are all different, so each of us has our own obsessive thoughts. However, all obsessive thoughts can be divided into obsessive doubts, obsessive fears of contamination or contamination, and contrasting obsessions. So, let's talk about each of these groups separately.

Obsessive doubts

Obsessive doubts have probably arisen in each of us. Have I done everything? Did you make the right decision? Did I close the door? Did I turn off the gas? Did you write everything in the answer to the ticket when taking the entrance exam? Familiar thoughts, right?

Obsessive doubts can be associated with everyday issues (is the door closed, is the gas turned off), with official activities (a bank employee will doubt whether he correctly indicated the account to which he transferred the money, a teacher will doubt whether he gave the correct grade to a student). To make sure that everything is done, a person will check gas, electricity, water, and current account number again and again. And even if you do everything carefully, after a while doubts may return again (what if the tap was not closed completely, and I didn’t see it; what if I still mixed up the numbers in the account number?)

If such thoughts sometimes arise, it’s okay, this happens to almost everyone. But if you are forced to check many times whether the gas and lights are turned off and are still not sure that everything is turned off, in this case it is better to visit a psychiatrist. You may have obsessive-compulsive personality disorder. Here, by the way, is a small anecdote on this topic.

The appearance of various obsessions, especially obsessive doubts, is characteristic of such a personality disorder as.

Contrasting obsessions

Contrasting compulsions can also occur in obsessive-compulsive disorder. These are vivid ideas that arise in a person’s imagination, unpleasant in meaning, blasphemous thoughts.

Contrasting obsessions include an absolutely groundless fear of harming oneself or others. It may also be a desire to continue someone’s remark with an ironic, offensive statement. This group of obsessions can include obsessive ideas of sexual content - obsessions like forbidden ideas of sexual acts with animals, representatives of the same sex.

Pollution Obsessions

Obsessions about pollution are also called mysophobia. They can manifest themselves as fear of getting dirty with soil, feces, urine, fear of microorganisms and harmful substances entering the body.

Sometimes the fear of pollution is not very pronounced. At the same time, for many years a person washes his hands only too diligently or several times a day without apparent reason mop the floor. This kind of phobia does not significantly affect a person’s quality of life, and is regarded by others only as increased cleanliness.

It's much worse if obsessions pollution becomes more complex. At the same time there appear various actions, rituals aimed at preventing pollution. Such a person will avoid touching objects that might be contaminated. He will only go outside when special clothing, supposedly protecting against pollution. He will also wash his hands in a certain sequence and in no case will he break it (otherwise he will assume that his hands are still dirty). On late stages illness, some people even refuse to go outside so as not to get dirty or catch some kind of infection.

Another manifestation of mysophobia is the fear of contracting some disease. Most often, patients fear that pathogenic microorganisms will enter their body from outside somehow in an unusual way(for example, due to contact with old things that once belonged to a sick person).

Obsessive actions

Compulsive actions– stereotypically repetitive, obsessive behavior. In some cases, obsessive actions take the form protective rituals: By performing certain actions under certain conditions, a person tries to protect himself from something. It is these compulsions that can most often be found in OCD.

Among obsessive actions, especially in childhood and adolescence, tics predominate. From tics when organic diseases of the brain, they differ in that they are much more complex movements that have lost their original meaning. For example, hand movements can be classified as obsessive actions, as if throwing back long hair(although a person has been walking with short hair) or trying to blink your eyes vigorously, as if a speck had gotten into your eye. Performing these movements is accompanied by a painful feeling of obsessiveness; the person understands the meaninglessness of these movements, but still performs them.

Many of us have bad habits - some bite their lips, some twirl their rings, others spit from time to time. However, these actions are not accompanied by a feeling of intrusiveness.

If you take good care of yourself, you can get rid of such habits. Or if someone from the outside notices that a person is biting his lips at this moment, then this person will stop doing this, and his mental state will not be disturbed.

In the presence of obsessive thoughts and actions that become increasingly absurd, it must be taken into account that similar symptoms can be observed with. It is also characterized by the progression of emotional impoverishment and loss of habitual interests.

Treatment of the disorder

Antidepressants (anafranil, imipramine, amitriptyline, fluvoxamine) can be used to treat obsessive-compulsive disorder. With contrasting obsessions best effect has the antidepressant sertraline (Zoloft).

Tranquilizers (hydroxyzine, alprazolam, diazepam, clonazepam) can also be prescribed for a short period of time to treat OCD.

For obsessive fear of contamination, accompanied by a complex system of protective rituals, antipsychotics (Sonapax, Truxal, Ridazine) can be used.

In most cases effective OCD treatment impossible without the use of psychotherapy. Its goal is to reduce a person’s self-control and teach him to relax. One of the methods of psychotherapeutic treatment is targeted and consistent contact of a person with things that he avoids. This is done so that the patient learns to consciously control his emotions in such situations.

Mild evidence of obsessive-compulsive disorder may occur in up to 30% of adults and up to 15% of adolescents and children. Clinically confirmed cases account for no more than 1%.

The appearance of the first symptoms is usually attributed to the age of 10 to 30 years. Apply for medical care usually people are 25-35 years old.

In pathology, two components are distinguished: obsession (obsession) and compulsion (coercion). Obsession is associated with the occurrence of obsessive, constantly recurring emotions and thoughts. It can be triggered by coughing, sneezing, or another person touching a doorknob. A healthy person will note to himself that someone sneezed and move on. The patient becomes fixated on what happened.

Obsessive thoughts fill his entire being, giving rise to anxiety and fear. This happens because some object, a person, becomes important and valuable to him. At the same time, the environment appears too dangerous.

Compulsions are actions that a person is forced to perform to protect himself from moments that provoke obsessive thoughts or fears. Actions can be a response to what happened. In some cases, they are preventive in nature, that is, they are the result of some idea, idea, fantasy.

Compulsion can be not only motor, but also mental. It consists in the constant repetition of the same phrase, for example, a conspiracy aimed at protecting a child from illness.

The obsession and compulsion component form an OCD attack. In principle, we can talk about the cyclical nature of pathology: the appearance of an obsessive thought leads to filling it with meaning and the emergence of fear, which, in turn, causes certain defensive actions. After completing these movements, a period of calm begins. After some time, the cycle starts again.

When obsessive thoughts and ideas are predominantly present, they speak of intellectual obsessive-compulsive disorder. The predominance of obsessive movements indicates motor pathology. Emotional disorder associated with the presence of constant fears that turn into phobias. Mixed syndrome is said to occur when obsessive movements, thoughts or fears are detected. Although all three components are part of the disorder, categorizing the predominance of one has implications for treatment decisions.

The frequency of symptoms makes it possible to distinguish a pathology with an attack that occurred only once, regularly occurring incidents and a constant course. In the latter case, it is impossible to distinguish between periods of health and pathology.

The nature of obsession affects the characteristics of the disease:

1. Symmetry. All items must be placed in a certain order. The patient constantly checks how they are placed, corrects them, rearranges them. Another type is the tendency to constantly check whether appliances are turned off.
2. Beliefs. These can be all subjugating beliefs of a sexual or religious nature.
3. Fear. The constant fear of becoming infected or getting sick leads to the appearance of obsessive actions in the form of cleaning the room, washing hands, using a napkin when touching something.
4. Accumulation. Often there is an uncontrollable passion to accumulate something, including things that are absolutely unnecessary for a person.

Causes

Today there is no clear and unambiguous reason why obsessive-compulsive disorders develop. Hypotheses are identified, most of which seem logical and reasonable. They are divided into groups: biological, psychological and social.

Biological

One of the well-known theories is the neurotransmitter theory. The basic idea is that in obsessive-compulsive disorder, too much serotonin is taken up into the neuron. The latter is a neurotransmitter. It is involved in the transmission of nerve impulses. As a result, the impulse cannot reach next cell. This hypothesis prove that by taking antidepressants, the patient feels better.

Another neurotransmitter hypothesis relates to dopamine excess and dependence. The ability to resolve a situation related to an obsessive thought or emotion leads to “pleasure” and increased dopamine production.

The hypothesis behind PANDAS syndrome is that the antibodies produced in the body to fight streptococcal infection, for some reason, affect the tissues of the basal ganglia of the brain.

Genetic theory associated with a mutation in the hSERT gene, responsible for the transfer of serotonin.

Psychological

The nature of obsessive-compulsive disorder has been examined by psychologists of various directions. Thus, S. Freud associated it mainly with the unsuccessful passage of the anal stage of development. Feces at that moment were considered something valuable, which ultimately led to a passion for accumulation, neatness and pedantry. He connected obsession directly with the system of prohibitions, rituals and the “omnipotence of thought.” Compulsion, from his point of view, is associated with a return to the experienced trauma.

From the point of view of followers of behavioral psychology, the disorder arises from fear and the desire to get rid of it. For this purpose, repeated actions and rituals are developed.

Cognitive psychology emphasizes mental activity and fear of inventing meaning. It arises due to a feeling of hyper-responsibility, a tendency to overestimate danger, perfectionism and the belief that thoughts can come true.

Social

The hypothesis of this group connects the appearance of pathology with traumatic circumstances environment: violence, death of loved ones, change of place of residence, changes at work.

Symptoms

The following symptoms indicate obsessive-compulsive disorder:

• the appearance of recurring thoughts or fears;
• monotonous actions;
• anxiety;
• high level anxiety;
• panic attacks;
• phobias;
• appetite disorders.

Adults in some cases realize the groundlessness of their fears, thoughts, and the meaninglessness of their actions, but they cannot help themselves. The patient loses control over his thoughts and actions.

In children, the disorder is extremely rare. It most often appears after 10 years. Associated with the fear of losing something. A child, afraid of losing his family, tends to constantly clarify whether his mother or father loves him. He is afraid of getting lost himself, so he holds his parents’ hands tightly. The loss of any item at school or the fear of it forces the child to double-check the contents of his backpack and wake up at night.

Obsessive-compulsive disorder may be accompanied by nightmares, tearfulness, moodiness, dejection, and loss of appetite.

Diagnostics

The diagnosis is determined by a psychiatrist. The main diagnostic methods are conversation and testing. During the conversation, the doctor identifies characteristics associated with the manifestation significant symptoms. So, thoughts must belong to the patient, they are not the product of delusion or hallucination, and the patient understands this. In addition to obsessional ones, he has ideas that he can resist. Thoughts and actions are not perceived by him as something pleasant.

Testing is based on the Yale-Brown obsessive-compulsive scale. Half of its items assess how severe obsessions are, the other half helps analyze the severity of actions. The scale is completed during the interview based on the manifestation of symptoms for last week. The level of psychological discomfort, the duration of symptoms during the day, the impact on the patient’s life, the ability to resist symptoms and exercise control over them are analyzed.

The test determines 5 various degrees disorders - from subclinical to extremely severe.

The disease is differentiated from depressive disorders. In the presence of symptoms of schizophrenia, organic disorders, and neurological syndromes, obsession is considered part of these diseases.

Treatment

The main methods of treating obsessive-compulsive disorder are psychotherapy, the use of medicines, physiotherapy.

Psychotherapy

The disease can be treated using hypnosis, cognitive-behavioral, and aversive methods of psychoanalysis.

The main goal The cognitive-behavioral method is to help the patient understand the problem and resist illness. The patient may be placed in an artificially created stress situation, and during the session the doctor and the patient try to cope with it. The psychotherapist comments on the fears and meaning that the patient puts into his thoughts, focuses his attention on actions, and helps change the ritual. It is important that a person learns to identify which of his fears really make sense.

According to researchers, the compulsive part of the syndrome responds better to therapy. The effect of treatment lasts for several years. Some patients experience increased anxiety levels during treatment. It goes away over time, but for many it is important reason to choose other methods of therapy.

Hypnosis allows you to relieve the patient of obsessive thoughts, actions, discomfort, and fears. In some cases, the use of self-hypnosis is recommended.

Within the framework of psychoanalysis, the doctor and the patient discover the causes of experiences and rituals, and work out ways to free themselves from them.

The aversive method is aimed at causing discomfort and unpleasant associations in the patient when performing obsessive actions.

Psychotherapeutic methods are used individually and in groups. In some cases, especially when working with children, it is recommended family therapy. Its goal is to establish trust and increase the value of the individual.

Medicines

Severe obsessive-compulsive disorder is recommended to be treated with medications. They complement, but do not replace, psychotherapy methods. The following groups of drugs are used:

1. Tranquilizers. They reduce stress, anxiety, and reduce panic. Phenazepam, Alprazolam, Clonazepam are used.
2. MAO inhibitors. Drugs in this group help reduce feelings of depression. These include Nialamid, Phenelzine, Befol.
3. Atypical neuroleptics. Medicines are effective for serotonin uptake disorders. Clozapine and Risperidone are prescribed.
4. Selective serotonin reuptake inhibitors. These drugs prevent the destruction of serotonin. The neurotransmitter accumulates in receptors and has a longer lasting effect. The group includes Fluoxetine, Nafazodone, Serenata.
5. Normotimics. Medicines are aimed at stabilizing mood. This class includes Normotim, Topiramate, and lithium carbonate.

Physiotherapy

It is recommended to take various water treatments. These are warm baths with a cold compress on the head for 20 minutes. They are taken up to 3 times a week. Wiping with a towel soaked in cold water and dousing is useful. It is recommended to swim in the sea or river.

Forecast

Obsessive-compulsive disorder is a chronic pathology. Usually, the use of any treatment stops and softens its manifestations. Disease in the lungs and medium degree it is possible to cure, but in the future in some emotionally difficult situations exacerbation is possible.

The severe disorder is difficult to treat. Relapses are likely.

Lack of treatment can lead to impaired performance, the emergence of suicidal intentions (up to 1% of patients commit suicide), some physical problems(frequent hand washing leads to skin damage).

Prevention

Primary prevention includes preventing the occurrence of traumatic factors, including conflicts at home, at school, and at work. If we're talking about about a child, it is important to avoid imposing on him thoughts about his inferiority, instilling fears and guilt.

It is recommended to include bananas, tomatoes, figs, milk, and dark chocolate in your diet. These foods contain tryptophan, from which serotonin is formed. It is important to take vitamins, get enough sleep, and avoid alcohol, nicotine, and drugs. The rooms should have as much light as possible.

Obsessive-compulsive disorder even in mild degree cannot be ignored. The condition of such a patient may worsen over time, leading to severe impairments in emotional sphere, inability to adapt to society. Psychotherapeutic and medicinal methods allow a person to return to normal life.

Obsessive compulsive disorder (OCD) is a group of pathopsychological syndromes that manifests itself as obsessive thoughts and actions that prevent patients from leading full life. This condition is characterized by a person’s inability to control his thoughts (ideas) or actions, which become habitual, stereotypical and constant fear and anxiety. Obsessive compulsive disorder is considered one of the most common mental disorders, according to some sources, every third adult suffers from obsessive thoughts or actions, and a severe disorder is observed in 1 child in a thousand.

The reasons for the development of obsessive-compulsive disorder in children and adults are still unclear. It has been proven that the occurrence of the disease is influenced by both physiological and psychological factors. It is impossible to say in advance exactly which factors can cause a disorder and which cannot, since each organism reacts individually to stimuli.

Risk factors for developing OCD are:

Obsessive compulsive disorder develops when a person develops a pattern of certain behavior. For example, having experienced fear or anxiety, the patient walked around the room or, in order to get rid of fear, turned on the light and checked to see if there was anyone in the room.

This reaction is fixed in the brain as a possible response to any dangerous situation and in the future the patient cannot get rid of this behavior, continuing to perform certain rituals every day. Sometimes, such behavior does not seem strange to others, but the patients themselves experience constant anxiety, which they try to get rid of with new rituals, which are gradually increasing in number.

What happens with obsessive-compulsive disorder?

The development of OCD is influenced by many factors; under their influence, the patient begins to constantly focus on certain thoughts and events, giving them excessive significance.

Obsessive thoughts arise from events or things that are of great value to a person, from his fears and experiences. From time to time, such thoughts or actions that cannot be dealt with appear in everyone - for example, while waiting and worrying about a loved one who stays late in the evening or the habit of constantly checking the keys to the apartment.

But with OCD, patients do not try to cope with the influx of thoughts, because they consider them too important, and their behavior is the only correct and possible in such a situation.

Certain rituals and patterns of behavior help them feel safe and “cope” with anxiety, but gradually, there are more and more of them and the patient finds himself in a vicious circle - any unfulfilled or untimely ritual causes even more severe anxiety, and to get rid of it, you need to perform some other ritual.

Rituals and habits can be very different, from the harmless - “knock on wood so as not to jinx it” or spit on left shoulder“if a black cat crossed the road” to complex, multi-component ones: to prevent bad things from happening, you must definitely avoid the color blue, and if you see a blue object, you must definitely return home, change clothes and leave the house only in the dark.

People suffering from neurosis are characterized by an exaggeration of danger and “obsession” with it; any event in life turns into a problem or even a disaster that a person is not able to cope with. This supports constant feeling anxiety and tension, interfering normal life sick.

Symptoms

The main symptoms of obsessive-phobic disorder are obsessive thoughts and compulsive actions (rituals). These two combinations give great amount various options clinical picture of the disease.

You can suspect OCD and make a diagnosis based on the following signs:

1. Rituals are one of the most characteristic signs of OCD. Rituals are repetitive activities whose main purpose is to calm anxiety or to try to “avoid” something scary. Patients themselves realize the wrongness and abnormality of such actions, but cannot cope with these impulses. For some, this becomes the only way to calm down, while others believe that this is the only way to avoid various misfortunes. Rituals can be very different: from the habit of arranging all objects by size, to daily cleaning of the entire house with disinfectants, maybe more strange habits: for example, before going to bed, read the same page in a book every day, turn off and then turn on the lights in the room 10 times, and so on.
2. Obsessive rumination is the second characteristic sign of the disease. Patients think about the same event for hours, “chew” it in their brain, not finding the strength to interrupt this flow of thoughts. “Mental chewing gum” can be associated with the need to perform some action: call someone, talk, do something, or perform an ordinary, everyday action that healthy man does it without any thought. Such thoughts can also concern relationships and unfinished actions: is the light turned off, is there a thief breaking into the house, and so on.
3. Anxiety – with obsessive compulsive disorder, patients always have a feeling of anxiety. It can arise due to small, everyday situations (a child was late for 10 minutes) or due to “global” ones that are in no way controllable - terrorist attacks, deterioration environmental situation and so on.
4. Obsessive thoughts – negative thoughts or desires to harm other people may occur in certain situations or occur periodically. Patients try to control such thoughts, but there is always a risk that they will do something similar.
5. or obsessive states - can be sensual and figurative. Sensual obsessions are sensations that one’s own thoughts, feelings and desires are imposed by someone, “not one’s own.” Imposed images can relate to any imaginary situations: patients “see” themselves committing some act, usually illegal or aggressive, or vice versa, unreal images seem to them to be real, to have already happened.
6. Obsessive impulses are an unexpected desire to perform some action that may be inappropriate or even dangerous. Sometimes in this way the patient tries to cope with obsessive thoughts or anxiety by doing strange, often destructive or dangerous things.
7. Obsessive drives - the patient feels an irresistible desire to do something, regardless of whether it is feasible, whether such actions are allowed, and so on. The attraction can be quite harmless: the desire to eat something, or completely unacceptable: to kill someone, commit arson, and so on. But in any case, the patient’s inability to cope with his feelings causes great discomfort and becomes another reason for anxiety and concern.
8. - a very characteristic symptom of obsessive disorder. Fears and phobias can be of very different types; nosophobia is common ( obsessive fear severe or fatal disease), fear of heights, open or closed spaces, fear of pollution. Various rituals help to temporarily cope with fear, but then it only intensifies.

With severe OCD, the patient may experience all the symptoms simultaneously, but most often increased anxiety, obsessive thoughts and rituals. Sometimes they are accompanied by obsessions: aggressive thoughts and behavior, as well as phobias.

OCD in children

Unfortunately, today the number of children suffering from such a pathology as obsessive-compulsive disorder continues to increase. It is quite difficult to diagnose, especially in younger children school age and manifestations of the disease are often mistaken for attention deficit hyperactivity disorder, depression, conduct disorder or autism. This is due to fewer characteristic symptoms which the child demonstrates by the fact that he cannot and does not know how to accurately characterize and describe his condition.

Children with OCD also suffer from obsessive thoughts and anxiety, but they can only articulate their condition at an older age; young children can be very restless, overly irritable, aggressive and hyperactive.

Anxiety and fears are manifested by fear of being left without parents, alone, fear of strangers, new premises, situations and even clothes.

Rituals are considered the most characteristic sign of obsessive-compulsive disorder in childhood. This can be repeated repetition of the same actions that seem senseless to adults, excessive neatness and disgust (after any contamination, hands need to be washed for a long time with soap), attachment to the same things or sequence of events (a lullaby before bed, an obligatory glass of milk for breakfast ).

Moreover, the child categorically refuses to replace the old thing with a new one, change anything in the ritual, or abandon it. Attempts by parents or others to “break” the ritual are perceived extremely aggressively; children with OCD cannot be switched to something else or distracted from performing actions.

At an older age, severe fears or phobias may appear, as well as anxiety and obsessive movements. Young children with this disorder are usually considered hyperactive or have neurological problems.

Diagnosing obsessive-phobic disorder in children is very difficult, since the clinical picture, due to age characteristics, unclear and difficult to navigate differential diagnosis with other diseases.

Treatment

How is obsessive compulsive disorder treated? great effort on the part of the patient and the doctor. Until recently, this disease was considered extremely resistant to treatment and doctors, first of all, tried to cope with the most pronounced symptoms of the disease, without trying to rid the patient of the disorder itself. Today, thanks to fairly effective and safe medications and new methods of psychotherapy, it is possible to stabilize the condition of a patient with OCD in most cases.

For this use:

• drug therapy: antidepressants, antipsychotics, anti-anxiety and sedatives;
• psychotherapy: prevention method, 4-step therapy, thought stopping method and cognitive behavioral therapy, as adjuvant therapy family psychotherapy, personal and other methods can be used;
• treatment at home - this disease requires medication and psychotherapeutic treatment, but if the patient does not fight his disorder independently, at home, the effect of treatment will be minimal.

Drug therapy

Antidepressants are used for treatment: Fluvoxamine, Paroxetine, Clomipramine; atypical antipsychotics: Olanzapine, Lamotrigine; anxiolytics: Clonazepam, Buspirone; mood stabilizers: lithium salts and others. All these drugs have contraindications and side effects, therefore, should be used only as indicated and under the supervision of a physician.

Treatment for OCD begins with a 2-3 month course of antidepressants; they help cope with anxiety, worries, normalize the mood and general condition of the patient. After or simultaneously with taking antidepressants, psychotherapy is started. It is very important to monitor the use of antidepressants, especially during initial stage treatment, when there is no visible effectiveness from taking medications, and the patient’s psyche continues to remain depressed. Only after 2-3 weeks of use do the first pronounced changes into a person’s mood and well-being, after which it becomes much easier to control treatment.

In addition to antidepressants, sedatives and sleeping pills, as well as neuroleptics and normotics - these drugs are used only for treatment comorbid disorders. Neuroleptics are indicated for pronounced aggressive intentions, thoughts or actions, and mood stabilizers are indicated for decreased mood, fears and phobias. The drugs are prescribed for 10-30 days, depending on the severity of symptoms.

Psychotherapy

The main goal of psychotherapy for OCD is to make the patient aware of his problem and ways to deal with anxiety and obsessive thoughts and actions.

“4 Steps” therapy is based on replacing or simplifying rituals that help patients relieve anxiety. Patients must be clearly aware of what and when they provoke attacks of compulsions and control their actions.

The “Thought Stopping” method teaches the patient the ability to stop and “look” at his actions and thoughts “from the outside.” This helps you realize the absurdity and fallacy of your fears and misconceptions and teaches you how to cope with them.

Treatment at home

Very important for successful treatment help and support of the patient’s relatives and friends. They must understand the causes and manifestations of the disease and help him cope with panic attacks and anxiety.

The patient himself learns to control his thoughts and actions, avoiding situations in which obsessions may appear. This includes giving up bad habits, reducing exposure to stressors, relaxation and meditation techniques, and so on.

Treatment of OCD can take a long time, and both the patient and his family need to tune in to long-term therapy - it takes from 2 to 6 months, and sometimes more, to stabilize the condition. And in order to exclude the possibility of relapse of the disease, you need to periodically visit your doctor and repeat the course of medication and psychotherapy.

Obsessive-compulsive disorder is a dysfunction of mental activity, manifested by involuntary thoughts of an obsessive nature that interfere with normal life, as well as various fears. These thoughts create anxiety, which can only be relieved by performing obsessive and tiresome activities called compulsions.

Obsessive-compulsive disorder can be progressive or episodic, or chronic. Obsessive thoughts are ideas or inclinations that appear again and again in a stereotypical form in a person’s head. The essence of these thoughts is almost always painful, since they are either perceived as meaningless ideas or carry obscene or aggressive content.

Causes of obsessive-compulsive disorder

The root causes of the disorder in question can rarely be found on the surface. Obsessive compulsive disorder OCD is characterized by compulsions (ritualistic actions) and obsessions (obsessive thoughts). The most common involuntary intrusive thoughts are:

— fear of infection (for example, viruses, microbes, from liquids, chemicals or excrement);

Signs of obsessive-compulsive disorder in children:

— wet, cracked hands (if the child suffers from compulsive hand washing);

- prolonged stay in the bathroom;

- slow completion of homework due to fear of making a mistake;

- introducing many corrections and amendments to school work;

- strange or repetitive behavior, such as constantly checking doors or taps to make sure they are closed;

- tiresome, constant questions that require reassurance, for example, “Mom, touch it, I have a fever.”

How to treat obsessive-compulsive disorder in children? Many parents want to know this. First of all, it is necessary to accurately determine whether their child suffers from obsessive-compulsive disorder or simply practices some of his own rituals. There are quite normal rituals for childhood which parents often mistake for violations. These include:

- children under three years of age often have certain “traditions” of going to bed; by the school period this usually either goes away or becomes mild;

- invented games with certain rules, collecting (from the age of five);

- excessive passion for some performer, subculture, which is a way of socialization, building relationships with peers who have similar hobbies.

Before getting rid of obsessive-compulsive disorder, parents need to differentiate it from normal manifestations inherent in the age period in which their baby is located. The main difference between the described syndrome and normal rituals is the understanding by adolescents and children of the abnormality of obsessive thoughts and ritual actions. Children realize that their actions are deviant from the norm, so they try to resist them. This understanding pushes them to hide obsessive thoughts and ritual actions from the environment. Therefore, if a baby openly performs a certain ritual before going to bed, this does not indicate the presence of an illness. You need to understand that such behavior is only inherent in his age period.

Treatment of obsessive-compulsive disorder

Previously, the syndrome in question was considered a condition that was resistant (unresponsive) to treatment, since traditional psychotherapeutic methods based on the principles rarely brought effect. The results of using various medications were also not encouraging. However, in the eighties of the last century, the current situation changed dramatically due to the introduction of new methods of behavioral therapy and pharmacopoeial medicine, the effectiveness of which was proven through large-scale studies.

Scientists of that time, trying to find the answer to the question “how to treat obsessive-compulsive disorder,” experimentally proved that the most effective method of behavioral therapy for the disorder in question is the method of preventing reaction and exposure.

The patient receives instructions on how to resist performing compulsive actions, after which he is placed in a situation that provokes discomfort caused by obsessions.

The main thing in the treatment of the disease in question is the timely recognition of obsessive-compulsive disorder and correct diagnosis.

Currently the main medications Treatments for obsessive-compulsive disorder include selective serotonin reuptake inhibitors (Clomipramine), anxiolytics (Clonazepam, Buspirone), mood stabilizers (Lithium drugs) and antipsychotics (Rimozide).

How to get rid of obsessive-compulsive disorder? Most therapists agree that treatment of this disease should begin with the prescription of antidepressants, namely drugs from the group of selective serotonin reuptake inhibitors in an adequate dose. Drugs of this pharmacotherapeutic group are better tolerated by patients and are considered safer than Clomipramine (a tricyclic antidepressant that blocks serotonin reuptake), previously widely used in the treatment of the disorder in question.

It is also practiced to prescribe anxiolytics in combination with other drugs. It is not recommended to use them as monotherapy. The prescription of mood stabilizers, namely Lithium preparations, is indicated, since Lithium promotes the release of serotonin.

A number of researchers have proven the effectiveness of prescribing atypical antipsychotics(Olanzapine) in combination with serotonergic antidepressants.

In addition to the use of drugs in the treatment of obsessions and compulsions modern approach involves the use of psychotherapeutic methods. An excellent psychotherapeutic effect is provided by the four-step technique, which provides the opportunity to simplify or modify ritual procedures. This method is based on the patient’s awareness of the problem and gradual overcoming of symptoms.

Treatment of obsessive compulsive disorder at home is not recommended, but there are a number of therapeutic and preventive measures that can reduce the severity of symptoms.

So, treatment for obsessive compulsive disorder at home involves:

- reducing the consumption of alcohol and drinks containing caffeine;

- getting rid of bad habits;

- regular meals, since hunger, lack of nutrients, low sugar levels can provoke stressful state which will cause symptoms of obsessive-compulsive disorder;

- regular execution physical exercise, since the systematic release of endorphins improves metabolism, increases stress resistance and improves general health person;

- massage;

— establishing optimal sleep and wakefulness patterns;

- taking warm baths, during which a cool compress should be placed on the head of the suffering individual, this procedure should be carried out several times a week for twenty minutes, each procedure must reduce the temperature of the water;

- to relieve anxiety, for the purpose of relaxation and calming of a sick individual, taken orally herbal decoctions and infusions that have a sedative effect (the herbs of valerian officinalis, lemon balm, and motherwort are used);

- systematic use of St. John's wort, which allows you to increase mental concentration, improve clarity of consciousness, which affects the force of compulsion to perform ritual actions;

- daily breathing exercises, which allow you to restore a normal emotional background, promoting a “sober” assessment of the current situation.

After therapy it is necessary social rehabilitation. Only in case of successful adaptation after treatment of obsessive-compulsive disorder clinical symptoms will not come back. Complex rehabilitation activities includes learning to interact fruitfully with the social and immediate environment. For a complete recovery from obsessive-compulsive disorder, the support of loved ones plays a special role.