Obsessive-Compulsive disorder is a disorder characterized by the presence of obsessions and/or compulsions. The obsessions or compulsions are either time consuming of more than 1 hour per day or cause clinically significant distress and/or impairment. Other related disorders include body dysmorphic disorder and hoarding disorder. These disorders have a prevalence around 2% and exhibit very high rates of comorbidity. These disorders also share genetic vulnerability.
Obsessive-compulsive disorder is a diagnosis based on the presence of obsessions and/or compulsions in which most people experience both and often before the age of 14. Obsessions are intrusive and persistent thoughts, images, or impulses that are uncontrollable and are often experienced as irrational. Typically, a person spends hours immersed in obsessions with the most common obsessions being contamination, responsibility for harm, sex and morality, violence, religion, and symmetry/order. Compulsions are repetitive, clearly excessive behaviors or mental acts to reduce anxiety and are extremely difficult to resist the impulses that may involve elaborate behavioral rituals. Compulsive gambling, eating, etc are NOT considered compulsions because they are pleasurable. Compulsions are motivated by the desire to reduce anxiety. The DSM-5 criteria defined obsessions by recurrent, intrusive, persistent unwanted thoughts, urger, or images in which the person has tried to ignore, suppress or neutralize the thoughts, urges, or images. Compulsions are defined by repetitive behaviors or thoughts that the person feels compelled to perform to prevent distress or a dreaded event. The person feels driven to perform the repetitive behaviors or thoughts in response to obsessions or according to rigid rules and the acts are excessive or unlikely to prevent the dreaded situation. The obsessions or compulsions are either time consuming of more than 1 hour per day or cause clinically significant distress and/or impairment.
The next form of treatment for people with OCD who are resistant to pharmacological treatments is brain stimulation. However, not much was mentioned in the powerpoint about further types of brainstimulation. A method of brain stimulation is repetitive transcranial magnetic stimulation (rTMS). A research article assessed how affective rTMS was as a form of treatment for OCD. The purpose of the study was to evaluate the efficiency and safeness of rTMS in OCD patients with emphasis on their dorsomedial prefrontal cortex. The methods involved administering 20 sessions of a low frequency rTMS to 20 patients with OCD during 10 weekdays using a twice daily protocol. The results showed that the symptoms exhibited in the patients with OCD had significantly decreased over the period of treatment. This suggests that tRMS if a safe and effective treatment that can help treat symptoms in not only OCD, but anxiety and depression as well.
Tandt, H. L., Van de Velde, N., De Witte, S., Audenaert, K., Baeken, C., & Lemmens, G. M. (2020). Is twice daily LF-rTMS a viable treatment option for treatment-resistant OCD? Results from an open-label feasibility study. European Archives of Psychiatry and Clinical Neuroscience, 271(1), 211–214. https://doi.org/10.1007/s00406-020-01142-x