Obsessive-compulsive disorder: diagnosis & treatment

Obsessive-compulsive disorder, subsequently abbreviated as OCD, is a psychological condition, formerly known as obsessive-compulsive disorder. There are different forms, but the most common ones involve the performance of certain ‘rituals’: actions (compulsions) that are performed because of an obsessive urge to do so.


The urge comes from unavoidable thoughts. Such a person with the aforementioned thoughts considers the performance of certain rituals to be very important. If this were not adhered to, harmful consequences could occur. Examples of actions are when someone checks whether the tap is turned off, the door is locked, the iron has been unplugged, etc. The condition stems from fear.


The purpose of the actions performed because of the obsessive thoughts is to reduce a certain fear and thus prevent frightening situations. Situations that are of course possible to occur, such as fire, burglary or flooding. Such a neurosis greatly magnifies the fear of a feared situation. By giving in to compulsive actions, structure is created. With this structure one unconsciously tries to create certainty, which partly succeeds, but one also realizes that this is a false certainty.


In the past, it was thought that the basis of such a disorder was due to unprocessed impressions or experiences from childhood. Nowadays, more attention is paid to genetic factors . The chance of developing OSC in a child with a parent who suffers from this is greater than in a child with a parent without OCD. In rare cases, brain damage can be the cause. Streptococcal infection in children can occasionally cause brain damage and can also be a possible cause of OCD. Finally, it is possible that if there is a neurological disorder , OCD can also develop.


There are four criteria for obsessive thoughts:

  1. Recurring and persistent thoughts, impulses, or images that are perceived to be imposed or unhelpful and that cause stress and/or anxiety.
  2. The thoughts, images, and impulses are clearly more than an excessive concern about problems in daily life.
  3. An attempt is made to suppress or ignore the thoughts, impulses or images or to neutralize them with another thought or action.
  4. One is aware that the thoughts, impulses or images are produced by one’s own mind and not by thought input (from outside).

There are two criteria for compulsions:

  1. Behaviors that are repeated such as organizing, checking or mental actions such as counting, repeating words softly in response to an obsession or performed according to strict rules.
  2. The behavior is purely aimed at preventing the situation that one is afraid of, preventing or reducing the stress that accompanies the situation that one is afraid of. The actions or behavior are not related to an actual event, the aim is to prevent it or the actions are clearly exaggerated.

Once it has been established that previous actions and thoughts are present, four other criteria must be met before OCD can be said to exist:

  1. When the patient himself also realizes at a certain point that the actions are unnecessary and exaggerated.
  2. The disorder is not the result of drugs, medication or a general medical condition (chronic mental suffering that manifests itself in physical complaints).
  3. The actions clearly disrupt daily life.
  4. When another condition has been diagnosed, but the content of the actions or obsessions is not limited to that.



OCD is often treated with (cognitive) behavioral therapy. The patient is then exposed to the situation he/she fears. The compulsive action that is normally performed may then not be performed. Naturally, the intensity of the fear builds up slowly during the treatments. Ultimately, this should lead to a situation where only minimal fear or compulsion is evoked. Behavioral therapy appears to be very effective: it has been proven that 85% of patients experience improvement after 10 to 20 treatments. 55% of patients show a large to very large improvement.


There is also the possibility that anti-anxiety medication may be prescribed, such as Fluoxetine. Prozac and Fluox are medications that belong to this group. Unfortunately, medication can cause side effects. Examples include increased anxiety, headaches, sexual problems, insomnia, blurred vision and so on. Fortunately, these side effects are almost always temporary.

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