Obsessive Compulsive Spectrum Disorders

Obsessive compulsive spectrum disorders (OCSD), commonly referred to as OCD, are serious and often debilitating disorders that are characterized by obsessions and compulsions.

Obsessions are recurrent thoughts, impulses, or images, which are intrusive, usually senseless, sometimes frightening and often repulsive. They may involve repetitive thoughts of:

  • Contamination
  • Worry
  • Doubt
  • Sexuality
  • Violence

Many efforts are made to suppress or resist these thoughts, but the more a person tries to control them, the more powerful they become.

Compulsions are behaviors that are performed persistently and repetitively without leading to an actual reward or pleasure. Often, compulsions are an attempt to make obsessions go away and to reduce the anxiety caused by the obsessions. There is an urgent insistent sense of “I have to do it” inside.

Compulsions are often performed according to certain rules in a very strict or rigid manner, and can result in elaborate rituals. The most common compulsions include:

  • Rituals
  • Hand-washing
  • Counting
  • Checking
  • Touching (especially in a particular sequence)
  • Picking skin or hair
  • Other behaviors that feel necessary to do

There are several conditions that have obsessive-compulsive qualities and are described as Obsessive Compulsive Spectrum Disorders (OCSD):

  • Trichotillomania (hair pulling)
  • Dermatillomania (skin picking)
  • Onychophagia (nail biting)
  • Tourette’s Syndrome
  • Kleptomania (compulsive stealing)
  • Compulsive shopping
  • Body Dysmorphic Disorder (unreasonably feeling a part of the body is excessively ugly)
  • Hypochondriasis (excessive preoccupancy or worry about having a serious illness)
  • Oppositional Defiant Disorder

The course of OCSD is quite varied. Symptoms may come and go, ease over time, or get worse. If the symptoms become severe, OCSD can keep a person from working or carrying out normal responsibilities at home.

Although the exact cause of OCSD is not fully understood, studies have shown that a combination of biological and environmental factors may be involved.

Research shows that OCSD does run in families, and that genes likely play a role in the development of the disorder. However, genetics appear to be only partly responsible for causing the disorder.

Brain abnormalities have also been found in people with OCSD. Brain SPECT studies have shown increased blood flow in the basal ganglia and anterior cingulate gyrus. The anterior cingulate gyrus is involved in allowing a person to shift his or her attention from subject to subject. When this area is overactive, a person gets “stuck” on the same thought or behavior.

Additionally, there is new research showing a link between certain types of infections caused by the Streptococcus bacteria and certain types of OCSD.

Environmental stressors may trigger OCSD in people with a tendency toward developing the condition or cause a worsening of symptoms. These include:

  • Abuse
  • Early childhood trauma or neglect
  • Changes in living situation
  • Illness
  • Work- or school-related changes or problems
  • Relationship concerns
  • Death of a loved one

OCSD, like many other conditions, is not just a single and simple disorder; therefore, treatment is not a one-size-fits-all solution. It is imperative to find out what is causing the symptoms you are experiencing and treat the underlying cause, rather than just trying to fix the symptoms. If we don’t look at the brain, how do we know exactly what we’re treating?

Have a Question?