Fact sheet on Obsessive-compulsive disorder and comorbid disorders with Aspergers and Autism, two Autism Spectrum Disorders


Obsessive-compulsive disorder (OCD) is a psychiatric disorder; more specifically, it is an anxiety disorder. OCD is manifested in a variety of forms, but it is most commonly characterized by a subject’s obsessive, distressing, intrusive thoughts and related compulsions (tasks or rituals) which attempt to neutralize the obsessions.

The phrase “obsessive-compulsive” has worked its way into common use in English, and is often used in an offhand manner to describe someone who is meticulous or absorbed in a cause. Such casual references should not be confused with obsessive-compulsive disorder which is a specific and well-defined condition.


Obsessive-compulsive disorder can be a common comorbid condition with autism and Aspergers syndrome because of the tendency to become fixated and obsessive over certain ideas, objects and activities. As a rough rule of thumb, a child or adult may be diagnosed when life is seriously disrupted by obsessive thoughts and/or compulsions.


Diagnosis of Obsessive-compulsive Disorder

To be diagnosed with Obsessive-Compulsive Disorder, one must have either obsessions or compulsions alone, or obsessions and compulsions, according to the DSM-IV-TR diagnostic criteria. The Quick Reference to the diagnostic criteria from DSM-IV-TR (2000) describes these obsessions and compulsions as recurrent and persistent thoughts, impulses, or images that are experienced at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress – the thoughts, impulses, or images are not simply excessive worries about real-life problems. The person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action. The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind.


Compulsions are defined as repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly. The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive.

In addition to these criteria, at some point during the course of the disorder, the sufferer must realize that his/her obsessions or compulsions are unreasonable or excessive. Moreover, the obsessions or compulsions must be time consuming (taking up more than one hour per day), cause distress, or cause impairment in social, occupational, or school functioning. OCD often causes feelings similar to that of depression.

Examples of OCD include:
Repeated hand-washing.
Arranging or counting objects in patterns
Having to “cancel out” bad thoughts with good thoughts
A fear of contamination by germs
A need for both sides of the body to feel even
Obsessions about getting hurt or hurting others.
Most OCD sufferers are aware that such thoughts and behavior are not rational, but feel bound to comply with them to fend off feelings of panic or dread. Because sufferers are consciously aware of this irrationality but feel helpless to push it away, untreated OCD is often regarded as one of the most vexing and frustrating of the major anxiety disorders.]


Causes of Obsessive-compulsive Disorder

The community of scientists studying obsessive-compulsive disorder has been split into two factions — psychological causes and biological causes. The former group believes that OCD is caused when people believe that they are personally responsible for the obsessional thoughts they experience. This exaggerated sense of responsibility makes sufferers more anxious, keeping the distressing thought in their mind. They try to avoid this feeling of responsibility by performing compulsions.

The latter group includes scientists who believe that obsessive-compulsive behavior is caused by abnormalities in the brain. A majority of researchers now believe in this biological hypothesis of OCD. Some research has discovered a type of size abnormality in different brain structures. The majority of researchers believe that there is some type of abnormality in the neurotransmitter serotonin, among other possible psychological or biological abnormalities; however, it is possible that this activity is the brain’s response to OCD, and not its cause. Recent research has revealed a possible genetic mutation that could be the cause of OCD.


Treatment of Obsessive-compulsive Disorder

OCD can be treated with Behavioral therapy, Cognitive therapy medications, or any combination of the three. Psychotherapy can also help in some cases, while not being one of the leading treatments. The specific technique used in Cognitive Behavioral Therapies is called Exposure and Ritual Prevention.


This involves gradually learning to tolerate the anxiety associated with not performing the ritual behavior. At first, for example, someone might touch something only very mildly “contaminated” (such as a tissue that has been touched by another tissue that has been touched by the end of a toothpick that has touched a book that came from a “contaminated” location, such as a school.) That is the “exposure.” The “ritual prevention” is not washing.

Medications used to treat OCD include selective serotonin reuptake inhibitors (SSRIs) as well as tricyclic antidepressants. SSRIs seem to be the most effective drug treatments for OCD, and help about 60% of OCD patients, but do not “cure” OCD. While parents of children diagnosed with OCD will understandably be reluctant to consider medication, it can have good results, particularly if cognitive therapies have had limited or no success.


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This autism fact sheet is licensed under the GNU Free Documentation. It is derivative of an autism and Asperger's syndrome-related articles at http://en.wikipedia.org

Obsessive-compulsive disorder (OCD) is a an anxiety disorder commonly associated with Autism, Asperger syndrome and other autism spectrum disorders