Obsessive-compulsive disorder

Introduction Obsessive-compulsive disorder (OCD). It is based on repeated persistent obsessive or 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. The cause is unknown, genetic factors, compulsive personality characteristics and psychosocial factors play a role in the onset of obsessive-compulsive disorder. The formation of compulsive personality is not a one-off event, and must be identified or corrected early in childhood and adolescence.

Cause

First, genetic factors: the same patient rate among patients with close relatives is higher than the average resident. For example, the prevalence of this disease in the parents of the patient is 5 to 7%. The results of the twin survey also support obsessive-compulsive disorder.

Second, personality characteristics: 1/3 obsessive-compulsive patients have a certain degree of forced personality before the disease, and their compatriots, parents and children also have compulsive personality characteristics. It is characterized by restraint, hesitation, frugality, carefulness, careful attention to detail, good thinking, and perfect requirements, but too rigid and inflexible.

3. Mental factors: 35% of the Shanghai survey data have mental factors before the illness. Any social or psychological factors that cause long-term ideological tension 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 cannot be ignored. When the body is not healthy or long-term physical and mental fatigue, it can promote obsessive-compulsive disorder in those with compulsive personality. There are also different explanations about the pathogenesis; the Pavlovian school believes that under the influence of strong emotional experience, the cerebral cortex excitability or inhibition process is excessively tight or conflicting to form an isolated pathologically inert excitatory foci, which is the pathophysiological basis of the obsessive concept. Psychodynamics believe that obsessive-compulsive symptoms are derived from suppressed 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. There is no direct evidence of structural or functional changes in cingulate gyrus that may be associated with the occurrence of obsessive-compulsive disorder.

an examination

First, the symptoms

The clinical manifestations of this disease have the following common characteristics:

(1) Forced symptoms:

Obsessive-compulsive symptoms are not the patient's wishes but are difficult to get rid of and control, making the patient feel anxious and painful.

(2) Obsessive symptoms include:

Forced thinking, forced intentions, forced behaviors, etc., some are related to spiritual factors, the content is not absurd and bizarre, the patient's self-awareness exists, no other mental illness and obvious mental debilitating personality characteristics.

Second, physical examination found

Physical and neurological examination failed to detect signs of yang.

Differential diagnosis

Differential diagnosis of obsessive-compulsive disorder:

1. Schizophrenia: There may be obsessive-compulsive symptoms in the early stage, but the content gradually becomes ridiculous, incomprehensible, without anxiety, pain and other corresponding emotional reactions; poor self-knowledge, not actively requesting treatment or denying illness and refusing treatment, with 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, and depression, lack of interest, 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, and other tests can help identify.

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