Obsessive Compulsive Disorder (OCD)
Facts to Know:
- Approximately 2% of the general population will experience OCD in their lifetime.
- Obsessions (intrusive thoughts, images, or urges) and compulsions (repetitive behaviors that people feel compelled to perform) can be distressing and significantly impact people’s lives.
- The best treatment for OCD is a form of Cognitive Behavioral Therapy called Exposure and Response Prevention (EXRP) in combination with medications such as selective serotonin reuptake inhibitors (SSRIs).
What is Obsessive Compulsive Disorder?
Obsessive Compulsive Disorder (OCD) is defined by the presence of obsessions or compulsions, or both, which are time-consuming (taking greater than 1 hour per day) or cause significant impairment in functioning at home, work, or school. Often, intrusive or unwanted thoughts, images, or urges (obsessions) lead to repetitive behaviors (compulsions) such as washing, checking, repeating words.
The exact cause of OCD is not known, but genetic and environmental factors both play an important role. People with a family history of OCD are more likely to develop OCD. Also, certain events, such as premenstrual and postpartum periods, recent exposure to trauma, and neurologic events such as stroke have been shown to increase risk for the development of OCD.
OCD typically begins in adolescence and may persist into adulthood. Approximately 2% of people will experience OCD during their lifetime. Other difficulties that tend to co-occur with OCD include anxiety disorders and depression.
Common obsessions include fears of contamination (dirt, germs, bodily fluids, chemicals), fears that one will be responsible for a negative outcome (fire, burglary, car accident), fears of having a serious medical condition, fears that one is morally wrong or offensive, fears that one will harm themselves or others, and distress when items and objects are not symmetrical or exact.
Intrusive thoughts may develop related to topics that are considered taboo or inappropriate (such as acting on an inappropriate impulse or sexual obsessions). People who experience these thoughts often seek to suppress them or avoid them in some way. However, the suppression of these thoughts only serves to strengthen them and the OCD symptoms associated with them.
Compulsions are repetitive behaviors that people with OCD feel compelled to perform. These rituals may include praying, counting, repeating certain words, washing, or checking behaviors as well as many others. Some compulsions may be mental acts that are not observable to others but may still be distressing or problematic for the individual.
The diagnosis of OCD is best made by a healthcare professional, who will conduct a thorough clinical interview. The evaluation will include understanding symptoms, the individual’s subjective experience, environmental factors, family history, and impact on functioning. An assessment called the Yale Brown Obsessive Compulsive Scale is frequently used to assess the nature and severity of OCD symptoms.
A specific form of cognitive-behavioral therapy (CBT) called Exposure and Response Prevention (EX/RP), is considered the gold-standard starting treatment for OCD in both adults and children. This type of psychotherapy has been demonstrated to be the most effective treatment for OCD symptoms. This form of therapy teaches individuals to more effectively respond to obsessions and compulsions. Therapists will work with patients to develop strategies to manage obsessions and compulsions by gradually facing their fears in a systematic, supportive, and therapeutic way.
Medication may be helpful in treating OCD symptoms. A family of medications known as SSRIs is the first-line medication for both adults and children with OCD. A psychiatrist or nurse practitioner can prescribe these medications. SSRIs are generally well tolerated and are helpful in improving OCD symptoms in the majority of patients.
How Can I Receive Treatment for OCD at Columbia?
At ColumbiaDoctors, we provide a full array of treatments for OCD. In particular, our Columbia University Center for Anxiety and Related Disorders in Columbus Circle and Tarrytown provide comprehensive programming for OCD. Our clinicians believe treatment approaches must be tailored to address each person’s individual needs and goals.
Search our providers for a therapist or psychiatrist with expertise in OCD.
To make an appointment, please call 212-305-6001 or submit our online form.