What Comorbidities Exist with Severe OCD?

Severe OCD

An Exploration of Psychiatric Comorbidities in Severe OCD Patients 

Severe OCD is a serious and debilitating mental health condition. This chronic psychiatric disorder is distinguished from others by two distinct elements: obsessive thoughts and compulsions. The intrusive thoughts are pervasive and detrimental to health and wellness, functionality, and day-to-day living. The recurring behaviors – the compulsions – are designed to quell the obsessive thoughts. It’s a vicious cycle. Unfortunately, OCD is often under-diagnosed. People with this mental health disorder tend not to seek treatment for many years before the OCD becomes extremely problematic. A stigma remains about seeking help for psychiatric disorders, and OCD fits snugly into that spectrum. Among others, OCD sufferers battle with a variety of topics including cleanliness, hygiene, order, perverse thoughts, symmetry, et al. But the most striking statistic to emerge from the studies indicates that up to 90% of OCD sufferers actually have other psychiatric comorbidities. 

Topping the charts is the following list of comorbidities*:

  • Mood disorders – 63.3%
  • Anxiety disorders – 75.8%
  • Impulse control disorders – 55.9%
  • Substance abuse disorders – 38.6%
  • Major Depressive Disorder – 40.7%

Other comorbidities associated with OCD include nervous disorders, hypochondriasis, and attention deficit hyperactivity disorder. Given that OCD is largely hereditary, with substantial genetic studies being conducted on this topic, families can expect a 45% – 65% genetic contribution to their severe OCD. Obsessive-compulsive disorder symptoms are varied and include an unreasonable fear of contamination, a constant need to get things in order, aggressive and overpowering thoughts about losing control of one’s life and causing substantial harm to others, and a perpetual feeling of uncertainty. 

Obsessive symptoms can also include unpleasant sexual fantasies or images or causing grievous bodily harm to crowds of people. The symptoms of compulsions are evident for all to see. Constant hand washing, cleaning, organizing, counting, rituals, arranging, stacking, checking, locking/unlocking et cetera.


What are mood disorders?

A mood disorder is more severe than a passing or temporary feeling of sadness. It is characterized by overwhelming feelings of despair, hopelessness, and depression. According to the DSM-V manual of mental disorders, there are several categories of depression, notably bipolar disorder, major depressive disorder, and dysthymia. Mood disorders are not limited to negative feelings, they also reference elevated moods.  


What are anxiety disorders?

Anxiety disorders differ from occasional anxiety related to fear, stress, or concern. Anxiety is essential to our survival – it’s the element that gives rise to fight or flight, sharpening our senses and protecting us from harm. However, anxiety disorders are characterized by constant fear, concern, and worry. The symptoms of anxiety disorders are so overwhelming that they interfere with every conceivable aspect of daily life. There are many different types of anxiety disorders, notably separation anxiety disorders, agoraphobia, social phobia, simple phobias, panic disorder, and generalized anxiety disorder (GAD).


What are impulse control disorders?

Impulse control disorders are mental health conditions where people find it extremely difficult to control their impulses. Often, people with impulse control disorder behave in a way that is contrary to accepted societal behavior, and oftentimes illegal. According to DSM-IV, some 10.5% of the population has an impulse control disorder, with a greater propensity towards the male sex. Various types of impulse control disorders exist, notably conduct disorder, kleptomania, oppositional defiant disorder, intermittent explosive disorder, and pyromania.


What are substance-use disorders?

A substance use disorder/substance abuse disorder is a serious and debilitating mental health condition. This disorder largely relates to drugs and alcohol and is evident when the individual starts experiencing major problems at home, at school, or at work. It is unknown what causes substance use disorder, but it is often a combination of factors including a mental health disorder such as depression, anxiety, emotional hardship, peer pressure, or the effects of alcohol, drugs, or chemicals. The most commonly abused substances include marijuana, LSD, depressants, opiates, amphetamines, etcetera.


What is Major Depressive Disorder?

Major Depressive Disorder (MDD) is otherwise known as unipolar depression. It is treatable, provided the right combination of medication and therapy is administered. Major depression is described as a severe form of depression where there are intense feelings of sadness, lack of interest, fatigue, misery, despair, and the like. It is a persistent, and unrelenting form of depression with no ups – unlike bipolar depression. The medical community understands major depressive disorder and has a well-established framework in place for treating patients with MDD.

Often, MDD may not respond well to certain antidepressants. In instances like this, treatment-resistant depression requires a different approach. A medical practitioner may need to test multiple medications at different doses to find one that works to his theory alleviate the symptoms of depression in the patient. Alternative treatments (somatic) or combined treatments are certainly effective with MDD, notably therapy, surgical and nonsurgical alternatives. Females are disproportionately represented with major depressive episodes and severe impairment, likely a result of depression occurring alongside other medical conditions such as pregnancy, and hormonal changes.


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