personality disorder obsessive compulsive

personality disorder obsessive compulsive: causes, symptoms, diagnosis and treatment.

Definition

personality disorder obsessive compulsive (OCD) is a mental disorder characterized by intrusive thoughts, images, or ideas (obsessions) and repetitive behaviors (compulsions).

Causes of personality obsessive compulsive disorder

The disease develops in adolescence and young age (the average age of onset of OCD is 19-20 years). In the adult population, women are more often ill, and in childhood - boys.

personality disorder obsessive compulsive is more common than in the general population in schizophrenia, bipolar disorder, anorexia nervosa and bulimia nervosa, and Tourette's syndrome.

Doctors identify the following factors that contribute to the development of personality disorder obsessive compulsive:

• genetic disorders;
• hyperactivity in certain areas of the brain (prefrontal cortex, anterior dentate gyrus, and caudate nucleus);
• changes in the content of various metabolites (serotonin, dopamine) in the structures of the brain (cortico-striatal-thalamo-cortical circuit (CSTCS));
• abnormal functioning of brain receptors;
• anatomical abnormalities (in the CTCS, in the dorsomedial prefrontal cortex, inferior frontal gyrus, and cerebellum);
• disturbances in the transmission of nerve impulses.

Triggering factors for the development of OCD can be:

• autoimmune process in the body;
• acute reaction to stress;
• hormonal fluctuations in the premenstrual and postpartum periods;
• acute cerebrovascular accident, traumatic brain injury;
• neurosurgical interventions.

Factors that may contribute to the unfavorable course of the disease:

• concomitant mental disorders (personality disorder, depression, schizophrenia spectrum disorder, etc.);
• unfavorable social and family conditions (loneliness);
• unfavorable lifestyle (stress, sedentary lifestyle, lack of a healthy regime of work and rest);
• poor adherence to prescribed treatment;
• alcohol and psychoactive substance abuse.

Classification of the disease

According to the International Statistical Classification of Diseases and Related Health Problems:

• Predominantly intrusive thoughts or ruminations.
• Predominantly compulsive action (compulsive rituals).
• Mixed obsessive thoughts and actions.
• Other obsessive-compulsive disorders.
• Obsessive-compulsive disorder, unspecified.

Symptoms of personality disorder obsessive compulsive

The development of OCD can be gradual or acute (for example, after an infectious disease or traumatic brain injury).

OCD can manifest as obsessions, compulsions, obsessions, and compulsions at the same time.

Obsessions are annoying and unwanted repetitive, persistent thoughts, ideas, or impulses that cause suffering and anxiety in the patient. Patients try to ignore, avoid or suppress them with other thoughts or actions (performing rituals).

Depending on the content, the following types of obsessions are distinguished:

• obsession with infection and pollution, accompanied by actions aimed at cleansing, washing, etc.;
• intrusiveness of an aggressive, sexual or religious nature;
• obsessive thoughts associated with symmetry, accompanied by an obsessive rearrangement of furniture, rearrangement of things, or other actions;
• obsessive desire for hoarding ("Plyushkin's syndrome").

The recurring thoughts and ideas that constantly visit the patient are involuntary and almost always distressing.

Compulsions (rituals) are repetitive excessive actions that a person performs out of a sense of necessity in connection with intrusive thoughts (obsessions), in accordance with the rules that require accuracy in execution, in order to achieve a sense of completeness.

Obsessive rituals are not a way to get pleasure. Their goal is to relieve anxiety and discomfort caused by obsessions. The action is based on the fear of danger to which the patient himself may be exposed or to which he may expose another. The patient believes that in this way he prevents an unpleasant event. Often a person understands the meaninglessness and inefficiency of such behavior and tries to resist it.

If compulsive actions can still be suppressed, then anxiety becomes more pronounced.

Patients with personality disorder obsessive compulsive have varying degrees of senselessness and excessiveness in their obsessive thoughts and rituals. The degree of criticality depends on individual characteristics and may change as the disease progresses.

In some patients, obsessive thoughts can transform into delusional ones.

The main symptoms that are present in patients with OCD are:

• an exaggerated sense of responsibility for upcoming events and a tendency to exaggerate the negative consequences of failure;
• perfectionism and inability to tolerate uncertainty;
• overestimation of the importance of their thoughts;
• belief in the possibility and need to control their thoughts;
• suicidal behavior.

Patients with OCD are concerned about:

• discomfort from overcoming intrusive thoughts and rituals;
• the need to spend more and more time on rituals, rechecks;
• anxiety, a feeling of "incompleteness" with the "wrong" order of one's own or even other people's actions;
• restriction of social activity due to behavioral characteristics.

Obsessions and compulsions can vary in frequency and intensity, from minor to persistent distressing symptoms that reduce the ability to work and quality of life.

Without treatment, the disease usually becomes chronic, avoidance behavior is formed when patients avoid people, things, places that increase obsessions and compulsions.

Diagnosis of personality disorder obsessive compulsive

Diagnosis of OCD is based on a detailed analysis of the patient's condition, aimed at identifying the time of onset and the nature of the course of the disease, assessing the dynamics of avoidant behavior, obtaining objective medical history data from the patient's relatives, identifying a psychiatric history, assessing the risk of developing self-injurious and suicidal behavior, physical examination data (measurement of height, body weight, level of physical development, integrity of the skin, identification of traces of self-damaging behavior).

Criteria for establishing the diagnosis of OCD:

• obsessions and compulsions present for at least two weeks;
• obsessions and compulsions are not the result of other mental disorders;
• obsessions or compulsions cause distress or interfere with the patient's activities by wasting time;

obsessions and compulsions include all of the following:

1. perceived by the patient as originating in his own mind,
2. repeated and unpleasant to the patient,
3. the patient tries unsuccessfully to resist them,
4. Compulsive acts and obsessive thoughts do not cause pleasant sensations.

To exclude other pathology, laboratory and instrumental research methods are used:

• a clinical blood test with the determination of hemoglobin concentration, the number of erythrocytes, leukocytes and platelets, hematocrit and erythrocyte indices;
• general urinalysis;
• biochemical blood test, including total protein, albumin, protein fractions, assessment of kidney function indicators (urea, creatinine, glomerular filtration), assessment of liver function indicators (bilirubin, ALT, AST), assessment of carbohydrate metabolism: glucose, glucose tolerance test with determination of glucose in venous blood on an empty stomach and after exercise after 2 hours;