Obsessive Compulsive Disorder: Causes and Symptoms

Obsessive Compulsive Disorder: Causes and Symptoms

Obsessive Compulsive Disorder: Causes, Symptoms, and Treatment

There is a vast literature on  obsessive compulsive disorder ( OCD ) and most of the theories can be traced back to a marked sense of guilt  and a strong  fear of criticism found in OCD  patients.

Those who suffer from  OCD , in general, have a critical insight, that is, they realize that the compulsions implemented are exaggerated compared to the perceived threat, however they cannot behave differently.


  • DSM-V diagnostic criteria
  • OCD subtypes and symptoms
    – checker symptoms
    – washer
    – order and symmetry
    – endogenous obsessions
  • Obsessive Compulsive Disorder: Causes
    – Genetic and Neurobiological
    – Psychological Causes – Vulnerability Factors in Childhood
  • Obsessive Compulsive Disorder: Treatment
    – Drug Therapy and Psychotherapy

DSM-V diagnostic criteria

The  diagnosis of obsessive compulsive disorder  is based on the presence of obsessions and compulsions. The DSM-5 clarifies the definition of  obsessions  and  compulsions . In particular, the obsessions:

  • They are defined by recurring thoughts, impulses or images. Thoughts are intrusive, persistent, and unwanted.
  • The person tries to ignore, suppress or neutralize those thoughts, impulses or images.

Compulsions are defined by:

  • Repetitive behaviors or thoughts that the person feels pushed to implement to prevent their malaise or a feared event.
  • The person feels compelled to engage in repetitive behaviors or thoughts in response to obsessions or according to strict rules.
  • Actions are excessive or unlikely to prevent the feared situation.

Obsessions and compulsions are time consuming or cause a clinically significant level of malaise or malfunction.

OCD has a comorbidity with  accumulation disorder (serial accumulator) and body dysmorphic disorder ; these three conditions are partially overlapping as regards their etiology.

Subtypes of OCD, classification by symptoms

At a descriptive level, clinical psychology has identified four particular types of OCD, divided according to symptoms, these are: checker, washer, order and symmetry and the category of “inconvenient thoughts” where typical symptoms are related to endogenous obsessions. All OCD patients  feel obligated to go through the ritualized procedure that serves to neutralize obsessive thinking or relieve anxiety and related discomfort.


Checkers are obsessed with the idea that something may have gotten out of their control and that, as a result, a catastrophe may occur that they are responsible for. Compulsions are  controlling . For example: check over and over again that you have locked the car, carefully fix the gas key several times to make sure it is closed and repeat the act of locking several times.


Washers are  obsessed with the idea of ​​being contaminated  with material that is “disgusting” or harmful to health. The  compulsion , in this case, is  washing . Washing does not have to be rough but careful. Critical insight is present in most patients with OCD, however the logic can be of the doxastic type, that is, the critical sense is lacking in situations that the patient perceives as a threat. To give an example, in the case of the Washer subtype, the patient knows that there is a low probability of contracting HIV.

Order and symmetry

In this case,  OCD  manifests itself with the unpleasant and persistent feeling that  something is out of place : things are not as they should be and the  compulsions  are aimed at putting in order and neutralizing any risks. The result pursued in compulsions aims at perfection because the  feeling that things are not in their place  is unbearable.

Endogenous obsessions

In this case, the  obsessions  manifest themselves with forbidden, blasphemous, taboo thoughts, perverse ideas or aggressive and violent images. Compulsions vary a lot from case to case. Some patients neutralize endogenous obsessions by counting, others employ  prayer formulas  . Intrusive images and aberrant thoughts materialize in the mind of the OCD patient, what is striking is the nature of these obsessions which are placed in antithesis to the natural laws of life (blasphemous thoughts in a church, incestuous thoughts, violent images…).

Obsessive Compulsive Disorder: Causes