Obsessive-Compulsive Disorder (OCD)

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Obsessive-Compulsive Disorder (OCD)

Emotional Impact:

Depression

Social withdrawal

Feelings of shame or embarrassment

Anxiety and distress

Treatment Approaches:

Lifestyle changes: stress management, mindfulness, exercise

Support groups and peer support

Medication (e.g., selective serotonin reuptake inhibitors or SSRIs)

Cognitive-Behavioral Therapy (CBT), particularly Exposure and Response Prevention (ERP)

Long-Term Outcomes:

Preventing relapse with consistent follow-up care

Building resilience through coping strategies

Role of ongoing therapy

Importance of early intervention

Associated Disorders:

Excoriation (skin-picking)

Trichotillomania (hair-pulling)

Hoarding Disorder

Body Dysmorphic Disorder

Causes & Risk Factors:

Family history of anxiety disorders

Environmental factors (e.g., traumatic events)

Brain structure and functioning (e.g., overactivity in certain neural pathways)

Genetic predisposition

Behaviors

Compulsions:

Arranging items until “just right”

Counting or repeating actions

Repeated checking

Excessive cleaning/washing

Obsessions:

Unwanted sexual or aggressive thoughts

Doubts about safety (e.g., leaving doors unlocked)

Fear of contamination

Intrusive thoughts

Pathophysiology

Key Brain Regions:

Thalamus:

Hyperactivity in this region reinforces obsessive thoughts and behaviors.

Acts as a relay station, filtering sensory information.

Basal Ganglia:

Dysfunction contributes to compulsive behaviors.

Plays a role in the initiation and control of movements and habits.

Includes structures like the striatum.

Anterior Cingulate Cortex (ACC):

Dysregulation leads to heightened awareness of perceived "errors."

Associated with error detection and emotional regulation.

Orbitofrontal Cortex (OFC):

Overactivity in the OFC contributes to excessive worry and intrusive thoughts.

Involved in decision-making and evaluating rewards.

Brain Circuitry Dysfunction

Associated with hyperactivity in specific brain regions,

Cortico-striato-thalamo-cortical (CSTC)

Involves complex interactions between brain circuits

Environmental factors

Epigenetics:

Environmental stressors, infections (e.g., PANDAS syndrome), and trauma may modify gene expression and contribute to OCD development.

Neuroinflammation:

Elevated cytokines and inflammatory markers in OCD patients suggest a possible role of immune dysregulation.

PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections):

Inflammatory processes may alter brain function in susceptible individuals.

In some cases, OCD is triggered by autoimmune responses following streptococcal infections.

Genetic

Variants in genes regulating serotonin (e.g., SLC6A4), glutamate, and dopamine pathways have been implicated.

Family studies indicate a heritability rate of 45-65% in first-degree relatives.

Neurotransmitters

Glutamate:

Emerging research implicates glutamate in OCD, suggesting excitatory-inhibitory imbalances in neural circuits.

Dopamine:

Hyperactivity in the striatum exacerbates compulsions.

Altered dopamine activity may influence compulsive behaviors and habit formation.

Serotonin (5-HT):

SSRIs (Selective Serotonin Reuptake Inhibitors) help restore serotonin balance.

Dysregulation affects mood, anxiety, and inhibitory control.

Reduced serotonin signaling is a significant factor in OCD.