Obsessive-Compulsive Personality Disorder

In contrast to flexibility, openness, and efficiency, obsessive-compulsive personality disorder (OCPD), also known as anankastic personality disorder, is characterized by a general pattern of concern with orderliness, perfectionism, excessive attention to details, mental and interpersonal control, and a need for control over one's environment. In people with this personality condition, workaholism and miserliness are also frequently observed behaviors. Rituals are carried out to the extent that they forbid friendships and free time. People who suffer from this disease may find it difficult to unwind because they constantly feel as though there isn't enough time for their interests and that more work needs to be done in order to succeed. They might meticulously schedule their tasks.

Causes

• OCD could develop as a result of adjustments to your body's natural chemistry or how your brain works. Although specific genes have not yet been discovered, OCD might possibly have a hereditary component.
• Although some environmental elements, such as illnesses, have been proposed as OCD triggers, more research is required to be certain.

Symptoms

Obsessive-

• Fear of contamination while handling objects or shaking hands with others.
• Questions about whether you properly locked the door or turned off the stove.
• When things aren't in order or facing the right way, it causes a lot of stress.
• Images of harming oneself or someone.
• Considering yelling insults or acting improperly.
• Avoiding circumstances that might set off obsessions, like shaking hands.
• Anxiety caused by disturbing sexual images that keep coming to mind.

Compulsive-

Obsessions often have themes to them, such as:

• Fear of contamination or dirt.
• Having things orderly and symmetrical.
• Aggressive or horrific thoughts about harming yourself or others.
• Unwanted thoughts, including aggression, or sexual or religious subjects.

Diagnosis

The diagnosis of OCD cannot be made in a lab. The doctor bases the patient's diagnosis on an evaluation of their symptoms, including how much time is spent engaging in ritualistic behaviors.

Treatment

• Cognitive behavioral therapy:
  • Cognitive behavioral treatment teaches OCD sufferers how to face their worries and deal with anxiety without engaging in the disorder's ritualistic activities (called exposure therapy or exposure and response prevention therapy). The goal of therapy is to lessen the overly pessimistic or catastrophic thinking that OCD sufferers frequently engage in.
• Medication therapy :
  • OCD may benefit from antidepressants like SSRIs like Luvox, Prozac, and Zoloft, which are selective serotonin reuptake inhibitors. There may also be a need for older medications, such as tricyclic antidepressants like Anafranil. It has also been demonstrated that some atypical antipsychotics, like Risperdal and Abilify, are useful for treating OCD, either on their own or in combination with an SSRI.
• Electroconvulsive therapy (ECT) or psychosurgery may be used to treat OCD in severe cases and in those who do not respond to medication and behavioral therapy.

Nursing management

• Slowly approach the sufferer.
• Don't express surprise, amusement, or disapproval of the ritualistic conduct; instead, create a welcoming environment.
• Allow the patient time to engage in the ritualistic behavior until he may be diverted by another activity (unless it is unsafe). The level of worry increases as you try to stop doing this activity.
• Consider the patient's physical condition. For instance, routines or preoccupations may lead to inadequate food and fluid intake, tiredness, and skin damage from compulsive hand washing. If the patient becomes so engrossed in ritualistic thoughts and activities that they disregard their fundamental requirements like rest, food, and grooming, this is a sign that they need your help.
• Inform the patient that you are aware of his actions. For example, you might say, I noticed you've made your bed three times today; that must be very tiring for you. Help the patient explore feelings associated with the behavior. For example, ask him, What do you think about while you are performing your chores?
• Set realistic expectations, make acceptable demands, and be clear about your goals. Avoid putting yourself in situations that make you angry and frustrated because this could hinder your treatment.
• Investigate the patterns that underlie the behavior or persistent issues.
• Pay close attention while providing commentary.
• Encourage the adoption of effective coping strategies to reduce feelings of isolation and loneliness.
• Engage the patient in activities that will help him achieve success and boost his confidence and self-esteem.
• Promote active diversionary techniques, such as whistling or humming, to draw the mind away from negative ideas and to enhance a pleasant experience.
• Set boundaries for unwanted conduct and help the patient learn new ways to manage problems and create more effective coping mechanisms. (for example, by limiting the number of times per day he may indulge in obsessive behavior). Gradually shorten the time allowed. Help him focus on other feelings or problems for the remainder of the time.
• Determine understanding and improved conduct (reduced compulsive behavior and fewer obsessive thoughts). Utilize both your own and the patient's reports to assess behavioral changes.
• Talk about uncomfortable subjects that reveal underlying fear or anxiety.
• Observe when interventions fail, then reassess and suggest different tactics.
• Observe the effects of the medication.

Complications

• Not being able to go to job, school, or social events
• Conflicting relationships
• Poor overall quality of life
• Anxiety conditions
• Depression
• Disorders of eating
• Suicidal ideas and actions
• Abuse of alcohol or other drugs
• Skin irritation brought on by repeated hand washing.