Obsessive Compulsive Disorder
Obsessive compulsive disorder (OCD) and obsessive-compulsive–related disorder (OCRD) conditions ( i.e., trichotillomania, hoarding disorder, body dysmorphic disorder, excoriation disorder, Tourette’s syndrome) are psychiatric conditions that are fairly common, painful to the patient and their family and depressingly influence the functionality and quality of life. Happily, thrilling treatment advances have confirmed the effectiveness of behaviorally based interferences for OCD, trichotillomania, hoarding disorder, body dysmorphic disorder, excoriation disorder, and Tourette’s syndrome. Though, distribution of such interferences has lagged considerably, and many individuals could not access treatment.
The contamination subtype of obsessive compulsive disorder (OCD) is characterized by beliefs, images, or impulses (obsessions) of dirt, germs, and illness that are typically invasive, repetitive, and overstated afar the genuine possibility of contamination, the spread of germs, or constricting a disease. These contamination-related obsessions creates fear, repulsion, discomfort, and/ or distress and frequently end in compensatory actions, habits, or rituals (compulsions) executed to achieve brief relief or to defuse the worry, such as disproportionate washing, cleaning, or avoidance of contamination-related stimuli or circumstances. The lifetime occurrence of obsessive compulsive disorder is projected to be around 2–3% and approximately 50% of patients note suffering contamination-related symptoms. Obsessive compulsive disorder characteristically follows a chronic course and is amongst the most restricting of psychiatric and medical conditions without sufficient intervention.
Contamination Obsessive Compulsive Disorder
For a person with contamination OCD, possible contaminants can be anywhere and everywhere, including other persons, places, objects, or even the air, regularly holding the patient constantly attentive, anxious, and alert for germs, dust, or other impurities. Even in a apparently innocent environment, such as one’s home, one may run together a series of links to the contaminated external world that leaves the person feeling anxious and in necessity to clean.
Studies propose that contamination OCD symptoms are originated to be linked with poor perception more frequently than other symptom types. The extent of insight the patient has into the overstated nature of their anxieties and needless frequency of the compulsions is a significant qualifier when relating to patients with OCD. Limited or poor perception is often linked with more severe OCD and can make treatment more puzzling. Many patients spot that their contamination-related anxieties are not reasonably linked to the genuine risk. Patients who know that their contamination-related worries and behaviors are irrational may still grip strong dogmas about germs and cleanliness that fall near the extreme end of the cleanliness range when contrasted to the general population.
Many persons with contamination anxiety may have inherited and/ or acquired these dogmas and behaviors from family members. Studies support the heritability of OCD and propose that symptom scopes, such as contamination, may be heritable as well. In youth, childrearing performances can also back the preservation and often exacerbation of OCD symptoms. In addition, family issues such as high family consistency, low family conflict, and low parental blame are considerably associated to better treatment outcome.
Disgust has developed as a key disturbing experience for many patients with contamination OCD. Like fear, avoidance related to a strong disgust response inhibits the individual from learning that disgusting stimuli are not hurtful or unsafe, and that the feared consequence is not likely to come true. With patients for whom disgust is an important part of the emotional pain linked to contamination anxieties, introduction to and tolerance of this feeling is a significant feature of the treatment. Washing and cleaning ceremonies can take up an important quantity of time, frequently leaving these patients late, interference with work or school, and disparaging from social relationships and social circumstances.
Treatment of Contamination OCD
Like most OCD symptoms, cognitive behavioral therapy (CBT), precisely exposure and response prevention (ERP) treatment, to be effective in decreasing contamination OCD symptoms in adults and to increase the quality of life for these patients. Pharmacotherapy with serotonin reuptake inhibitors (SRIs) has also been exposed to be effective in the treatment of OCD. ERP was more successful to the atypical antipsychotic medication risperidone and to placebo in decreasing OCD symptoms and improving perception, functioning, and quality of life. The use of benzodiazepines and antipsychotic drugs were also a common method of treatment in this sample of patients, often in the lack of an SRI medication, notwithstanding limited care for these medications as main interferences for OCD.
In ERP treatment, the patient is slowly put in interaction with feared stimuli, while abstaining from engaging in compensatory compulsions. When ERP is operational, prolonged, and repeated exposure results in familiarization to or learned acceptance of the anxiety and a disappearance of the fear that beforehand triggered compulsive behavior. ERP is a stimulating treatment modality, necessitating motivation, work, and often worry to accomplish benefit. In order to help patients tolerate the contact process, these performances are characteristically done gradually in accordance with a prearranged list made by the patient’s therapist, called an exposure hierarchy. In spite of the challenge intrinsic in ERP treatment, a survey of patient liking found that patients noted preference for ERP or mixture treatment (ERP+medication) over medication alone or other novel and experimental interventions.