Obsessive-Compulsive Disorder (OCD)

In our clinic we offer help for a range of anxiety disorders, including obsessive-compulsive disorder, using neuropsychological and neuromodulation methods.

Information about the disorder:

Obsessive-compulsive disorder (OCD) is an anxiety disorder that affects 2-3% of the population. It is characterised by intrusive thoughts that produce uneasiness, apprehension, fear or worry, and by repetitive behaviours aimed at reducing the associated anxiety. Everyone double checks things sometimes; such as checking to make sure the stove or iron is turned off before leaving the house. However, people with OCD feel the urge to check things repeatedly, or have certain thoughts or perform routines and rituals over and over. These thoughts and rituals cause distress and affect the person’s daily life.

Obsessions are exaggerated versions of concerns and worries that most people have at some time. These thoughts recur and persist despite efforts to ignore or confront them. Compulsions, which can be behavioural (actions) or mental (thoughts), are repetitive actions that are usually carried out in a special pattern or according to specific rule. The symptoms of OCD may include excessive washing or cleaning; repeated checking; extreme hoarding; preoccupation with sexual, violent or religious thoughts; relationship-related obsessions; dislike of certain numbers; and nervous rituals (e.g. opening and closing a door a certain number of times before entering or leaving). The sufferers usually perform tasks, or compulsions, to seek relief from an obsession-related anxiety.

Both psychological and biological factors appear to play a role in the development of OCD. The neurotransmitter serotonin is thought to have a role in regulating anxiety. To send neural signals from one neurone (nerve cell) to another through a synapse, serotonin must bind to the receptor sites located on the next neurone’s membrane. It is believed that the serotonin receptors of OCD sufferers may be relatively under-stimulated. Therefore, a class of antidepressant drugs called selective serotonin reuptake inhibitors (SSRIs), which cause serotonin to remain in the synapse for longer periods, is used as first line treatment option in OCD. Unusual levels of another neurotransmitter, dopamine, may also contribute to OCD.

Currently, behavioural therapy (BT), cognitive behavioural therapy (CBT), and medications are considered as first-line treatments for OCD. However, in recent years various research studies using non-invasive neuromodulation methods, such as transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS), are suggesting promising outcomes. For example, recently, it was reported that tDCS improved depression and anxiety in a treatment-resistant OCD case (Volpota et al. 2012).