Assessing and treating obsessive compulsive disorder in practice

Health professionals in primary care may be the first to notice or hear of patients who are experiencing obsessive compulsive disorder. While care from specfic professionals is likely to be needed, Andy Young explains how practice nurses can direct the care for these patients Obsessive compulsive disorder (OCD) is a mental health condition in the which the quality of the sufferer's life is adversely affected by intrusive or inappropriate thoughts and actions. People with OCD have repetitive thoughts that cause anxiety symptoms. In order to control these thoughts and their associated unpleasant effects, the person develops behaviours they feel might prevent the thought from becoming reality. OCD is found in 1% of the UK population, affecting men and women equally. There is evidence to suggest that OCD runs in families and has some genetic basis, and it appears to be partly caused by alterations to the balance of serotonin and/or dopamine in the brain. OCD often develops in childhood or young adulthood, and the presence of obsessive and compulsive phenomena may require referral and treatment from Child and Adolescent Mental Health Services. ‘Pathological doubting’ and the inability to distinguish between the memory of real or imagined actions is a central feature of OCD, especially compulsions associated with the disorder. The primary care team have an opportunity to recognise OCD symptoms and intervene before the condition worsens and the patient requires hospitalisation.