Obsessive–compulsive spectrum

Conditions

The following conditions have been hypothesized by various researchers as existing on the spectrum.

• Body dysmorphic disorder
• Some forms of delusional disorder
• Eating disorders, including anorexia nervosa, bulimia nervosa and binge eating disorder
• Hypochondriasis
• Kleptomania
• Impulse control disorders in general
• Olfactory reference syndrome
• Paraphilias
• Pathological gambling
• Pica
• Non-paraphilic sexual addictions
• Tourette syndrome
• Stereotypic movement disorder
• Body-focused repetitive behaviors, such as trichotillomania
• Autism spectrum disorder
• Social phobia
• Compulsive hoarding
• Depersonalization-derealization disorder However, recently there is a growing support for proposals to narrow down this spectrum to only include body dysmorphic disorder, hypochondriasis, tic disorders, and body focused repetitive behaviors.

Body dysmorphic disorder

Main article: Body dysmorphic disorder

Body dysmorphic disorder is defined by an obsession with an imagined defect in physical appearance, and compulsive rituals in an attempt to conceal the perceived defect. Typical complaints include perceived facial flaws, perceived deformities of body parts and body size abnormalities. Some compulsive behaviors observed include mirror checking, ritualized application of makeup to hide the perceived flaw, excessive hair combing or cutting, excessive physician visits and plastic surgery. Body dysmorphic disorder is not gender specific and onset usually occurs in teens and young adults.

Hypochondriasis

Main article: Hypochondriasis

Hypochondriasis is excessive preoccupancy or worry about having a serious illness. These thoughts cause a person a great deal of anxiety and stress. The prevalence of this disorder is the same for men and women. Hypochondriasis is normally recognized in early adult age. Those with hypochondriasis are constantly thinking of their body functions, minor bumps and bruises as well as body images. Hypochondriacs go to numerous outpatient facilities for confirmation of their own diagnosis. Hypochondriasis is the belief that something is wrong but it is not known to be a delusion.

Tic disorders

Tourette's syndrome is a neurological disorder characterized by recurrent involuntary movements (motor tics) and involuntary noises (vocal tics). The reason Tourette's syndrome and other tic disorders are being considered for placement in the obsessive compulsive spectrum is because of the phenomenology and co-morbidity of the disorders with obsessive compulsive disorder. Within the population of patients with OCD up to 40% have a history of a tic disorder and 60% of people with Tourette's syndrome have obsessions and/or compulsions. Also, 30% of people with Tourette's syndrome have clinically diagnosable OCD. Course of illness is another factor that suggests correlation because it has been found that tics displayed in childhood are a predictor of obsessive and compulsive symptoms in late adolescence and early adulthood. However, the association of Tourette's and tic disorders with OCD is challenged by neuropsychology and pharmaceutical treatment. Whereas OCD is treated with SSRI, tics are treated with dopamine blockers and alpha-2 agonists.

Trichotillomania

Trichotillomania is a body-focused repetitive behavior disorder which causes an individual to pull out their hair from various parts of their body without a purpose. The cause for trichotillomania remains unknown. Like OCD, trichotillomania is not a nervous condition but stress can trigger this habit. For some people pulling their hair out of boredom is normal, but that is not the case for someone that is dealing with trichotillomania. Emotions do not affect the behavior but these behaviors are more prevalent in those with depression. Review articles recommend behavioral interventions such as habit reversal training and decoupling.

References

Sources

References

1. McElroy SL. (October 1994). "Obsessive compulsive spectrum disorder". The Journal of Clinical Psychiatry.
2. Brakoulias, V. (2011). "Obsessive-compulsive spectrum disorders: a comorbidity and family history perspective". Australasian Psychiatry.
3. Mayo Clinic Staff. "Obsessive-compulsive disorder (OCD)". Mayo Clinic.
4. "Quizlet: Abnormal Psych Ch 6 vocab".
5. (1996). "Body dysmorphic disorder as an obsessive-compulsive spectrum disorder". Actas Luso-españolas de Neurología, Psiquiatría y Ciencias Afines.
6. (1995). "Body dysmorphic disorder: an obsessive–compulsive spectrum disorder, a form of affective spectrum disorder, or both?". The Journal of Clinical Psychiatry.
7. (1998). "Is olfactory reference syndrome an obsessive–compulsive spectrum disorder?: two cases and a discussion". The Journal of Neuropsychiatry and Clinical Neurosciences.
8. Blaszczynski A. (February 1999). "Pathological gambling and obsessive–compulsive spectrum disorders". Psychological Reports.
9. (December 2008). "Is Pica an eating disorder or an obsessive–compulsive spectrum disorder?". Progress in Neuro-psychopharmacology & Biological Psychiatry.
10. (2008). "Symptom Overlap between Autism Spectrum Disorder, Generalized Social Anxiety Disorder and Obsessive-Compulsive Disorder in Adults: A Preliminary Case-Controlled Study". Psychopathology.
11. (1999). "Depressive comorbidity of panic, social phobic, and obsessive–compulsive disorders re-examined: is there a bipolar ii connection?". Journal of Psychiatric Research.
12. (September 2003). "Obsessive-compulsive spectrum disorders". Dialogues in Clinical Neuroscience.
13. "Body dysmorphic disorder - Symptoms and causes".
14. (2004). "Advances in the behavior analytic treatment of trichotillomania and Tourette's Syndrome.". Journal of Early and Intensive Behavior Intervention.
15. (2012). "Complementary medicine, self-help, and lifestyle interventions for Obsessive Compulsive Disorder (OCD) and the OCD spectrum: A systematic review". Journal of Affective Disorders.