Septiani De Vinta

154310618

III A D IV Kebidanan

TOPIC : OCD / Obsessive compulsive disorder

Reason :
1. Obsessive compulsive disorders rank fourth from mental
disorders after phobias, substance abuse and severe
depression disorder.
2. The exact number of OCD patients is difficult to know
because the sufferers are generally reluctant to see a doctor.
OUTLINE :

A. DEFENITION
Obsessive-Compulsive Disorder (OCD) disorder is a condition in which the
individual is unable to control his or her obsessive thoughts which he or she does not
expect and repeats several specific actions to control his or her mind to lower his anxiety
level. Obsessive-compulsive disorder is an anxiety disorder in which the individual's life
is dominated by repetatif thoughts (obsessions) which are followed by repetitive actions
to decrease their anxiety.

B. The Compulsive Obsessive Causes are:

1. Genetic - (Hereditary).
Those who have family members who have a history of the disease may be at risk for
OCD (Obsessive Compulsive Disorder).
2. Organic
Organic problems such as neurological problems in certain parts of the brain are also
a factor for OCD. Nerve abnormalities such as those caused by meningitis and
encephalitis are also one of the causes of OCD.
3. Personality
 Those with obsessive personalities are more likely to get OCD disorders. The traits of
those who have this personality are as outrageous about the aspect of cleanliness,
someone who is too obedient to the rules, fussy, difficult to cooperate and not easily
succumb.
4. Past experience
Past / past experiences are also easy to cheer the way a person handles problems by
showing the symptoms of OCD.
5. Obsessive-compulsive disorder is closely related to depression or previous anxiety
history. Some symptoms of obsessive-compulsive sufferers often also show
6. Conflict
Those who experience this disorder usually face a mental conflict that comes from
life problems. For example the relationship between husband and wife, at work,
confidence.

C. INDIVIDUAL RISK
Individuals at risk for obsessive-compulsive disorder are;
1. Individuals who experience problems in the family from broken home, mistakes or lost
childhood. (this theory is still considered weak but still can be taken into account)
2. Neurobilogic factors may include damage to the frontal lobe, basal ganglia and
singulum.
3. Individuals who have high stress intensity
4. History of anxiety disorder
5. Depression
6. Individuals who experience sexual disorders

D. SYMPTOMS
Common obsessions can be anxiety about pollution, doubt, loss and assault. The patient
feels compelled to perform a ritual, that is repeated action, with a specific intent and
intentional.
 1. Most rituals can be seen instantly, such as washing hands repeatedly or checking the
door over and over to ensure that the door is locked. Other rituals are mental activities,
such as counting or repeating statements to eliminate harm.
2. Patients can be obsessed by all things and the ritual is not always logically associated
with the discomfort that will be reduced if the patient runs the ritual. Patients who feel
worried about pollution, his discomfort will be reduced if he put his hand into his
trouser pocket. Therefore every obsession with pollution arises, so he will repeatedly
put his hand into his trouser pocket.

E. THERAPY OR TREATMENT
1. Pharmacotherapy
The efficacy of pharmacotherapy in obsessive-compulsive disorder has been
demonstrated in many clinical trials. The benefits were enhanced by the observation
that the study found the placebo response rate was approximately 5 percent. The
percentage is low, compared with the 30 to 40 percent placebo response rate often
found in antidepressant and anxiolytic drug research.
Available data suggest that drugs, all used to treat depressive disorders or other
mental disorders, may be used within the usual dose range. Initial effects are usually
seen after four to six weeks of treatment to obtain maximum therapeutic benefit.
Although treatment with antidepressant drugs is controversial, some mean patients
with obsessive-compulsive disorder who respond to antidepressant treatments appear
to relapse if drug therapy is stopped.
The standard approach is to initiate with serotonin-specific drugs (for example,
clomipramine (Anafranil) or serotonin-specific reuptake inhibitor (SSRI-serotonin-
specific reuptake inhibitors), such as fluoxetine (Prozac) - and then move on to other
pharmacological strategies if serotonin-specific drugs ineffective Many therapists
strengthen the first drug by adding lithium (Eskalith) Other drugs that can be tried are
monoamine oxidase inhibitors (MAOI, monoamine oxidase inhibitors), especially
phenelzine (Nardil) .The less-studied pharmacological drugs are buspirone (BuSpar)
fenfluramine (Pondimin), tryptophan, and clonazepam (Klonopin).
2. Behavior Therapy
 Although some comparisons have been made, behavioral therapy is as effective as
pharmacotherapy in obsessive-compulsive disorder, and some data suggest that
beneficial effects are long-lasting with behavioral therapy. Thus, many clinicians
consider behavior therapy as the preferred therapy for obsessive-compulsive disorder.
Behavioral therapy can be done in both inpatient and outpatient situations. The main
behavioral approach to obsessive-compulsive disorder is the exposure and prevention
of responses. Decentization, stopping the mind, flooding, implosion therapy, and firm
habituation have also been performed in patients with obsessive-compulsive disorder.
In patient behavior therapy must really run it to get improvement.
3. Psychotherapy
In the absence of adequate research on self-oriented psychotherapy for obsessive-
compulsive disorder, any legitimate generalizations about its benefits are difficult to
make, despite anecdotal reports of success. Individual analysts have seen clearly and
lasted forever a better change in patients with obsessive compulsive personality
disorder, particularly if they were able to come up with aggressive impulses located
behind the nature of the patient's character. Apparently, analysis-oriented psychiatric
and psychiatric physicians have observed significant improvement symptoms in
patients with compulsive obsessive disorders in the course of long-term analysis or
psychotherapy.
Supportive psychotherapy clearly has its part, especially for patients with obsessive-
compulsive disorder which, despite its symptoms varying degrees of severity, is able
to work and make social adjustments. With continuous and regular contact with
interested, sympathetic, and encouraging professionals, patients may be able to
function on the basis of assistance, without which their symptoms will cause them
disruption. Sometimes if obsessional rituals and anxieties reach an intolerable
intensity, patients need to be hospitalized to relieve stress from the external
environment until the symptoms reach a tolerable level.
4. Other Therapies
Family therapy is often useful in supporting families, helping to reduce the disruptive
marital engagement, and establishing a therapeutic bond with family members for the
good of the patient.
Group therapy is useful as a support system for some patients. For patients who are
very resistant to treatment, electroconvulsive therapy (ECT) and surgical
psychosurgery should be considered. ECT is not as effective as psycho-surgery but
may have to be tried before surgery. The most frequent psycho-surgical procedure for
obsessive-compulsive disorder is a singulotomy, which succeeds in treating 25 to 30
patients who are unresponsive to other treatments. The most frequent complication of
psycho-surgery is the development of seizures, which are almost always controlled
with phenytoin treatment (Dilantin). Some patients who do not respond to psycho-
only surgery and who do not respond to pharmacotherapy or behavioral therapy
before surgery respond to pharmacotherapy or behavioral therapy after
psychoanalysis.