Obsessions are not always considered obsessive compulsive disorder. It is not obsessive compulsive disorder that a father frequently checks the gas in order to ensure the safety of his children and his family, locks the doors and windows at a certain time every night before going to bed, or stays out of bed on the right side every morning due to the belief of the person, and constantly enters the toilet with his left foot.

Obsessive compulsive disorder (OCD) diagnosis : 

Obsessions are not always considered obsessive compulsive disorder. It is not obsessive compulsive disorder that a father frequently checks the gas in order to ensure the safety of his children and his family, locks the doors and windows at a certain time every night before going to bed, or stays out of bed on the right side every morning due to the belief of the person, and constantly enters the toilet with his left foot.

For an obsession to be obsessive-compulsive disorder, it must severely limit the person’s daily activities and prevent their vital activities.



The diagnosis of obsessive compulsive disorder is made by interviewing the patient, obtaining information from the family, and excluding other possible diseases.

Obsessive compulsive disorder diagnostic criteria:

  • Obsessions, compulsions, or both:

Obsessions:

  • Recurrent and persistent thoughts, urges, and phantasies that are sometimes forced and involuntary and often cause anxiety or distress.
  • These thoughts, impulses, and fantasies in the person are not just extreme sadness over real-life problems.
  • The person tries to ignore or suppress these thoughts, impulses, or neutralize them with another thought or action.
  • The person sees these thoughts, impulses or phantasies as a product of his own mind.

Compulsions:

  • Repetitive behaviors (e.g., handwashing, ordering, checking) or mental acts (e.g., praying, counting, uttering certain words silently) in response to an obsession or according to strict rules don’t keep saying it)
  • Behaviors or mental actions are aimed at relieving or reducing distress or avoiding a fearful event or situation; however, these behaviors or mental acts are either not realistically related to what they are designed to neutralize or protect, or are clearly too extreme.
  • The obsessions or compulsions cause marked distress, are time-wasting (take more than 1 hour a day), or significantly interfere with the person’s usual routine, occupational (or educational) functioning, or usual social activities or relationships .
  • The disorder is not due to the direct physiological effects of a substance (eg, a drug of abuse or a therapeutic drug) or a general medical condition.
  • If there is another disease, the content of the obsessions or compulsions is not only related to this disease (eg, the person who has an accident and has a serious scar on his face constantly thinks about his face, tries to cover it up; if he has an eating disorder, he keeps thinking about food).

While making the diagnosis, the patient’s opinion about the obsessions and compulsions and whether they are real or not are taken. Family history is also investigated.

Obsessive compulsive disorder (OCD) treatment : 

The main purpose of treatment is to improve functionality with alleviation of symptoms.

Medication :

  • SSRIs (selective serotonin reuptake inhibitors) may be used. Sertraline, fluvoxetine, fluvoxamine, paroxetine, citalopram, escitalopram can be used in this area. The duration of treatment is up to 12 weeks. The treatment is evaluated, if the expected effect is achieved, it is extended to 1 year. It may be the first choice due to the low incidence of side effects.
  • Clomipramine: It is recommended to be added to the treatment, but like other tricyclic antidepressants, it may have side effects such as sexual dysfunction, dry mouth, and weight gain.
  • Behavioral therapy : It is aimed to fight obsessions that cause anxiety in the patient and to get rid of compulsions. Like exposing the patient to the feared situations in a controlled manner.
  • Cognitive therapy : It is aimed to bring less disturbing comments to the patient’s uneasy thoughts. They are taught that their thoughts are less likely to materialize. It is tried to be replaced with more realistic thoughts.
  • Cognitive behavioral therapy : It is aimed to help the patient acquire new behaviors and fight stress by using learning strategies.
  • Psychoanalysis or psychotherapy : Methods of combating anxiety and depression are taught to the patient, family, social and work life is tried to be organized.



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