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Obsessive-Compulsive Disorder is characterised by obtrusive, uncontrollable thoughts, or obsessions, and compulsive actions or rituals. Obsessions and compulsions can occur separately, or in conjunction.
Obsessions are very uncomfortable thoughts, images, or impulses that appear involuntarily, and are usually associated with feelings of anxiety, revulsion, or shame. Typical themes of obsessions are ideas associated with hurting other people inadvertently (especially loved ones), performing obscene acts in public or doing something profane in a religious environment. Very common are also thoughts and worries that something in the house has not been locked or switched off properly. The gist of an obsessive thought is in many cases that something terrible might happen or that one might cause something terrible to happen. Because these thought processes evoke anxiety, the person usually tries to suppress these thoughts, to counteract "bad" thoughts with "good" thoughts, or to reduce the anxiety with the help of a ritual.
Compusions are recurring, often stereotypic and ritualised behaviours that a person repeatedly performs, even though he or she might be fully aware that the behaviour is exaggerated or irrational, e.g. excessive hand washing, showering, or cleaning, repeated checking of electrical appliances or locked doors, mental counting or repeated vocalising of certain words. Compulsions or rituals serve to reduce discomfort or anxiety associated with obsessive fears and imagery.
Obsessions and compulsions can be very debilitating. They may last for hours every day and cost enormous amounts of energy, preventing the individual from leading a normal life. Often, the impact on social relationships is quite severe, and the person feels isolated and excluded. Formerly, obsessions and compulsions were said to be difficult to treat. Nowadays, however, a range of treatment options is available. Cognitive-behavioural treatment techniques are usually considered as a first-line treatment.