What OCD is
OCD is different from being tidy or meticulous. People with OCD usually recognize that the thoughts are excessive but cannot push them away, and the rituals take time, cause distress and interfere with life.
Signs and symptoms
Common obsessions:
- Fear of contamination or illness
- Persistent doubts (leaving the door unlocked, the stove on)
- Unwanted aggressive, sexual or religious thoughts
- Need for symmetry, order or exactness
Common compulsions:
- Repeated hand-washing or cleaning
- Checking doors, stoves or documents many times
- Counting, repeating words or ritualized praying
- Arranging objects until they feel “right”
How it is diagnosed
The diagnosis is clinical. The psychiatrist assesses the type of obsessions and compulsions, the time spent on them, the distress and impairment they cause and how far the person recognizes them as excessive, and screens for associated conditions such as depression, other anxiety disorders and tics.
Treatment
- Cognitive behavioral therapy with exposure and response prevention, the psychotherapy with the best evidence in OCD
- Medication, when indicated, often at doses and for periods different from those used in depression, with close follow-up
- Guidance for the family, who often take part in the rituals without meaning to
When to see a psychiatrist
When obsessions and rituals take more than an hour a day, cause distress or interfere with work, studies and family life.
Follow-up at the practice
At Dr. Petrus Raulino’s practice in Campinas, treatment is planned after a detailed assessment and reviewed at follow-up visits, in person or by video, together with psychotherapy.
Staging: text awaiting medical review by Dr. Petrus before publishing.
This content is for information only and does not replace a medical consultation. Diagnosis and treatment depend on an individual assessment. In crisis or having thoughts of suicide? In Brazil call 188 (CVV, 24 hours, free) or go to the nearest emergency room. In an emergency, call 192 (SAMU).