What is obsessive-compulsive disorder?

What is obsessive-compulsive disorder? Obsessive-compulsive disorder

The basic symptoms of obsessive-compulsive disorder include compulsive thinking, compulsive emotion, compulsive intention and compulsive behavior, which can be one of the main symptoms or several symptoms. Clinical research shows that about 75% patients often have obsessive-compulsive ideas and behaviors at the same time, and some researchers even think that 100% patients exist at the same time. However, there are indeed some patients who only have obsessive-compulsive ideas and have no compulsive behavior, and the things that these patients think repeatedly are often related to sexual assault and things that patients think should be condemned.

To sum up, whether it is obsessive-compulsive concept or compulsive behavior, it often has the following characteristics: ① An idea or impulse constantly invades the patient's conscious activities, and the patient is aware of this idea or impulse at this time. ② Obsessive ideas or impulses are often accompanied by obvious anxiety, disgust or fear, so that patients often take some opposite measures to resist the original ideas and impulses. ③ Obsessive concept or behavior is something other than self, which is definitely not what patients think when they experience it. (4) No matter how vivid or serious the compulsive concept or behavior is, most patients can realize that it is irrational and have the desire of compulsive resistance, which is different from the delusion of mental patients. What they think is often the pain and unhappiness of patients. Of course, some patients may not have a strong desire to resist, and sometimes the concepts of coercion and coercion become an overpriced concept. For example, some patients lose their jobs because of forced hand washing, but patients think it is necessary.

Baer( 1994) found that obsessive-compulsive behavior is a typical response to obsessive-compulsive concept through the relationship between the main symptoms of obsessive-compulsive disorder. He divided obsessive-compulsive disorder into three subtypes: type I is symmetrical/collectible, which consists of symmetrical and thrifty obsessive-compulsive concept and order, collectible behavior, repetitive and counting compulsive behavior; Type ⅱ is pollution/inspection type, which is mainly composed of pollution concept and forced behavior of washing and inspection; Type ⅲ is pure compulsion, including a lot of aggressive, sexual and religious compulsion ideas. Clinical observation and research show that the three subtypes of obsessive-compulsive disorder have certain guiding significance for the choice of clinical treatment schemes. The treatment effect of type ⅱ patients is good, type ⅲ patients respond well to drug therapy but poorly to behavioral therapy, type ⅰ patients are difficult to treat, and the drug therapy effect is not as good as that of type ⅲ patients.

The symptoms of obsessive-compulsive disorder patients can be varied, overlapping and changing with time. Common manifestations are as follows:

(A) the concept of coercion

1. Obsessive thinking often shows that some words or short sentences invade the patient's mind, and these words and short sentences often make the patient feel disgusted. For example, a religious person repeatedly invades some obscene and blasphemous words in his mind.

2. Compulsive exhausted the patient's repeated thinking about some common things, concepts or phenomena, asking questions, knowing that it is meaningless and completely unnecessary, but unable to control himself. If you think about it repeatedly, why does the light bulb glow? Why do people have two legs? Why is 1+ 1 equal to 2 instead of 3? When it is serious, it reaches the level of exhaustion, so that it is unwilling to eat, fidgeting, and work and body and mind are seriously damaged. There are also some patients who repeatedly think about some complicated things, such as what will the end of the world look like? When will the earth be destroyed and so on.

3. Obsessive-compulsive disorder patients repeatedly doubt the reliability of what they do, knowing that it is unnecessary, but they can't get rid of it. This is one of the most common symptoms of obsessive-compulsive disorder. In order to alleviate the anxiety caused by compulsive suspicion, patients often check their words and deeds repeatedly, such as checking whether the door is closed to avoid theft, whether the power plug is unplugged to avoid fire, and some cashiers celebrate cash several times or even dozens of times to avoid mistakes. However, no matter what patients suspect, they can realize that things have actually been done.

4. If you are forced to associate an idea or see a sentence in the patient's mind, you will involuntarily associate another idea or sentence, and most of them are opposite sentences. This is called forced opposing thinking. If you think of "peace", you will immediately think of "war". When you see "support", you think of "opposition". Because rational thinking is not the patient's subjective will, the patient feels distressed.

5. Forced to repeatedly and involuntarily recall what the patient has experienced, unable to get rid of it and distressed. For example, when eating, there are some disgusting and dirty scenes that are repeatedly seen. Sometimes the recalled scenes are vivid and lifelike, reaching the level of reappearance, which is called forced reappearance, and its content often makes patients feel embarrassed and sick.

6. Forced fear patients are afraid of losing self-control, madness, cancer, doing things that violate moral customs, such as stabbing others with a knife and losing control. Some patients see something, such as a corpse, a pipe, a person, etc., which will produce an aversion and a bad mood. At this time, it is also called coercion. Different from compulsive intention, patients have no internal driving force to act immediately, and this symptom overlaps with the symptoms of terror.

7. Forcing interested patients to feel a powerful internal driving force to do things against their will, but in fact it will not be directly translated into action. Knowing that it is irrational, absurd and even impossible to do so, I tried to control myself from doing it, but I couldn't get rid of my inner impulse. What you want to do can be a trivial act, or a serious act of cutting others or yourself with a knife. If some patients go to the balcony, they will have the impulse to hold their children in their arms and throw them downstairs. When they see the opposite sex, they will have the impulse to hug and kiss. When they see the TV on, they will have the impulse to smash it. When they stand high, they will have the impulse to jump down. It is worth noting that patients want to do something completely harmless, but they still feel strongly uneasy. Therefore, the key is not the specific way and content of the action, but the patient strongly feels that his will is out of control, which is a terrible experience for the patient.

(2) Forced actions and behaviors

Compulsive actions and behaviors are often subordinate to the concept of compulsion, and compulsive actions can be divided into compliant compulsive actions and antagonistic compulsive actions. Compulsive behavior of obedience and compulsive concept are consistent in the content of compulsive behavior, such as repeated inspection and verification caused by compulsive suspicion and repeated washing caused by compulsive concept of pollution. Antagonistic compulsive behavior is a confrontation with compulsive concept. Being shortlisted to fight against the compulsive concept of obscene content, patients repeatedly recite moral proverbs or political slogans is a typical performance, and various ritualized behaviors such as counting or reciting irrelevant words are also common countermeasures. No matter from obedience or confrontation, it is random at first, and then it is compulsive. At this time, even if the patient doesn't want to, he should force himself to abide by the established rules. As long as he violates this set of rules, the patient will feel anxious. Common specific manifestations of compulsive behavior are as follows:

1. Mandatory inspection

Measures taken to alleviate anxiety caused by compulsive suspicion, such as repeatedly checking whether the doors and windows are closed when going out, whether the power supply is turned off, whether there are children under the car before driving, whether the money is wrong when shopping or collecting money, and whether there are typos in the letter when sending it.

Step 2: Forced washing

This is the most common symptom in compulsive behavior, which stems from the compulsive concept of fear of pollution. In order to eliminate the worry about pollutants, poisons and bacteria, it often takes a lot of energy and time to wash hands, wash clothes, engage in sanitation, disinfection and sterilization, but it is still out of control. Some patients not only wash themselves repeatedly, but also ask people who live with him, such as spouses, children, parents, etc., to wash according to his requirements. This kind of patients think that there are a lot of bacteria in the air, and contact with others or objects will spread diseases. Light people wear masks and gloves when they go out, and heavy people dare not touch anything all day or even raise their hands to go out.

3. Forced ritual movement

Compulsive ritual movements are often developed to counter the anxiety caused by a compulsive concept. Its confrontational actions are either simple or complex, and some are even childish and eccentric. Patients know that it is unnecessary and unreasonable, but if they don't do it, they can't relieve their anxiety and anxiety. For example, a middle school student shakes his head when he starts to have compulsive thoughts, which is really smart. After a few hard shakes, the compulsive thoughts disappeared. However, the good times did not last long, and this method gradually failed, so the patient added an action of patting the table with his hand. This method began to be effective, but the effect gradually declined. At this time, the patient added a chop to strengthen the confrontation. After a long time, the patient developed a complicated ritual procedure: shaking his head several times, then striking the table several times, then chopping off his feet, then shaking his head while striking the table and chopping off his feet, and so on. Distraction can temporarily relieve the symptoms of obsessive-compulsive disorder and reduce tension. Because it is really effective, its role has been strengthened and it is difficult to get rid of it. Similarly, after the patient gets up, he cleans the room according to strict procedures. After the patient finishes eating, put away the cooker according to strict procedures. Before going out, he had to take two steps and take a step back before he dared to go out. When the patient goes up and down the stairs, count the steps. If there is any mistake, he has to do it all over again. Sometimes he remembers unimportant things, such as the number of windows and the number of roadside poles. This is called forced counting.

Step 4 ask compulsive questions

People with obsessive-compulsive disorder often don't believe in themselves. In order to eliminate anxiety caused by doubt or exhausted efforts, they often ask others for assurances repeatedly. There is a symptom that makes family members very embarrassed, that is, repeatedly asking them to answer the same simple question, giving assurances, being entangled, knowing that it is unnecessary, but unable to control it.

5. The slowness of obsessive-compulsive disorder is relatively rare. Patients overemphasize the symmetry or accuracy of things, which leads to compulsive slowness. Patients may spend hours shaving meticulously, counting grain by grain while eating, reading word by word while reading, or concentrate on the first word in the first line without reading the rest smoothly. Some patients clearly know that it is time to go to work, and still wash and dress slowly and carefully.

The above are just common clinical symptoms, and their distinction is also a general and superficial distinction. In fact, the same patient may have multiple symptoms. The study found that adults with obsessive-compulsive disorder and children and adolescents with obsessive-compulsive disorder. There are still some differences in symptoms. Ra *** ussen( 1992) studied the symptom spectrum of 200 adult patients with obsessive-compulsive disorder. The top three obsessive-compulsive concepts are compulsive cleaning (45%), compulsive doubt (42%), compulsive concept about physical condition (36%), followed by compulsive inquiry and compulsive slowness. About half of the patients are forced to take action for some reason. Rapoport( 1998) reported the symptom spectrum of 70 children and adolescents with obsessive-compulsive disorder. The top three obsessive-compulsive concepts are: excessive concern or aversion to body excreta, dirt, bacteria and toxins (43%), fear of some horrible things such as fire, death and loss of loved ones (24%), and excessive attention to the symmetry, accuracy and details of certain things (24%). The top three types of compulsive behavior are: excessive hand washing and bathing, brushing teeth, combing hair and so on. (85%), repeated ritual actions such as going in and out, standing up repeatedly and sitting down repeatedly. (565,438+0%), and repeatedly check doors and windows, electrical plugs, gas pipes, etc. (46%).

In addition, it should be noted that almost all patients with obsessive-compulsive disorder are accompanied by anxiety, and nearly half of them may have depressive symptoms. Some patients' depressive symptoms may be secondary to obsessive-compulsive symptoms, while others may appear independently. The opposite is also common.

The essential reason for the formation of obsessive-compulsive disorder (OCD) is that we always have a strong psychological habit and dislike and like some physical feelings in all aspects of life, such as what we hear, see and think. When this psychological habit accumulates to a certain extent and has a serious impact on our lives, we call it obsessive-compulsive disorder. You can call it Zhang San or Li Si, but this psychological reflection mode is the same. OCD is just one of them. Most people also have it, but this habit is light enough to affect his life, so most people will also have troubles. Judging from most of our consulting cases, many friends with obsessive-compulsive disorder have perfect personalities, either black or white, good or bad, and it is easy to look at the problem in two. When it is not in a perfect state, obsessive-compulsive friends are always used to condemning themselves and not accepting themselves. Obsessive-compulsive disorder (OCD) is such a psychological habit, which accumulates in the little things in life. For some introverts, they may form social phobia, for some people who love thinking, they may form compulsive thinking, for some people who love cleanliness, they may form cleanliness addiction, and for some people who are cautious, they may form uneasy terror. For some people with strong moral concepts, it may lead to moral terror. But some people have perfect requirements for themselves. Why don't people form compulsion, because when people don't reach that perfect state, they won't condemn themselves, or the degree of condemnation is very light, so there will be no conflict in your heart and there will be no obsessive-compulsive disorder. The essence of obsessive-compulsive disorder is that there is conflict, confrontation and binary opposition in your heart. So, perfection is not a problem. The problem is that we can't accept our imperfections. Before we are infinitely close to perfection, we must learn to accept imperfection. Sometimes we accept them for better change. The essential reason of obsessive-compulsive disorder is that we have strong psychological habits of hate and like in life.

1. Obsessive-compulsive disorder is a group of neurosis with obsessive-compulsive symptoms (mainly including obsessive-compulsive ideas and behaviors) as its main clinical manifestations.

2. Etiology of obsessive-compulsive disorder: Anxiety disorder is related to genetic factors, personality characteristics, adverse events and stress factors. , especially closely related to the patient's personality characteristics, such as excessive pursuit of perfection, indecision, caution, stubbornness and so on. With these bad personality characteristics, it is easy to suffer from obsessive-compulsive disorder.

3. Symptoms of OCD generally include: ① OCD patients repeatedly think about some ideas, such as doubt, memory and fatigue; ② Patients with compulsive behavior repeatedly do some unnecessary behaviors, such as repeated examination, repeated hand washing, repeated counting, ritual movements, etc.

Obsessive-compulsive disorder and anxiety disorder are like twins. Obsessive-compulsive disorder patients often have obvious anxiety symptoms.

I. Concept

Obsessive-compulsive disorder (OCD) is a neurosis characterized by obsessive-compulsive ideas and behaviors. The patient realized that it was unnecessary, but he couldn't control it, so he was upset. Their self-awareness is intact and they are eager to seek treatment.

The prevalence of obsessive-compulsive disorder in China is 0.3%. The onset age is mostly 16~30 years old, which is more common in mental workers.

Obsessive concept: compulsive suspicion, locking the door repeatedly and checking repeatedly; Obsessive memory, recalling some past experiences repeatedly, knowing that it lacks practical significance but can't get rid of it; Obsessive thinking, endlessly thinking about some problems that lack practical significance; Compulsive thinking, opposing thoughts appear in my mind, and when I read "war", I think of "peace".

Compulsory actions include: compulsory hand washing, such as repeated hand washing and bathing, knowing that it has been washed clean and can not be controlled; Force counting, count when you see telephone poles, window bars and floors, otherwise you will feel bored; Mandatory ritual actions, as a symbol of good or bad luck, will make you anxious if you don't do these actions.

Biological factors: genetic factors, brain tissue structure (increased frontal cerebral blood flow, increased cerebral cortex metabolism in frontal orbital region, caudate nucleus and basal ganglia).

Psychodynamics: The fierce conflict between ID and ego forms a series of defense mechanisms.

Behaviorism: strengthening behavior through operational conditioning, leading to repeated compulsive behavior or ritualized action.

Cognitive point of view: excessive negative cognition or wrong reasoning about dangerous events hinders its normal processing of information.

Third, clinical manifestations

Obsessive conceptual thinking (forced doubt, forced memory, forced exhaustion)

Obsessive emotion-worry

Forced intention-impulse

Forced behavior-action (forced inspection, forced cleaning, forced counting, forced ritual action)

Four. treat cordially

Psychotherapy: psychoanalytic therapy, desensitization therapy, shock therapy, Morita therapy, etc.

Drug therapy: antidepressants (clomipramine, serotonin reuptake inhibitor) and anti-anxiety drugs.

Obsessive-compulsive disorder, also known as obsessive-compulsive neurosis, or obsessive-compulsive disorder, is a neurosis with obsessive-compulsive symptoms, which is manifested as conscious self-compulsion and anti-compulsion. The intense conflict between them makes patients feel anxious and painful. The main clinical manifestations are compulsive concept, compulsive intention and compulsive action.

OCD is the most common type of anxiety. Patients always have compulsive thoughts and behaviors repeatedly in their lives, which makes them feel uneasy, panic or worried, thus repeating their behaviors and actions.

Obsessive-compulsive disorder (OCD) is the fourth most common mental problem in the world, and its incidence is as common as asthma and diabetes, with an incidence of 2%.

Obsessive-compulsive disorder or obsessive-compulsive neurosis is a kind of neurosis and anxiety disorder. Patients with this disease are always troubled by an obsessive-compulsive thinking. Patients have repeated obsessive-compulsive ideas and behaviors in their lives. The patient's self-awareness is intact, knowing that it is unnecessary and even painful, but he can't get rid of it.

Obsessive-compulsive disorder (OCD) is a recurring thought, image and impulse that can cause obvious anxiety, pain or fear. Subjects hate them, but they can't be stopped.

Common symptoms are:

1, persistent irrational fear or doubt, usually always feel sick or dirty.

2. I am fascinated by something that is arranged in order or in a certain way.

3. Always worry that your thoughts or actions will hurt yourself or others.

4. meaningless hoarding of goods.

5. Irrationally doubt or worry that you will hurt others.

6. Wash your body or clean your room repeatedly.

7. Check things repeatedly, such as whether the door is locked.

8. Keep saying the same thing or counting.

9. I'm used to saying a word or the same name repeatedly, or walking in the same place repeatedly and in the same way.