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Obsessive Compulsive Disorder (OCD)

Q: In the recent Singapore Mental Health Study (SMHS) conducted in 2010, Obsessive Compulsive Disorder (OCD) emerged as one of the top three most common disorders in Singapore. What is OCD and how does a person develop this condition?

Obsessions are defined as recurrent persistent ideas, thoughts, images or impulses. A person may develop compulsions to reduce the anxiety caused by his obsessions. These may include repetitive and purposeful behaviours or mental acts that must be applied rigidly. Common obsessions include irrational fears of contamination with dirt or germs, fear of hurting someone, distressing sexual or religious thoughts, a desire to hoard or a need for symmetry and exactness. Up to 72 percent of sufferers have multiple obsessions. Common compulsions include checking, cleaning and washing, counting, hoarding and mental ruminations. Up to 58 percent of sufferers have multiple compulsions. The symptoms are distressing, time consuming and significantly interfere with a person’s normal routine, work, or social activities and relationships.

About 30 percent of people with OCD also have hoarding behaviour. They acquire excessive items and have great difficulty discarding them, even if they are apparently useless items. Their homes are usually filled with excessive clutter and they feel distress if they cannot hoard. Patients with OCD may have co-morbid depression where they worry incessantly, often overwhelmed by repetitive negative thoughts. Both psychological and biological factors have been found to play a role in causing OCD.


Q: Where can people with these conditions turn to for help?

They can see a general practitioner for the first assessment. If necessary, the doctor may refer the patient for specialist treatment. The main mode of treatment is behavioural therapy where the patient is deliberately exposed to obsessional cues, and then prevented from engaging in the repetitive behavior triggered by the cues. With repeated and prolonged exposure, the person is able to stop engaging in his repetitive behavior. Drugs may also be used to manage depression and anxieties.

Q: How do friends and family help someone who has this problem?

As family members are often ignorant about the disorder, they may be drawn into the patient’s rituals. It is important to involve them in the management of patients with OCD, to help them understand the symptoms so that they may offer support to the affected person.

Case Study: A Patient's Triumph over OCD

Jay Ang (not her real name) thought that she was just a perfectionist until she realised that she has OCD. 

"I was never contented with the quality of my work. I felt it could be done better. I kept redoing and perfecting things." This became a debilitating condition because her productivity dropped. She did things very slowly because she was spending too much time on things that were not important.

"It affected my capacity to prioritise things," she recalled. Her personal relationships also became affected and she became anti-social and withdrawn.

But, things turned around for her after she saw a psychiatrist.

Read her full story here.


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