In obsessive-compulsive disorder (synonyms: Anancasm; anancastic depression; anancastic neurosis; impulsive neurosis; compulsive psychoneurotic reaction; neurotic rumination; psychogenic rumination; psychogenic disorder with obsessive thoughts; psychoneurotic reaction with obsessive thoughts; predominantly compulsive act; predominantly obsessive ritual; obsessive thoughts and obsessive acts, mixed; obsessive action; obsessive ideas; obsessive disorder; obsessive neurosis; obsessive phobia; obsessive reaction; obsessive rumination; obsessive syndrome; obsessive imagination syndrome; ICD-10 F42. -: Obsessive-compulsive disorder) involves repetitive unpleasant thoughts, impulses, or actions that persist for at least 2 weeks on most days, are experienced as belonging to one’s person, and are resisted (at least partially and often unsuccessfully).
Obsessive-compulsive disorder is a neuropsychiatric disorder and belongs to mental disorders.
Obsessive-compulsive disorder can be divided into the following forms:
- Predominantly obsessive thoughts/ruminations (ICD-10 F42.0).
- Aggressiveness
- Religious content
- Sexual content
- Pollution
- Diseases
- Infection, contagion
- Predominantly compulsive acts/rituals (ICD-10 F42.1).
- Collective compulsion
- Repetition compulsion
- Self-chastisement compulsion
- Control compulsion (frequent)
- Washing compulsion (frequent)
- Order compulsion
- Obsessive thoughts and compulsive acts, mixed (in more than 90% of sufferers; ICD-10 F42.2).
- Other obsessive-compulsive disorder (ICD-10 F42.8) – e.g., subclinical form of compulsive acts that is difficult to diagnose
- Obsessive slowness, unspecified (ICD-10 F42.9).
Men are more often affected by control compulsions and women by washing compulsions.
Sex ratio: men and women are equally affected. Some studies have found an increased lifetime prevalence for women. In childhood, boys are affected slightly more often than girls.
Frequency peak: The disorders usually manifest in adolescence (postpubertal) or young adults (< 30 years). They may even occur in children. First-born children are frequently affected. Rarely, persons > 50 years of age are affected. The median age of onset is 20 years.
The prevalence (disease frequency) is 1-3 % (lifetime prevalence; in Germany). Obsessive-compulsive disorders with early onset (childhood and adolescence) occur with a prevalence of 1-3 %. Subclinical OCD occurs with a prevalence of 2%.
Course and prognosis: Often the disorder is not recognized or treated properly. In most cases, 10-17 years pass before the affected persons are adequately treated. The disease is slowly progressive and is often described as chronic. An onset of the disease before the age of twenty is a risk factor for an unfavorable course, especially for men. Obsessive-compulsive disorder causes considerable stress in the daily lives of those affected. The earlier therapy is started, the better the prognosis.
Comorbidities (concomitant diseases): In patients with obsessive-compulsive disorder, considerable psychological comorbidities (depressive disorders, panic disorder, social phobia, eating disorders, alcohol dependence) and dermatological comorbidities (trichotillomania/hair plucking: compulsive pulling out of one’s own hair, dermatitis (inflammatory reaction of the skin) due to excessive hand or body washing) are evident in the course of the disease.
