obsessive-compulsive disorder (redirected from Obsessive-compulsive syndrome)

Obsessive-Compulsive Disorder 

Definition

Obsessive-compulsive disorder (OCD) is a type of anxiety disorder. Anxiety disorder is the experience of prolonged, excessive worry about circumstances in one's life. OCD is characterized by distressing repetitive thoughts, impulses or images that are intense, frightening, absurd, or unusual. These thoughts are followed by ritualized actions that are usually bizarre and irrational. These ritual actions, known as compulsions, help reduce anxiety caused by the individual's obsessive thoughts. Often described as the "disease of doubt," the sufferer usually knows the obsessive thoughts and compulsions are irrational but, on another level, fears they may be true.

Description

Almost one out of every 40 people will suffer from obsessive-compulsive disorder at some time in their lives. The condition is two to three times more common than either schizophrenia or manic depression, and strikes men and women of every ethnic group, age and social level. Because the symptoms are so distressing, sufferers often hide their fears and rituals but cannot avoid acting on them. OCD sufferers are often unable to decide if their fears are realistic and need to be acted upon.

Most people with obsessive-compulsive disorder have both obsessions and compulsions, but occasionally a person will have just one or the other. The degree to which this condition can interfere with daily living also varies. Some people are barely bothered, while others find the obsessions and compulsions to be profoundly traumatic and spend much time each day in compulsive actions.

Obsessions are intrusive, irrational thoughts that keep popping up in a person's mind, such as "my hands are dirty, I must wash them again." Typical obsessions include fears of dirt, germs, contamination, and violent or aggressive impulses. Other obsessions include feeling responsible for others' safety, or an irrational fear of hitting a pedestrian with a car. Additional obsessions can involve excessive religious feelings or intrusive sexual thoughts. The patient may need to confess frequently to a religious counselor or may fear acting out the strong sexual thoughts in a hostile way. People with obsessive-compulsive disorder may have an intense preoccupation with order and symmetry, or be unable to throw anything out.

Compulsions usually involve repetitive rituals such as excessive washing (especially handwashing or bathing), cleaning, checking and touching, counting, arranging or hoarding. As the person performs these acts, he may feel temporarily better, but there is no long-lasting sense of satisfaction or completion after the act is performed. Often, a person with obsessive-compulsive disorder believes that if the ritual is not performed, something dreadful will happen. While these compulsions may temporarily ease stress, short-term comfort is purchased at a heavy price—time spent repeating compulsive actions and a long-term interference with life.

The difference between OCD and other compulsive behavior is that while people who have problems with gambling, overeating or with substance abuse may appear to be compulsive, these activities also provide pleasure to some degree. The compulsions of OCD, on the other hand, are never pleasurable.

OCD may be related to some other conditions, such as the continual urge to pull out body hair (trichotillomania) fear of having a serious disease (hypochondriasis) or preoccupation with imagined defects in personal appearance disorder (body dysmorphia). Some people with OCD also have Tourette syndrome, a condition featuring tics and unwanted vocalizations (such as swearing). OCD is often linked with depression and other anxiety disorders.

Causes and symptoms

While no one knows for sure, research suggests that the tendency to develop obsessive-compulsive disorder is inherited. There are several theories behind the cause of OCD. Some experts believe that OCD is related to a chemical imbalance within the brain that causes a communication problem between the front part of the brain (frontal lobe) and deeper parts of the brain responsible for the repetitive behavior. Research has shown that the orbital cortex located on the underside of the brain's frontal lobe is overactive in OCD patients. This may be one reason for the feeling of alarm that pushes the patient into compulsive, repetitive actions. It is possible that people with OCD experience overactivity deep within the brain that causes the cells to get "stuck," much like a jammed transmission in a car damages the gears. This could lead to the development of rigid thinking and repetitive movements common to the disorder. The fact that drugs which boost the levels of serotonin, a brain messenger substance linked to emotion and many different anxiety disorders, in the brain can reduce OCD symptoms may indicate that to some degree OCD is related to levels of serotonin in the brain.

Recently, scientists have identified an intriguing link between childhood episodes of strep throat and the development of OCD. It appears that in some vulnerable children, strep antibodies attack a certain part of the brain. Antibodies are cells that the body produces to fight specific diseases. That attack results in the development of excessive washing or germ phobias. A phobia is a strong but irrational fear. In this instance the phobia is fear of disease germs present on commonly handled objects. These symptoms would normally disappear over time, but some children who have repeated infections may develop full-blown OCD. Treatment with antibiotics has resulted in lessening of the OCD symptoms in some of these children.

If one person in a family has obsessive-compulsive disorder, there is a 25% chance that another immediate family member has the condition. It also appears that stress and psychological factors may worsen symptoms, which usually begin during adolescence or early adulthood.

Diagnosis

People with obsessive-compulsive disorder feel ashamed of their problem and often try to hide their symptoms. They avoid seeking treatment. Because they can be very good at keeping their problem from friends and family, many sufferers do not get the help they need until the behaviors are deeply ingrained habits and hard to change. As a result, the condition is often misdiagnosed or underdiagnosed. All too often, it can take more than a decade between the onset of symptoms and proper diagnosis and treatment.

While scientists seem to agree that OCD is related to a disruption in serotonin levels, there is no blood test for the condition. Instead, doctors diagnose OCD after evaluating a person's symptoms and history.

Treatment

Obsessive-compulsive disorder can be effectively treated by a combination of cognitive-behavioral therapy and medication that regulates the brain's serotonin levels. Drugs that are approved to treat obsessive-compulsive disorder include fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft), all selective serotonin reuptake inhibitors (SSRIs) that affect the level of serotonin in the brain. Older drugs include the antidepressant clomipramine (Anafranil), a widely-studied drug in the treatment of OCD, but one that carries a greater risk of side effects. Drugs should be taken for at least 12 weeks before deciding whether or not they are effective.

Cognitive-behavioral therapy (CBT) teaches patients how to confront their fears and obsessive thoughts by making the effort to endure or wait out the activities that usually cause anxiety without compulsively performing the calming rituals. Eventually their anxiety decreases. People who are able to alter their thought patterns in this way can lessen their preoccupation with the compulsive rituals. At the same time, the patient is encouraged to refocus attention elsewhere, such as on a hobby.

In a few severe cases where patients have not responded to medication or behavioral therapy, brain surgery may be tried as a way of relieving the unwanted symptoms. Surgery can help up to a third of patients with the most severe form of OCD. The most common operation involves removing a section of the brain called the cingulate cortex. The serious side effects of this surgery for some patients include seizures, personality changes and less ability to plan.

Alternative treatment

Because OCD sometimes responds to SSRI antidepressants, a botanical medicine called St. John's wort (Hypericum perforatum) might have some beneficial effect as well, according to herbalists. Known popularly as "Nature's Prozac," St. John's wort is prescribed by herbalists for the treatment of anxiety and depression. They believe that this herb affects brain levels of serotonin in the same way that SSRI antidepressants do. Herbalists recommend a dose of 300 mg., three times per day. In about one out of 400 people, St. John's wort (like Prozac) may initially increase the level of anxiety. Homeopathic constitutional therapy can help rebalance the patient's mental, emotional, and physical well-being, allowing the behaviors of OCD to abate over time.

Prognosis

Obsessive-compulsive disorder is a chronic disease that, if untreated, can last for decades, fluctuating from mild to severe and worsening with age. When treated by a combination of drugs and behavioral therapy, some patients go into complete remission. Unfortunately, not all patients have such a good response. About 20% of people cannot find relief with either drugs or behavioral therapy. Hospitalization may be required in some cases.

Despite the crippling nature of the symptoms, many successful doctors, lawyers, business people, performers and entertainers function well in society despite their condition. Nevertheless, the emotional and financial cost of obsessive-compulsive disorder can be quite high.

Resources

Organizations

Anxiety Disorders Association of America. 11900 Park Lawn Drive, Ste. 100, Rockville, MD 20852. (800) 545-7367. http://www.adaa.org.

National Alliance for the Mentally Ill (NAMI). Colonial Place Three, 2107 Wilson Blvd., Ste. 300, Arlington, VA 22201-3042. (800) 950-6264. http://www.nami.org.

National Anxiety Foundation. 3135 Custer Dr., Lexington, KY 40517. (606) 272-7166. http://www.lexington-on-line.com/naf.html.

Obsessive-Compulsive Anonymous. P.O. Box 215, New Hyde Park, NY 11040. (516) 741-4901. 〈west24th@aol.com〉 http://members.aol.com/west24th/index.html.

Obsessive-Compulsive Foundation. P.O. Box 70, Milford, CT 06460. (203) 874-3843. 〈JPHS28A@Prodigy.com〉 〈http://pages.prodigy.com/alwillen/ocf.html〉.

Key terms

Anxiety disorder — This is the experience of prolonged, excessive worry about circumstances in one's life. It disrupts daily life.

Cognitive-behavior therapy — A form of psychotherapy that seeks to modify behavior by manipulating the environment to change the patient's response.

Compulsion — A rigid behavior that is repeated over and over each day.

Obsession — A recurring, distressing idea, thought or impulse that feels "foreign" or alien to the individual.

Selective serotonin reuptake inhibitors (SSRIs) — A class of antidepressants that work by blocking the reabsorption of serotonin in brain cells, raising the level of the chemical in the brain. SSRIs include Prozac, Zoloft, Luvex, and Paxil.

Serotonin — One of three major neurotransmitters found in the brain that is related to emotion, and is linked to the development of depression and obsessive-compulsive disorder.

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disorder /dis·or·der/ (dis-or´der) a derangement or abnormality of function; a morbid physical or mental state.

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acute stress disorder  an anxiety disorder characterized by development of anxiety, dissociative, and other symptoms within one month following exposure to an extremely traumatic event. If persistent, it may become posttraumatic stress disorder.

adjustment disorder  maladaptive reaction to identifiable stress (e.g., divorce, illness), which is assumed to remit when the stress ceases or when the patient adapts.

affective disorders  mood d's.

amnestic disorders  mental disorders characterized by acquired impairment in the ability to learn and recall new information, sometimes accompanied by inability to recall previously learned information.

anxiety disorders  mental disorders in which anxiety and avoidance behavior predominate, i.e., panic disorder, agoraphobia, social phobia, specific phobia, obsessive-compulsive disorder, posttraumatic stress disorder, acute stress disorder, generalized anxiety disorder, and substance-induced anxiety disorder.

attention-deficit/hyperactivity disorder  a controversial childhood mental disorder with onset before age seven, and characterized by inattention (e.g., distractibility, forgetfulness, not appearing to listen), by hyperactivity and impulsivity (e.g., restlessness, excessive running or climbing, excessive talking, and other disruptive behavior), or by a combination of both types of behavior.

autistic disorder  autism; a severe pervasive developmental disorder with onset usually before three years of age and a biological basis; it is characterized by qualitative impairment in reciprocal social interaction, verbal and nonverbal communication, and capacity for symbolic play, by restricted and unusual repertoire of activities and interests, and often by cognitive impairment.

behavior disorder  conduct d.

binge-eating disorder  an eating disorder characterized by repeated episodes of binge eating, as in bulimia nervosa, but not followed by inappropriate compensatory behavior such as purging, fasting, or excessive exercise.

bipolar disorders  mood disorders with a history of manic, mixed, or hypomanic episodes, usually with present or previous history of one or more major depressive episodes; included are bipolar I d., characterized by one or more manic or mixed episodes, bipolar II d., characterized by one or more hypomanic episodes but no manic episodes, and cyclothymic disorder. The term is sometimes used in the singular to denote either bipolar I disorder, bipolar II disorder, or both.

body dysmorphic disorder  a somatoform disorder characterized by a normal-looking person's preoccupation with an imagined defect in appearance.

breathing-related sleep disorder  any of several disorders characterized by sleep disruption due to some sleep-related breathing problem, resulting in excessive sleepiness or insomnia.

brief psychotic disorder  an episode of psychotic symptoms with sudden onset, lasting less than one month.

catatonic disorder  catatonia due to the physiological effects of a general medical condition and neither better accounted for by another mental disorder nor occurring exclusively during delirium.

character disorders  personality d's.

childhood disintegrative disorder  pervasive developmental disorder characterized by marked regression in various developmental skills, including language, play, and social and motor skills, after two to ten years of initial normal development.

circadian rhythm sleep disorder  a lack of synchrony between the schedule of sleeping and waking required by the external environment and that of a person's own circadian rhythm.

collagen disorder  an inborn error of metabolism involving abnormal structure or metabolism of collagen, e.g., Marfan syndrome, cutis laxa. Cf. collagen disease.

communication disorders  mental disorders characterized by difficulties with speech or language, severe enough to interfere academically, occupationally, or socially.

conduct disorder  a type of disruptive behavior disorder of childhood and adolescence marked by persistent violation of the rights of others or of age-appropriate societal norms or rules.

conversion disorder  a somatoform disorder characterized by conversion symptoms (loss or alteration of voluntary motor or sensory functioning suggesting physical illness) with no physiological basis and not produced intentionally or feigned; a psychological basis is suggested by exacerbation of symptoms during psychological stress, relief from tension (primary gain), or gain of outside support or attention (secondary gains).

cyclothymic disorder  a mood disorder characterized by alternating cycles of hypomanic and depressive periods with symptoms like those of manic and major depressive episodes but of lesser severity.

delusional disorder  a mental disorder marked by well-organized, logically consistent delusions of grandeur, persecution, or jealousy, with no other psychotic feature. There are six types: persecutory, jealous, erotomanic, somatic, grandiose, and mixed.

depersonalization disorder  a dissociative disorder characterized by intense, prolonged, or otherwise troubling feelings of detachment from one's body or thoughts, not secondary to another mental disorder.

depressive disorders  mood disorders in which depression is unaccompanied by manic or hypomanic episodes.

developmental coordination disorder  problematic or delayed development of gross and fine motor coordination skills, not due to a neurological disorder or to general mental retardation, resulting in the appearance of clumsiness.

disruptive behavior disorders  a group of mental disorders of children and adolescents consisting of behavior that violates social norms and is disruptive.

dissociative disorders  mental disorders characterized by sudden, temporary alterations in identity, memory, or consciousness, segregating normally integrated parts of one's personality from one's dominant identity.

dissociative identity disorder  a dissociative disorder characterized by the existence in an individual of two or more distinct personalities, with at least two of the personalities controlling the patient's behavior in turns. The host personality usually is totally unaware of the alternate personalities; alternate personalities may or may not have awareness of the others.

dream anxiety disorder  nightmare d.

dysthymic disorder  a mood disorder characterized by depressed feeling, loss of interest or pleasure in one's usual activities, and other symptoms typical of depression but tending to be longer in duration and less severe than in major depressive disorder.

eating disorder  abnormal feeding habits associated with psychological factors, including anorexia nervosa, bulimia nervosa, pica, and rumination disorder.

expressive language disorder  a communication disorder occurring in children and characterized by problems with the expression of language, either oral or signed.

factitious disorder  a mental disorder characterized by repeated, intentional simulation of physical or psychological signs and symptoms of illness for no apparent purpose other than obtaining treatment.

factitious disorder by proxy  a form of factitious disorder in which one person (usually a mother) intentionally fabricates or induces physical (Munchausen syndrome by proxy) or psychological disorders in another person under their care (usually their child) and subjects that person to needless diagnostic procedures or treatment, without any external incentives for the behavior.

female orgasmic disorder  consistently delayed or absent orgasm in a female, even after a normal phase of sexual excitement and adequate stimulation.

female sexual arousal disorder  a sexual dysfunction involving failure by a female either to attain or maintain lubrication and swelling during sexual activity, after adequate stimulation.

functional disorder  a disorder of physiological function having no known organic basis.

gender identity disorder  a disturbance of gender identification in which the affected person has an overwhelming desire to change their anatomic sex or insists that they are of the opposite sex, with persistent discomfort about their assigned sex or about filling its usual gender role.

generalized anxiety disorder  (GAD) an anxiety disorder characterized by excessive, uncontrollable worry about two or more life circumstances for six months or more.

hypoactive sexual desire disorder  a sexual dysfunction consisting of persistently or recurrently low level or absence of sexual fantasies and desire for sexual activity.

impulse control disorders  a group of mental disorders characterized by repeated failure to resist an impulse to perform some act harmful to oneself or to others.

induced psychotic disorder  shared psychotic d.

intermittent explosive disorder  an impulse control disorder characterized by multiple discrete episodes of loss of control of aggressive impulses resulting in serious assault or destruction of property that are out of proportion to any precipitating stressors.

learning disorders  a group of disorders characterized by academic functioning that is substantially below the level expected on the basis of the patient's age, intelligence, and education.

lymphoproliferative disorders  a group of malignant neoplasms arising from cells related to the common multipotential lymphoreticular cell, including lymphocytic, histiocytic, and monocytic leukemias, multiple myeloma, plasmacytoma, and Hodgkin's disease.

lymphoreticular disorders  a group of disorders of the lymphoreticular system, characterized by the proliferation of lymphocytes or lymphoid tissues.

major depressive disorder  a mood disorder characterized by the occurrence of one or more major depressive episodes and the absence of any history of manic, mixed, or hypomanic episodes.

male erectile disorder  a sexual dysfunction involving failure by a male to attain or maintain an adequate erection until completion of sexual relations.

male orgasmic disorder  consistently delayed or absent orgasm in a male, even after a normal phase of sexual excitement and stimulation adequate for his age.

manic-depressive disorder  former name for a mood disorder now known as bipolar I d. or bipolar II d. and often called bipolar d. (q.v.).

mendelian disorder  a genetic disease showing a mendelian pattern of inheritance, caused by a single mutation in the structure of DNA, which causes a single basic defect with pathologic consequences.

mental disorder  any clinically significant behavioral or psychological syndrome characterized by the presence of distressing symptoms, impairment of functioning, or significantly increased risk of suffering death, pain, or other disability.

minor depressive disorder  a mood disorder closely resembling major depressive disorder and dysthymic disorder but intermediate in severity between the two.

mixed receptive-expressive language disorder  a communication disorder involving both the expression and the comprehension of language, either spoken or signed.

monogenic disorder  mendelian d.

mood disorders  mental disorders characterized by disturbances of mood manifested as one or more episodes of mania, hypomania, depression, or some combination, the two main subcategories being bipolar disorders and depressive disorders.

motor skills disorder  any disorder characterized by inadequate development of motor coordination severe enough to restrict locomotion or the ability to perform tasks, schoolwork, or other activities.

multifactorial disorder  one caused by the interaction of genetic and sometimes also nongenetic, environmental factors, e.g., diabetes mellitus.

multiple personality disorder  dissociative identity d.

myeloproliferative disorders  a group of usually neoplastic diseases possibly related histogenetically, including granulocytic leukemias, myelomonocytic leukemias, polycythemia vera, and myelofibroerythroleukemia.

neurotic disorder  neurosis.

nightmare disorder  repeated episodes of nightmares that awaken the sleeper, with full orientation and alertness and vivid recall of the dreams.

obsessive-compulsive disorder  (OCD) an anxiety disorder characterized by recurrent obsessions or compulsions, which are severe enough to interfere significantly with personal or social functioning. Cf. obsessive-compulsive personality disorder, under personality .

obsessive-compulsive personality disorder  see under personality.

oppositional defiant disorder  a type of disruptive behavior disorder characterized by a recurrent pattern of defiant, hostile, disobedient, and negativistic behavior directed toward those in authority.

organic mental disorder  a term formerly used to denote any mental disorder with a specifically known or presumed organic etiology. It was sometimes used synonymously with organic mental syndrome.

orgasmic disorders  sexual dysfunctions characterized by inhibited or premature orgasm; see female orgasmic d., male orgasmic d., and premature ejaculation.

pain disorder  a somatoform disorder characterized by a chief complaint of severe chronic pain which is neither feigned nor intentionally produced, but in which psychological factors appear to play a major role in onset, severity, exacerbation, or maintenance.

panic disorder  an anxiety disorder characterized by attacks of panic (anxiety), fear, or terror, by feelings of unreality, or by fears of dying, or losing control, together with somatic signs such as dyspnea, choking, palpitations, dizziness, vertigo, flushing or pallor, and sweating. It may occur with or, rarely, without agoraphobia.

paranoid disorder  older term for delusional d.

personality disorders  a category of mental disorders characterized by enduring, inflexible, and maladaptive personality traits that deviate markedly from cultural expectations and either generate subjective distress or significantly impair functioning. For specific disorders, see under personality.

pervasive developmental disorders  disorders in which there is impaired development in multiple areas, including reciprocal social interactions, verbal and nonverbal communications, and imaginative activity, as in autistic disorder.

phagocytic dysfunction disorders  a group of immunodeficiency conditions characterized by disordered phagocytic activity, occurring as both extrinsic and intrinsic types. Bacterial or fungal infections may range from mild skin infection to fatal systemic infection.

phobic disorders  see phobia.

phonological disorder  a communication disorder characterized by failure to use age- and dialect-appropriate sounds in speaking, with errors occurring in the selection, production, or articulation of sounds.

plasma cell disorders  see under dyscrasia.

postconcussional disorder  see under syndrome.

posttraumatic stress disorder  (PTSD) an anxiety disorder caused by an intensely traumatic event, characterized by mentally reexperiencing the trauma, avoidance of trauma-associated stimuli, numbing of emotional responsiveness, and hyperalertness and difficulty in sleeping, remembering, or concentrating.

premenstrual dysphoric disorder  premenstrual syndrome viewed as a psychiatric disorder.

psychoactive substance use disorders  substance use d's.

psychosomatic disorder  one in which the physical symptoms are caused or exacerbated by psychological factors, as in migraine headaches, lower back pain, or irritable bowel syndrome.

psychotic disorder  psychosis.

reactive attachment disorder  a mental disorder of infancy or early childhood characterized by notably unusual and developmentally inappropriate social relatedness, usually associated with grossly pathological care.

rumination disorder  excessive rumination of food by infants, after a period of normal eating habits, potentially leading to death by malnutrition.

schizoaffective disorder  a mental disorder in which symptoms of a mood disorder occur along with prominent psychotic symptoms characteristic of schizophrenia.

schizophreniform disorder  a mental disorder with the signs and symptoms of schizophrenia but of less than six months' duration.

seasonal affective disorder  (SAD) depression with fatigue, lethargy, oversleeping, overeating, and carbohydrate craving recurring cyclically during specific seasons, most commonly the winter months.

separation anxiety disorder  prolonged, developmentally inappropriate, excessive anxiety and distress in a child concerning removal from parents, home, or familiar surroundings.

sexual disorders 

1. any disorders involving sexual functioning, desire, or performance.

2. specifically, any such disorder that is caused at least in part by psychological factors; divided into sexual dysfunctions and paraphilias.

sexual arousal disorders  sexual dysfunctions characterized by alterations in sexual arousal; see female sexual arousal d. and male erectile d.

sexual aversion disorder  feelings of repugnance for and active avoidance of genital sexual contact with a partner, causing substantial distress or interpersonal difficulty.

sexual desire disorders  sexual dysfunctions characterized by alteration in sexual desire; see hypoactive sexual desire d. and sexual aversion d.

sexual pain disorders  sexual dysfunctions characterized by pain associated with intercourse; it includes dyspareunia and vaginismus not due to a general medical condition.

shared psychotic disorder  a delusional system that develops in one or more persons as a result of a close relationship with someone who already has a psychotic disorder with prominent delusions.

sleep disorders  chronic disorders involving sleep, either primary (dyssomnias, parasomnias) or secondary to factors including a general medical condition, mental disorder, or substance use.

sleep terror disorder  a sleep disorder of repeated episodes of pavor nocturnus.

sleepwalking disorder  a sleep disorder of the parasomnia group, consisting of repeated episodes of somnambulism.

social anxiety disorder  social phobia.

somatization disorder  a somatoform disorder characterized by multiple somatic complaints, including a combination of pain, gastrointestinal, sexual, and neurological symptoms, and not fully explainable by any known general medical condition or the direct effect of a substance, but not intentionally feigned or produced.

somatoform disorders  mental disorders characterized by symptoms suggesting physical disorders of psychogenic origin but not under voluntary control, e.g., body dysmorphic disorder, conversion disorder, hypochondriasis, pain disorder, somatization disorder, and undifferentiated somatoform disorder.

somatoform pain disorder  pain d.

speech disorder  defective ability to speak; it may be either psychogenic (see communication d. ) or neurogenic. See also aphasia, aphonia, dysphasia, and dysphonia.

stereotypic movement disorder  a mental disorder characterized by repetitive nonfunctional motor behavior that often appears to be driven and can result in serious self-inflicted injuries.

substance-induced disorders  a subgroup of the substance-related disorders comprising a variety of behavioral or psychological anomalies resulting from ingestion of or exposure to a drug of abuse, medication, or toxin. Cf. substance use d's.

substance-related disorders  any of the mental disorders associated with excessive use of or exposure to psychoactive substances, including drugs of abuse, medications, and toxins. The group is divided into substance use d's and substance-induced d's .

substance use disorders  a subgroup of the substance-related disorders, in which psychoactive substance use or abuse repeatedly results in significantly adverse consequences. The group comprises substance abuse and substance dependence.

undifferentiated somatoform disorder  one or more physical complaints, not intentionally produced or feigned and persisting for at least six months, that cannot be fully explained by a general medical condition or the direct effects of a substance.

unipolar disorders  depressive d's.

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obsessive-compulsive disorder

n. Abbr. OCD

A psychiatric disorder characterized by the persistent intrusion of repetitive, unwanted thoughts, sometimes accompanied by compulsive actions, that the individual is unable to prevent and that interfere with normal functioning.

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obsessive-compulsive disorder (OCD),

an anxiety disorder characterized by recurrent and persistent thoughts, ideas, and feelings or repetitive acts sufficiently severe to cause marked distress, consume considerable time, or significantly interfere with the patient's occupational, social, or interpersonal functioning. See also compulsive ritual.

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obsessive-compulsive disorder (OCD),

n the abnormal behavior of a person who tends to perform repetitive acts or rituals, usually as a means of releasing tension or relieving anxiety.

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obsessive-compulsive disorder

Obsessive-compulsive neurosis, OCD Psychiatry A disabling anxiety disorder characterized by repetitive patterns of intrusive and persistent thoughts–obsessions and behaviors–compulsions that are senseless–eg, rituals, distressing, and extremely difficult to overcome; OCD affects 1-2% of Americans, has a neurophysiopathologic component and may respond to TCAs Management Clomipramine for trichotillomania and other forms of OCD. Cf Obsessive-compulsive personality disorder.