| disease | OCD (Obsessive-Compulsive Disorder) |
Obsessive-compulsive neurosis (commonly known as obsessive-compulsive disorder) is characterized by persistent and repetitive obsessive thoughts and/or compulsive behaviors as its primary symptoms. These symptoms originate from within the patient but are not experienced or voluntarily produced; rather, they are unwanted thoughts. Although the patient recognizes them as irrational, they cannot be rid of, causing distress and a sense of incongruity with the patient's own personality.
bubble_chart Diagnosis
I. Symptom Characteristics
The clinical manifestations of this disorder share the following common features:
(1) Obsessive symptoms:
The obsessive symptoms are not the patient's intention but are difficult to shake off or control, causing the patient anxiety and distress;
(2) Obsessive symptoms include:
obsessive thoughts, obsessive intentions, compulsive behaviors, etc. Some are related to psychological factors, with content that is not bizarre or absurd. The patient retains insight and lacks other psychotic symptoms or obvious neurasthenic personality traits.
II. Physical Examination Findings
No positive signs were found during physical and neurological examinations.
III. Differential Diagnosis
It should be differentiated from the following conditions: neurasthenia, schizophrenia, depression, and certain organic brain diseases.
bubble_chart Treatment Measures
1. Psychotherapy:
The basic principles are the same as for neurasthenia.
2. Pharmacotherapy:
(1) The first-line drug is clomipramine at 150–300 mg/day, divided into two doses. Start with a small dose and gradually increase. Generally, therapeutic effects begin to appear 2–3 weeks after reaching the therapeutic dose, and the treatment duration should be no less than 3–6 months.
(2) Serotonin reuptake inhibitors such as fluoxetine and paroxetine have good efficacy for this condition.(3) Benzodiazepines can be used in combination for patients with severe anxiety accompanying obsessive-compulsive symptoms, such as clonazepam at 3–4 mg/day, divided into 2–3 doses.
3. Psychosurgery:
Considered for very few chronic cases of obsessive-compulsive disorder where both medication and psychotherapy have failed.
