OBSESSIVE-COMPULSIVE DISORDER
What is the Obsessive-Compulsive Disorder (OCD)?
The Obsessive–Compulsive Disorder – OCD is characterized by the presence either of obsessions or of compulsive actions, usually of both. These symptoms are quite common in the general population, but in order to speak about a diagnosis such as the Obsessive-Compulsive Disorder (OCD), the symptoms must cause significant functioning impairment and subjective difficulty, and, of course, the patients will have to recognize the irrationality of being occupied with these symptoms.
It is believed that 1-3% of the population presents obsessive-compulsive disorder. This means that in a city such as Athens, it is expected that the Obsessive-Compulsive Disorder (OCD) regards 40,000 to 120,000 of our fellow citizens.
Obsessive-Compulsive Disorder (OCD) belonged, according to the diagnostic manual DSM-IV of the American Psychiatric Association, to the Anxiety Disorders. More recently its properties as a clinical entity were revised, and, at the most recent edition of the DSM-V diagnostic manual, the Obsessive-Compulsive Disorder (OCD) belongs, along with the Body Dysmorphic Disorder (BDD), Trichotillomania / Hair Picking Disorder, Hoarding Disorder, the Compulsive Disorder of Excoriation / Skin Picking Disorder, to the Category of Obsessive Compulsive and Related Disorders – OCRDs.
What are obsessions and compulsions / rituals in Obsessive-Compulsive Disorder (OCD)?
An obsession is defined as an unwanted intrusive thought, image or urge that intrudes/enters repeatedly into a person’s mind. The content of obsessions presents some basic patterns and is categorized in obsessions about infection/cleanliness, order/symmetry, doubt/checking, aggressive/forbidden ideas and hoarding.
The compulsions/compulsive rituals are repetitive behaviors or mental acts that persons with OCD feel they must perform, usually in order to be relieved of anxiety which is caused to them by the content of their obsessions. A compulsion can be either apparent and observable by others, as in the case of checking if the door is locked, or a concealed mental act which cannot be observed, such as the repetition of a particular phrase in the mind of a patient with Obsessive-Compulsive Disorder.
What is the therapy of choice for Obsessive-Compulsive Disorder (OCD)?
Cognitive – Behavioral Therapy (CBT) it is internationally recognized as the therapy of choice and a first-line therapy for a series of disorders, including the Obsessive-Compulsive Disorder (OCD), as it also occurs by the following links on the Internet:
- patient.info/cognitive-behavioural-therapy-cbt
- ocduk.org/nice
- nice.org.uk/guidance/cg31/chapter/introduction
- thementalelf.net
Given the fact that the Obsessive-Compulsive Disorder (OCD) usually requires in parallel medication in its treatment, it is necessary to find/cooperate with a Psychiatrist – Cognitive Behavioral Therapist for the more complete treatment of the disease.
How can I find help for Obsessive-Compulsive Disorder in Athens from a Psychiatrist-Therapist with internationally certified training in Cognitive – Behavioral Therapy (CBT)?
The Psychiatrist Kiosterakis Georgios MD, PhD is a Cognitive Behavioral Therapist (CBT) in Athens and a Certified Member & Therapist of the Greek Association of Behavioral Research – EEES and of the European Association of Behavioral Cognitive Therapy – EABCT.
The Psychiatrist Kiosterakis Georgios is also a certified Therapist in Schema Therapy, an innovative method of the 3d wave of Cognitive Therapies, being a holder of the Advanced Training Certification of the International Society of Schema Therapy – ISST, as it is also described at the webpage of ISST.
Greek Association of Behavioral Research – EEES (eees.gr/θεραπευτές-με-επάρκεια-εκπαίδευσης)
European Association of Behavioral Cognitive Therapy – EABCT (www.eabct.eu)
Is it necessary that I seek help from a Psychiatrist - Cognitive Behavioral Therapist for Obsessive-Compulsive Disorder (OCD)? How difficult is the treatment and/or medication for this disease?
The Obsessive-Compulsive Disorder (OCD) is a specific mental disorder, that must be addressed by a specialist for a proper diagnosis and treatment. Given the fact that the available resources and specialized staff, such as cognitive behavioral therapists, are hard to find in the public health system, research has shown that even in the most advanced in health structures countries, such as the United Kingdom, the patients seek for treatment, on average, 10 years after they began having symptoms of Obsessive-Compulsive Disorder, having exhibited depression, after all these years, as a complication, and having lost hope of an effective treatment of their disorder.
The treatment of choice for Obsessive-Compulsive Disorder consists of the cognitive – behavioral technique of Exposure and Response Prevention- ERP. It is a quite demanding but particularly effective therapeutic technique with spectacular results if it is properly applied. Regarding the pharmacological intervention, it principally takes place with the administration of medicines of the category of Selective Serotonin Reuptake Inhibitors (SSRIs), which are quite widespread medicines of very high efficiency and good tolerability regarding possible adverse side effects.
Given the fact that most of the people who suffer from Obsessive-Compulsive Disorder experience significant improvement thanks to the Cognitive – Behavioral Therapy (CBT) or/and the proper medication, it is quite important that there exists immediate access for specialized help to a specialist Psychiatrist – Cognitive Behavioral Therapist, so that an efficient treatment of a disease with significant burden and chronicity, such as the Obsessive-Compulsive Disorder can take place.
What happens with the other Disorders of the category of Obsessive-Compulsive and Related Disorders - OCRDs, such as the Body Dysmorphic Disorder - BDD, Trichotillomania / Hair Picking Disorder and the Compulsive Disorder of Excoriation / Skin Picking Disorder?
What is the role of Cognitive – Behavioral Therapy (CBT) in their treatment?
The Body Dysmorphic Disorder (BDD) is characterized by the occupation with an imaginary defect in the appearance of a person, or with the disproportionately excessive concern about a possibly existing physical defect. The Body Dysmorphic Disorder is characterized by time-consuming behaviors, such as looking in the mirror, comparing some body characteristics with the ones of other people, the extreme urge to conceal the supposed defect and seeking confirmation of its absence. It is believed that 0.5-0.7% of the population suffer from BDD.
Similar disorders are Trichotillomania / Hair Picking Disorder and the Compulsive Disorder of Excoriation / Skin Picking Disorder, where the patients, in a mentally compulsive way, remove hair from various areas on their body or pick/ scratch their skin, in order to reduce their anxiety or, in general, to regulate their feelings.
The Cognitive – Behavioral Therapy (CBT) has a lot to offer in the case of these disorders, both in the context of addressing the obsessive-compulsive characteristics they present, and with the use of more specialized techniques, such as the behavioral technique of Habit Reversal.
Sources
http://www.patient.co.uk/directory/cognitive-behavioural-therapy-cbt
http://www.nhs.uk/Conditions/Obsessive-compulsive-disorder/Pages/Introduction.aspx
http://www.nice.org.uk/guidance/cg31/chapter/introduction
http://www.ocduk.org/nice