According to the classification of DSM-5, obsessive compulsive disorder (ocd) is a disorder characterized by the presence of obsessions and/or compulsions.
The obsessions are the thoughts, impulses, or images are recurrent and persistent that are experienced as unwanted, while the compulsions are behaviors or mental actions that are repetitive, that an individual feels compelled to perform in response to an obsession or according to rules that must be applied rigidly.
Obsessive-compulsive they differ from the normal worries and rituals of the development, because they are excessive or persist over the appropriate periods of evolution.
As you experience the compulsive disorders?
Obsessions
The obsessions is similar to thoughts (e.g. contamination), images (for example, violent scenes, or to the whims of wings) or pulse (e.g. stab someone) repetitive and persistent. Patients who suffer from the DOC do not live the obsessions as pleasant or voluntary, but on the contrary, as intrusive and unwanted and because of discomfort and anxiety marked in most individuals. The individual attempts to ignore and suppress this obsession (for example, avoiding trigger factors or repressing the thoughts), or to neutralize it with other thoughts or actions (for example to put in place a compulsion).
Compulsions
The compulsions (or rituals) are repetitive behaviors (for example, washing, checking) or shares mentali (for example, counting, repeating words and mentally) that the person feels compelled to put in place in response to an obsession or according to rules that must be applied rigidly. The majority of individuals with ocd have both obsessions that compulsions. Compulsions are usually put in place in response to an obsession (for example, thoughts of contamination leading to the rituals of washing, or the thought that something is wrong leads to repeat the ritual until you perceive that what is “right”).
The goal is to reduce the discomfort triggered by obsessions or to prevent a feared event (e.g. illness). However, these compulsions they are not connected in a realistic way to the feared event (for example, to Organize the objects symmetrically to prevent damage it is a loved one) or are clearly excessive (for example, taking a shower for hours every day). The compulsions are not act for pleasure, although some individuals derive relief from anxiety from the discomfort.
The compulsions and obsessions, must make be time consuming or cause significant distress or impairment in functioning in order to justify a diagnosis of ocd.
Content
The specific content of obsessions and compulsions varies between individuals. However, certain themes, or dimensions, are common, including those of cleaning (obsessions of contamination and cleaning functions); of symmetry (Or sessions of symmetry and compulsions of repetition, order, and counting); of thoughts forbidden or taboo (obsessions aggressive, sexual and religious and related compulsions); of damage (fear of harm to themselves or others, and related compulsions of control).
Reactions
Individuals with ocd experience a variety of emotional responses the situations that trigger obsessions, and compulsions. For example, many people experience a marked anxietythat can include recurrent attacks of panic. Others report strong feelings of disgust. During the implementation of the compulsions, some individuals report a distressing sense of incompleteness or restlessness until things don't seem “right”. It is common to theavoidance of people, places and things that are important for the obsessions and compulsions, for example, individuals with the concern of contamination can avoid public situations to reduce exposure to contaminants feared or individuals with thoughts, intrusive-related harm may avoid social interactions.
Prevalence, onset and causes
Obsessive compulsive disorder strikes in the span of life, which is about 2-3% of the population. The DOC begins, frequently, teen. It is, however, observed in the last years an increase of cases of DOC in children with symptoms almost identical to those of the adults. Typically, the onset of the disorder, obsessive compulsive disorder in children and adolescents is more common in males and is often associated with a greater severity of symptoms.
The causes that lead to develop an obsessive compulsive disorder are varied, as with many psychiatric disorders, and mainly fall into two groups: the psychological causes and those of the biological and genetic. To date, the literature does not show any definite answers, it is still likely to exist, and the causes predisposing, causes, precipitating factors that maintain the disorder.
Disorders related to the DOC
Disorder dismorfismo body
It is characterized by cognitive symptoms such as the perception of flaws or imperfections in appearance the physical that are not observable or appear only slight to the other, and repetitive behaviors (for example, look in the mirror, caring excessively about her appearance, stuzzicarsi the skin, or search for insurance), or mental actions (for example, compare their physical appearance with that of others) in response to concerns related to appearance. Concerns about the appearance are better justified by concerns related to body fat or weight in an individual with the eating disorder. The dismorfismo muscle it is a form of disorder dismorfismo body characterized by the conviction that their body build is too small or insufficiently muscular.
Noise from build-up
It is characterized by persistent the difficulty of throwing away or separate their belongingsregardless of their real value, as a result of a strong perceived need to save items and distress associated to throw them away. In some cases result in the accumulation of a number of possessions that congest and clutter up the living spaces to the point of compromising significantly to the intended use. Form acquisition excessive noise from build-up, which is a excessive collect, buy, or steal objects that are not needed or for which there is no space available.
Trichotillomania, and the disorder excoriation
The trichotillomania characterized by the recurrent tearing hair or hair, which leads to loss of hair and repeated attempts to decrease or stop the tear hair or dander. The disorder excoriation it is characterized by the applicant stuzzicamento of the skin that brings skin lesions and repetitive attempts to reduce stop the stuzzicamento. The repetitive behaviors focused on the body that characterize these two disorders are triggered by obsessions or worries, however, may be preceded or accompanied by various emotional states such as feelings of anxiety or boredom. May be preceded also by an increased sense of tension, or they can bring gratification and pleasure, or a sense of relief.
How we deal with the DOC (and related topics) in the Center Tice?
International guidelines indicate in drug therapy and cognitive-behavioral therapy treatments demonstrated at the time the most effective.
The care with drug it is important to relieve the crippling symptoms. In particular, many SSRIS have been shown to be effective in the treatment of ocd, reducing the symptoms significantly, improving the mood and reducing anxiety. However, it is important to emphasize that, in the treatment of these disorders, the drug therapy may be different between the individual and the individual, both for the choice of the drug for the recommended dosage. For these reasons, it is always important to rely on a psychiatrist for a correct drug, taking into account the individual variables of the subject.Tice, he collaborates with various doctors psychiatrists to ensure continuity and monitoring of the intervention, a coordinated and synergistic.
In the treatment of ocd, a strategy, cognitive-behavioral, which is very effective is Exposure with Response Prevention (E/RP). This treatment requires the patient's exposure to stimuli that provoke obsessions (for example, touch something dirty). Once you have exposed the patient to avoid which of these put in place the compulsive behaviors letting anxiety in order to placate him, of course.
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Mindfulness is a meditative practice that consists in the pay attention to the present moment with an attitude that is friendly and non-judgmentalby helping to mull less on the past and worry less about the future. Programs, cognitive-behavioral, integrating the mindfulness approach (MBCT), help patients better tolerate the painful emotions and to take away from one's own thoughts negativthe, and are especially useful in the relapse prevention. To TICE, we propose individual paths or in a group to raise awareness through meditation.
Depending on requirements, we offer support parental for young patients with a diagnosis of ocd. The psychological counseling helps family members to develop the emotional impact of having a loved one with a diagnosis of ocd, and explores the how can better support them. Is provided information on the ways to communicate and to put limits effective and loving.
Mindfulness is a meditative practice that consists in the pay attention to the present moment with an attitude that is friendly and non-judgmentalby helping to mull less on the past and worry less about the future. In the course of the last thirty years, numerous studies have demonstrated the effectiveness of the practice of mindfulness in clinical settings, in particular for the treatment of anxiety disorders. To TICE, we propose individual paths or in a group to raise awareness through meditation.
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Adolescents and children with ocd can be isolated from the other and are in need in different situations. The Centers TICE act as a sheltered environment in which to test your social skills, being frequented by many children, and kids that learn to communicate in a constructive and positive manner. through the observance of the rules, the development of the drug more effective, and the ability to decode the emotional state of others, to be able to respond and interact appropriately and functional. For this reason, the Centers TICE become a place of the protected exposure and experiential learning, in which learning by doing, and with the constant support of the adult to the self-monitoring.