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Symptoms of Obsessive-Compulsive Behavior

Obsessive-compulsive disorder (OCD) is classed as an anxiety disorder in DSM-IV. OCD has two symptom clusters: Obsessional thoughts (ruminations) and compulsive actions (rituals). Most patients have a mixture of both symptoms. Approximately 1.5 per cent of the population at any given time will suffer from OCD. The condition affects people irrespective of class, race, culture or gender. Normal obsessions also occur in the vast majority of people (for example, checking our children at night when newborn).

However, such obsessions are generally considered useful or slightly annoying and do not interfere with our day-to-day lives to a significant level or cause significant distress. It is when the obsessions become major preoccupations and have no significant rationale sense that they become pathologized. The most common themes of obsessions are:

1 being contaminated (for example, germs, dirt, diseases; and sufferers will be afraid of touching things for fear of becoming contaminated or passing on contaminants);

2 doubting, whereby, a sufferer may suddenly worry in case they haven’t locked their house properly, or may be driving down the street, and suddenly worry that they hit someone or ran over someone;

3 violent thoughts or imagery (for example, thoughts to kill one’s own children, partner, or to harm oneself);

4 sexual thoughts or imagery (for example, thoughts to run through the church service naked);

5 orderliness, where objects have to be lined up or arranged in a particular way (for example, at right angles to each other).

Common compulsions include:

1 washing or hygiene rituals (usually in the context of obsessions about cleanliness, germs, etc.);

2 repeated checking (usually in the context of obsessive doubting including seeing if the door is locked; the gas or taps are off; electricity is unplugged, etc.);

3 counting (usually there is a ‘magical number’ and the person has to do a behaviour a set number of times, for example, washing each finger 7 times then each hand 7 times);

4 Reassurance seeking, whereby the person will constantly seek reassurance from their partner, health care professional, friend, etc., that things are all right (for example, ‘Did I lock the door? Are you sure? Did you see me do it? Did I do it properly? Are you sure?’).

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