Obsessive-compulsive disorder
A debilitating psychiatric disorder characterized by anxiety-provoking intrusive thoughts (obsessions) that lead to stereotyped motor, cognitive acts, or rituals that are performed (compulsions) to relieve the associated anxiety 1).
It affects up to 2% of the population and is the 10th leading cause of disability worldwide 2) 3).
12–20% of cases remain refractory to standard behavioral psychotherapy and medical treatment with serotonin reuptake inhibitors (SSRI) or atypical antipsychotics 4).
DBS targets explored for OCD include the anterior limb of the internal capsule (ALIC), nucleus accumbens (NAc), ventral capsule / ventral striatum (VC/VS), subthalamic nucleus (STN), and inferior thalamic peduncle (ITP) 5) 6)
The FDA recently granted a humanitarian device exemption approving the use of VC/VS DBS for medically intractable OCD.
Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by intrusive thoughts that produce uneasiness, apprehension, fear or worry (obsessions), repetitive behaviors aimed at reducing the associated anxiety (compulsions), or a combination of such obsessions and compulsions.
Symptoms
Include excessive washing or cleaning, repeated checking, extreme hoarding, preoccupation with sexual, violent or religious thoughts, relationship-related obsessions, aversion to particular numbers and nervous rituals such as opening and closing a door a certain number of times before entering or leaving a room. These symptoms are time-consuming, might result in loss of relationships with others, and often cause severe emotional and financial distress. The acts of those who have OCD may appear paranoid and potentially psychotic. However, people with OCD generally recognize their obsessions and compulsions as irrational and may become further distressed by this realization.
A number of psychological and biological factors may be involved in causing obsessive-compulsive disorder.
Other disorders with similar symptoms include obsessive-compulsive personality disorder (OCPD), an autism spectrum disorder, or disorders where perseveration (hyperfocus) is a feature in ADHD, PTSD, bodily disorders, or just a habit problem.
Scales
Standardized rating scales such as Yale Brown Obsessive Compulsive Scale can be used to assess the severity of symptoms.