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4 In addition, first-degree relatives of patients suffering from OCD have an increased risk of developing the disorder. Susceptibility to OCD is at least partly genetic 3– 5 concordance rates are higher among monozygotic twins than dizygotic twins. 2 Men typically have an earlier onset than women. SPECIFY OCD WITH POOR INSIGHT: If the person does not recognize that the obsessions and compulsions are excessive or unreasonable for most of the time during the current episodeĪlthough OCD can begin in childhood, most cases first present in adolescence and early adulthood the average age of onset is 22 to 36 years. The disturbance is not due to the direct physiological effects of a substance or a general medical condition
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The obsessions and compulsions are not restricted to other Axis I disorders The obsessions or compulsions cause marked distress, are time consuming (> 1 hour/day), or significantly interfere with the person's social and work functions The person has recognized that the obsessions or compulsions are excessive or unreasonable (does not apply to children) 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 rigidlyĬlearly excessive behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation Recognition that the obsessional thoughts, impulses, or images are a product of his or her own mind rather than imposed from without Ignoring or suppressing such thoughts, impulses, or images, or neutralizing them with some other thought or action Thoughts, impulses, or images that are not simply excessive worries about real-life problems
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Recurrent and persistent thoughts, impulses, or images that are intrusive and inappropriate and that cause marked anxiety or distress Although the intrusive thoughts seen in OCD are often described as being ego-dystonic, many individuals struggle to determine whether or not their time-consuming behaviors are excessive. Examples of compulsions performed in response to obsessions include excessive hand washing, ritualized bathing or grooming, checking behaviors, mental rituals, need to repeat activities, re-reading text, hoarding behaviors, and superstitious behaviors. Common obsessions include fear of contamination, fear of harming self or others, intrusive violent images, recurrent forbidden or perverse sexual thoughts, a need to save items of perceived value, concern with sacrilege or morality, a need for symmetry, and excessive concern about appearance.
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Time-consuming obsessions and compulsions often distract from tasks at hand and significantly impair an individual's attention and concentration. The intrusive obsessional thoughts cause marked anxiety, and patients often describe their compulsions as efforts to reduce or neutralize these disturbing thoughts. 1 Patients with OCD experience recurrent, intrusive thoughts (obsessions) and/or repetitive, stereotyped behaviors (compulsions) that last for at least one hour per day and significantly interfere with the individual's normal level of functioning (see Table 1 for DSM-IV diagnostic criteria). Obsessive compulsive disorder (OCD) is a debilitating neuropsychiatric disorder with a lifetime prevalence of 2 to 3 percent and is estimated to be the 10th leading cause of disability in the world.