况利《精神病学教学》3.2anxiety disorders -OCD-huhua.pdfVIP

Anxiety Disorders Mental Health Center the first affiliated hospital of Chongqing Medical University Hu hua Definition  This disorder is a kind of anxiety disorders predominated by obsessive symptoms.  The feature is coexistence of conscious self- obsession and anti-obsession, the sharp conflicts of the two give patients anxiety and affliction. Definition  The patients have the experience of ideas or impulses ,but against own will;  they try to resist but unable to control;  they are aware of abnormality of obsessive symptoms, but unable to break away. Epidemiology  The estimated lifetime prevalence of OCD is approximately 2.5%, with a 1 year prevalence of 1% in males and 1.5% in females.  The condition usually begins in adolescence or early adulthood. Etiology Pathogenesis  There is some evidence of a genetic component  there is greater concordance of OCD in monozygotic than dizygotic twins  OCD clusters in families and appears to have a partly hereditary basis.  The biochemical and anatomic bases of OCD:  dysfunction of serotonin neurotransmission in a circuit involving the orbital cortex, caudate, globus pallidus, and thalamus may play a prominent part Manifestations Symptoms– Features of OCD  There are two main types of symptom.  First, obsessions:  Obsessional thoughts or image have been described as intrusive thoughts or image that the subject actively resists but cannot get rid of, although he/she realizes they are senseless, unreasonable, unnecessarily and unpleasant.  Eg: obsessional doubt/dirt/contamination/harm to others/sex or blasphemy/urges  Second, compulsions:  Repetitive behaviors (eg, hand washing, ordering, chec