Obsessive-compulsive disorder
Introduction
Introduction to OCD Obsessive-compulsive disorder (OCD) is characterized by repeated persistent obsessive-compulsive or/and forced movements. These symptoms are out of the patient's heart, but are not experienced and voluntarily produced, but rather the patient is unwilling to think about it. Knowing that it is unreasonable, but not able to get rid of it, makes the patient feel pain, and is incompatible with his own personality. basic knowledge The proportion of illness: 0.005%-0.007% Susceptible people: no special people Mode of infection: non-infectious Complications: anxiety
Cause
OCD
Personality characteristics (25%):
1/3 of patients with obsessive-compulsive disorder have a certain degree of forced personality before their illness, and their compatriots, parents and children also have compulsive personality characteristics, which are characterized by restraint, hesitation, frugality, careful and careful, excessive attention to detail, good thinking, requirements Perfect, but too rigid and inflexible.
Mental factors (35%):
In Shanghai survey data, 35% of patients have mental factors before their illness. Any social psychology factors that cause long-term mental stress, anxiety and anxiety, or accidents that cause heavy mental blows are all predisposing factors for obsessive-compulsive disorder.
In the occurrence of obsessive-compulsive disorder, social psychological factors are one of the pathogenic factors that can not be ignored. When the physical health is poor or the long-term physical and mental fatigue, it can promote obsessive-compulsive disorder in obsessive-compulsive persons. There are also different interpretations on the pathogenesis; The Luo Luofu school believes that under the influence of strong emotional experience, the cerebral cortex excites or inhibits the process of excessive tension or conflict to form an isolated pathologically inert excitatory foci, which is the pathophysiological basis of obsessive-compulsive thinking. The psychodynamics believe that obsessive-compulsive symptoms originate from repressed Aggressive impulses or "sexual desires", some people use learning theory to explain that obsessive-compulsiveness is the result of stimulating anxiety and establishing a conditional connection between the concepts. The saying that the over-reaction may be related to the occurrence of obsessive-compulsive disorder is still lacking. Direct evidence of structural or functional changes brought back.
Genetic factors (20%):
The same patient rate among the close relatives of the patients is higher than that of the general residents. For example, the prevalence of the disease in the parents is 5 to 7%. The twin pregnancy results also support the obsessive-compulsive disorder.
Prevention
OCD prevention
The formation of compulsive personality is not a one-off event, and must be identified or corrected early in childhood and adolescence.
Patients with obsessive-compulsive disorder have a strict relationship with their parents' parenting styles, stereotypes, and pursuit of perfect life patterns. We ask our children to develop serious and meticulous living habits from an early age. This is correct, but not excessive and extreme.
Everyday life should be combined with easy-going and flexible style. The basic point is to adapt to the society. It is consistent with the psychological characteristics of most people. It cannot be seriously deviated. Once you find a compulsive personality defect, you must go to the medical neurology clinic to actively rectify.
In addition, it should be understood that prevention of compulsive personality defects is important for the prevention and treatment of obsessive-compulsive disorder
First of all, don't care too much about self-image, don't pursue perfection too much, don't always ask yourself if I am doing well, this will not work, others will see me and other issues.
Secondly, learn to let it go. Another characteristic of obsessive-compulsive disorder is that you like to think about it. A big sesame thing often comes up with big things. So when thinking about problems, you must learn to accept others, dont dig into the corners, and learn to adapt to the environment. Don't deliberately change the environment.
Third, learn to enjoy the process, but not pay attention to the results, do what you do, do things with a kind of appreciation, feeling, experience happy mood and enthusiasm to pay attention to the process, do not pay too much attention to the results.
Fourth, have a correct and objective understanding of their own personality characteristics and diseases, have a correct and objective judgment on the actual situation, lose the spiritual burden to reduce insecurity, learn a reasonable stress treatment method, enhance self-confidence, and reduce its Uncertainty, not too high, but not the pursuit of excellence to reduce its sense of imperfection.
Fifth, family members and friends are not cuddling and arrogant to patients, and encourage patients to actively engage in beneficial cultural and sports activities, so that they are gradually freed from the forced situation.
Sixth, when self-regulation can't solve the problem, ask a psychiatrist or psychiatrist to perform psychotherapy, such as behavioral therapy, cognitive therapy, psychoanalytic therapy, etc. Systematic desensitization therapy can gradually reduce the number and time of repeated behavior of patients. .
Complication
OCD complications Complications
Generally, the onset is slow, the course of disease is long, the symptoms can last for many years or when the time is light and heavy, the pre-existing personality characteristics are obvious, the age of onset is earlier and the course of disease is longer, the prognosis is poor, and the symptoms gradually decrease with age; Obvious mental factors, compulsive personality characteristics are not significant, the course of disease; short, no positive family history of the symptoms may also spontaneously relieve.
Symptom
Obsessive-compulsive symptoms Common symptoms Anxiety Compulsive dedication Thoughts Compulsive repetitive obsessive-compulsive personality Compulsive behavior Mandatory thinking Child movement retardation Obsessive-compulsive disorder Compulsive sexual behavior Compulsive association
Symptoms vary from one symptom to another, or several symptoms. The symptoms can be relatively fixed over a period of time, and the symptoms can change over time.
First, the concept of obsession
That is, some kind of association, concept, memory or doubts are stubbornly repeated and difficult to control.
(1) Forced association: Repeatedly recalling a series of unfortunate events will happen. Although it is impossible to know, it cannot restrain and stimulate emotional tension and fear.
(2) Forced Memories: Repeatedly recalling the irrelevant things that have been done. Although they know that there is no meaning, they cannot restrain, and they cannot be repeated.
(3) Forced doubts: Whether the actions of oneself are correct, and generate unnecessary doubts, must be verified repeatedly. If you doubt whether the doors and windows are indeed closed after going out, repeat the inspection several times. Otherwise, I feel anxious.
(4) Compulsive and exhaustive thinking: Repeated thinking about natural phenomena or events in daily life, knowing that there is no meaning, but not restraining, such as repeated thinking: "Why is the house facing south instead of north?"
(5) Forcing opposing thoughts: Two opposite words or concepts appear repeatedly in the brain, and they are distressed and nervous. If they think of "support", they immediately appear "oppose"; when they say "good people", they think of "bad guys". Wait.
Second, forced action:
(1) Forced washing: Washing hands or washing things repeatedly, the heart can never get rid of "feeling dirty", knowing that it has been washed, but can not be homemade, not washed.
(2) Forced inspection: usually coincides with forced doubts. The patient is not assured of the things that have been known to be done, and repeatedly checks, such as repeatedly checking the locked doors and windows, and checking the written bills, letters or documents.
(3) Forced counting: Uncontrollable number of steps, electric poles, do a certain number of actions, or feel uneasy if you miss it.
(4) Forced ritual action: Before daily activities, first make a set of actions with certain procedures. For example, before going to bed, you must order the shoes to be undressed and placed according to the fixed rules. Otherwise, you will feel uneasy and re-wear your clothes and shoes. Then follow the procedure.
Third, the forced intention:
In some cases, the patient has a thought that is contrary to the situation at the time, but can not control the appearance of this intention, very distressed. When the mother took the child to the river, she suddenly thought of throwing the child into the river. Although no corresponding action occurred, the patient was very nervous and afraid.
Examine
Obsessive-compulsive disorder
Physical and neurological examination failed to detect signs of yang.
Diagnosis
Diagnosis and diagnosis of obsessive
diagnosis
Diagnosing obsessive-compulsive disorder is not a very difficult thing. The main basis for psychiatrists to diagnose obsessive-compulsive disorder is: the patient's medical history provided by the family (time of illness, poor performance, etc.), mental examination (by talking with the patient) Inspection results), physical examination, scale test, laboratory auxiliary examination, etc. The commonly used forcing scale in the clinic is the Yale Brown Forced Force Scale, which judges the severity and improvement of the condition by the score of the scale.
Differential diagnosis
1. Schizophrenia: There may be obsessive-compulsive symptoms in the early stage, but the content gradually becomes ridiculous and incomprehensible. There is no corresponding emotional reaction such as anxiety and pain; the self-knowledge is poor, and the patient is not actively required to treat or deny the disease and refuses treatment; With the development of the disease, the characteristic symptoms of schizophrenia gradually emerged.
Second, depression: patients with obsessive-compulsive disorder due to illness, long-term cure, can produce depression, and even negative attitudes, but no suicidal behavior, lack of interest in the outside world with depression, slow thinking, slow behavior and low mood,
Third, temporal lobe epilepsy: occasionally there may be obsessive attitudes and behaviors, presenting seizures, and other symptoms of temporal lobe epilepsy, EEG, EEG topographic maps and other tests can help identify.
