Talk:Obsessive–compulsive disorder/Archive 2

Archive 1

Archive 2

Psychological Causes

This section looks like it deserves more context and explanation. I made some edits in my sandbox and included a few sources for my information. Any advice or input would be greatly appreciated! RHam92 (talk) 17:29, 5 November 2013 (UTC)RHam92

A link to your sandbox is helpful: User:RHam92/sandbox. Per WP:MEDRS, WP:NOT (news), and WP:RECENTISM, proposals and hypotheses that have not been reviewed by independent, secondary sources are not encyclopedic content. If you can produce an independent, secondary review that covers these hypotheses, they might be included; Wikipedia:Wikipedia Signpost/2008-06-30/Dispatches might help you better understand how to apply WP:MEDRS. SandyGeorgia (Talk) 17:41, 5 November 2013 (UTC)

RHam92 Your sources so far include two medical hypotheses, unreviewed by other sources. Per WP:UNDUE and WP:MEDRS, what you have so far will not likely find a place in this article. SandyGeorgia (Talk) 16:50, 19 November 2013 (UTC)

I see this text was inserted without feedback from the student. As highly as I regard James F. Leckman's work in TS/OCD, one of the sources is a 15-year-old review (see WP:UNDUE and WP:MEDRS-- is it mentioned in recent reviews?), one is a comment, and two are primary sources. All strung together as original research. I've removed this text. SandyGeorgia (Talk) 12:33, 21 December 2013 (UTC)

Evolutionary considerations

Studies have shown many conceivable analogues for OCD in various species, such as paw-licking and excessive grooming in dogs suffering from acral lick dermatitis and feather-pulling in birds with excessive preening. The universality of common symptoms in these cross-species examples strengthen the support for obsessive compulsive disorder having evolutionary considerations. Close similarities between symptoms in OCD patients and new parents have also led to the hypothesis that these anxious intrusive thoughts and feelings may be associated with threat detection and avoidance behaviors of OCD. This may be a result of a dysregulation of the overlapping neural circuits that are usually active during the preliminary phases of parental behavior, which are marked by feelings of excitement and extreme sensitivity to environmental and emotive cues. These cues lead to further OCD-like risk avoidance behaviors and over-protectiveness of infants.

potential article from askmen

http://www.askmen.com/sports/health_60/86b_mens_health.html

listing ten types of OCD. potentially to add to article. Igottheconch (talk) 13:51, 12 January 2014 (UTC)

Askmen.com is not a reliable source on this subject, and certainly not a medical reliable source. SandyGeorgia (Talk) 13:52, 12 January 2014 (UTC)

General heading restored

I have restored the more general heading; the content that is there now makes the section appear to be about advantages, when in fact, the section is incomplete and the interplay between genetic and environmental factors needs to be written still. The addition of "advantages" was (mis)leading. SandyGeorgia (Talk) 13:56, 12 January 2014 (UTC)

Not an anxiety disorder in itself

What about "tourettic ocd" ? it doesn't imply anxiety (or at least not necessarily).

Plus the DSM-V created a category apart from anxiety disorders for OCD. — Preceding unsigned comment added by Oiseau de février (talk • contribs) 04:35, 20 February 2014 (UTC)

The Prognosis section is outdated and seems to be in need of updating. Remission is possible. There is no way to edit the article but I can provide sources that are newer than 2004 that say such things. — Preceding unsigned comment added by 173.55.57.173 (talk) 12:12, 24 May 2014 (UTC)

According to de DSM V - It is classified under "obsessive-compulsive and related disorders". http://emedicine.medscape.com/article/1934139-overview, http://psychnews.psychiatryonline.org/newsarticle.aspx?articleid=1653568, and "American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.".

The ICD still classifies it under "Neurotic, stress-related and somatoform disorders" roughly but not totally equivalent to the Anxiety category on the DSM IV. Either way, it is not an anxiety disorder by either system, and the information in the first line of the article is not correct. Maybe some rewriting, because "Obsessive compulsive disorder is an "obsessive-compulsive and related disorders" disorder is terrible, (although an interesting pun) --Rfrfgarcia (talk) 16:31, 12 July 2014 (UTC)

Society and Culture

- online entertainers Rhett and Link have created a viral video of their song, "It's my OCD."

http://www.youtube.com/watch?v=tnzz-eFmKaw

- since movies/TV is mentioned ("Movies and television often portray idealized representations of disorders such as OCD.") why not mention Monk?

We need a ref that shows notability. Doc James (talk · contribs · email) (if I write on your page reply on mine) 12:02, 30 August 2014 (UTC)

Prognosis section possibly outdated

As someone who had this disorder, I can tell you that remission and partial remission exist for OCD. There are several articles online saying so and I have lived it. OCD symptoms do not continue to be moderate after treatment, particularly if you only had moderate OCD to begin with. It is factually erroneous and potentially discouraging for sufferers to go seek out treatment after reading this. — Preceding unsigned comment added by 173.55.57.173 (talk) 15:25, 15 May 2014 (UTC)

Looking at the source they claim that no data on any patients passed 1 year is available. Seems highly unlikely this is still the case since 2004. — Preceding unsigned comment added by 173.55.57.173 (talk) 12:11, 24 May 2014 (UTC)

Various doctors sources say there is remission and partial remission for OCD: http://www.ocfoundation.org/eo_relapse.aspx

http://www.psychforums.com/obsessive-compulsive/topic25864.html

An actual study. http://www.ncbi.nlm.nih.gov/pubmed/16566623

Someone please fix the error it is doing harm for people. This article is often cited on OCD message boards as being the reason why so many give up hope. — Preceding unsigned comment added by 71.189.211.102 (talk) 12:29, 9 September 2014 (UTC)

http://tinybuddha.com/blog/accepting-your-battles-how-struggles-can-be-gifts/ — Preceding unsigned comment added by 71.189.211.102 (talk) 12:23, 9 September 2014 (UTC)

Assessment and Diagnosis Sandbox Edits for Obsessive-Compulsive Disorder

Hello all, I have made changes in my Sandbox about this topic focusing on evidence-based assessment and diagnosis. It would be great if people would look at it and leave comments on my talk page before I post it on the article.

The sandbox link can be found here (https://en.wikipedia.org/wiki/User:Amandalewis21/sandbox).

I appreciate it! YenLingChen (talk) 20:53, 3 November 2014 (UTC)

That appears to be a lot of work! However, I have several concerns. First, most of what I see on that page is much to jargonish and not appropriate for a general use encyclopedia. While it appears it would be useful for psychiatrist who already have an intimate knowledge of the criteria and schedules proposed, it would only confuse a general reader. Also, DSM criteria are generally not taken verbatim as you are proposing. Yobol (talk) 20:58, 3 November 2014 (UTC)

There are also copyright issues in many of these. Posted here User_talk:YenLingChen Doc James (talk · contribs · email) 21:34, 3 November 2014 (UTC)

YenLingChen, I have posted to your course talk page, and your instructor needs to become familiar with Wikipedia and online training specifically for medical content. Please do not move any of these edits to the article, as they will be reverted for a number of issues. SandyGeorgia (Talk) 23:48, 3 November 2014 (UTC)

see Talk:Autism_spectrum#Assessment_and_Diagnosis_Sandbox_Edits_for_Autism_Spectrum_Disorder Jytdog (talk) 00:18, 4 November 2014 (UTC)

and see User_talk:YenLingChen Jytdog (talk) 00:21, 4 November 2014 (UTC)

Don't agree with a statement statement

I DISAGREE with this statement: "Other individuals with OCD may experience the sensation of invisible protrusions emanating from their bodies, or have the feeling that inanimate objects are ensouled."

I can tell I know OCD well myself. I'm a sufferer for many years (first symptoms occurred 25 years ago, formally diagnosed 5 years ago), I've read a lot on the subject from various sources and I've consulted several specialists - both psychologist and psychotherapists, and I'm revisiting a psychotherapist every now and then. I can tell for sure that the above statement is INCORRECT for OCD, at least it's not common at all. As each individual psyche is unique, it's possible that some OCD sufferers might have actually had the above ideas - it might be that person had other psychological disease too, or it was simply a part of their own individual beliefs or worldview. But it's not common for OCD suffers at all.

I also noticed the source from where the quote was taken was "Abnormal child psychology". If such statement is based on writer's experience with children rather than adults, it must be clearly noted because at least the second part of the statement ("or have the feeling inanimate objects are ensouled") isn't that unusual for a child as it would be for an adult. — Preceding unsigned comment added by 77.78.23.129 (talk) 00:45, 11 November 2014 (UTC)

Addition to Causes of OCD

Cognitive-Behavioral Causes

Seemingly everyone occasionally has abnormal, negative, and even harmful thoughts that defy the average morality of society. However, something stops those with OCD from 'tuning out' these negative thoughts (cognitions). These people who initially have the negative thoughts cannot stop them from controlling their daily lives. With that being said, the compulsions arise through operant conditioning, and a cycle of negative thoughts and negative reinforcement contributes to the disorder. Melissadinkin (talk) 22:40, 7 December 2014 (UTC)melissadinkin

Need to update History Section

The history section seems to stop with Freudian ideas circa 1910s, which is discredited in other sections. There should include a history of the development of cognitive behavioral therapy for OCD and the introduction of the use of clomipramine, which I think are from the 1960s. 98.248.159.193 (talk) 07:13, 19 January 2015 (UTC)

Confusing phrase: "just a habit problem"

@Nikpapag: I noticed that you added this text to the article with this edit, where the phrase "no clinical condition" was removed from the article. Why was this sentence rewritten? Jarble (talk) 05:09, 29 January 2015 (UTC)

Common Personality Traits and OCD

Of course not all people are same and everyone have got their own skill set. But we should think what do we have in common? Sometimes a 'vague' is just enough to express something entirely!

To those who object, please define the 'feelings hunger, thirst, happy sad etc.'

We can't clearly define those feelings with words right?

For the feeling 'hunger', we can 'vaguely' say, it's a feeling from stomach.

For the feeling 'thirst', we can 'vaguely' say, it's a feeling from stomach.

For the feeling happy, we can 'vaguely' say, it's a type of emotional feeling when we just feels happy!

For the feeling sad, we can 'vaguely' say, it's a type of emotional feeling when we just feels sad!

These are feelings and we can't define some feelings with the correct word in any Language. Those feelings can't be described unless we feel it ourselves. So we express it vaguely because we can't 'exactly describe' what it is.

And hence, sometimes a 'vague word' is just enough to convey what it is to be conveyed!

Robin Mathew Rajan (talk) 23:28, 2 February 2015 (UTC)

Not sure what the purpose of this is? Doc James (talk · contribs · email) 23:34, 2 February 2015 (UTC)

Just an attempt to show we can't clearly and exactly describe everything in this universe with words of any Language. Words have their own limitations. If you're one of the thinking types, why we use a emoticons? Can't us just simply type 'smile' instead of a smiley? Just because the emoticons represents a human face with how humans express feelings. The word 'Smile' doesn't show us the how 'Smile' appears on human faces but emoticons do. It's just my attempt, to show how 'vague' words are beautiful or apt in some contexts. Of course, we all are interested in this topic because we have something in common right?

Robin Mathew Rajan (talk) 23:50, 2 February 2015 (UTC)

Hi Robin. This is a Talk page for discussing improvements to the article. It is not a forum for discussing OCD. Please don't abuse the talk page. Thanks! Jytdog (talk) 00:03, 3 February 2015 (UTC)

That was the same I was doing, making improvements to the article. But I'm sorry if you found my intentions otherwise! Regards, Robin Mathew Rajan (talk) 00:28, 3 February 2015 (UTC)

Suggestions

The first sentence of the first section should be considered for revision. Obsessive-Compulsive Disorder (OCD) is no longer considered an "Anxiety Disorder". In the newest revision of the DSM (DSM-5, 2013), OCD is included in the new section, Obsessive-Compulsive and Related Disorders.

Throughout the article, the word "symptoms" is used in a misleading way. It is important to note that "signs" and "symptoms" are very different things. Excessive hand washing, checking, etc. are signs - as they are observable by others. Symptoms are subjective and are only identified once verbalized by the person.

Also, a clearer distinction between the difference between obsessions and compulsions would benefit the article. Obsessions are unwanted, intrusive, and recurrent thoughts. Compulsions are repetitive physical or mental acts that the person may feel driven to perform in response to an obsession

LaurStuart (talk) 15:38, 21 May 2015 (UTC)

Semi-protected edit request on 11 June 2015

I would like to request that the opening line of the information page on OCD is slightly adapted to be more accurate. If possible, can it be altered so it reads:

Obsessive–compulsive disorder (OCD) is a mental health disorder where people feel negative, repetitive and intrusive thoughts which can cause severe anxiety, and in order to quieten the anxiety, they often have to carry out certain actions or behaviours repeatedly.

This information has been taken off the OCD Action website (a National Charity for people affected by OCD - www.ocdaction.org.uk). Not everyone with OCD feels the need to check or have routines (as the original page states) and the condition can manifest itself in many different ways, therefore I feel this sentence would be much more accurate.

Olive321 (talk) 15:25, 11 June 2015 (UTC)

I agree that not everyone with OCD feels the need to check or have routines, but I don't find the wording that you extracted from the website to be much of an improvement (just because it's organization focused on OCD doesn't mean they can describe it in one or two sentences any better than mental health professionals). It would make more sense to simply change the word "and" to "or" in the lead sentence ("check things repeatedly, have certain thoughts repeatedly, OR feel they need to perform certain routines repeatedly). The lead sentences doesn't have to encompass every manifestation of the disorder; it is described in more detail later in the article. Sundayclose (talk) 16:39, 11 June 2015 (UTC)

primary source

"It has generally been accepted that psychotherapy, in combination with psychiatric medication, is more effective than either option alone. However, more recent studies have shown no difference in outcomes for those treated with the combination of medicine and CBT versus CBT alone.[61]"

reference is primary source, result of only 1 study. WP:MEDPRI: Primary sources should not be cited or juxtaposed with intent to "debunk", contradict, or counter conclusions made by reliable secondary sources. (Assuming that the first statement can be backed up with reliable secondary sources of course...) Ssscienccce (talk) 01:07, 24 September 2015 (UTC)

non adaptability / OCD as an addiction to behaviour

BBC Horizon - OCD: A Monster in my Mind (2015) reintroduces an old idea, that OCD is a non adaptability to change disorder [or non adaptability plays a major role]

Here the mean article speaks about that aspect, but we need more data from experiments, or data from patients [without their names] etc.

Add more please.

Are you asking for a change to the article? If so we need much more information. Please read WP:MEDRS. Sundayclose (talk) 14:24, 24 September 2015 (UTC)

I thought OCD wasn't considered an addiction because of the lack of pleasure. The BBC isn't a medical source. Andrea Carter (at your service | my good deeds) 04:04, 27 September 2015 (UTC)

Colloquial use

Suppose I'm at work and I say to my co-worker, "Is it okay if I change the formatting on these cells to give the amounts to the second decimal place rather than the first? That way I'll have the satisfaction of seeing them tie perfectly to the amounts on the other spreadsheet." It's not full-blown OCD, so what would I call that desire to have it be just so, even though it may not be strictly necessary? Bardonrab (talk) 20:58, 29 October 2015 (UTC)

Article talk pages are for discussion about improvement of the article, not general discussion of the topic. You can ask such questions at the reference desk. Sundayclose (talk) 15:54, 30 October 2015 (UTC)

Note: Bardonrab is a WP:Sock, and has been blocked as such. Flyer22 Reborn (talk) 07:06, 3 November 2015 (UTC)

Verbal IQ / link

The phrase "verbal IQ" in the lede should be linked, but I'm not sure where. I chose these as candidates and tentatively linked it to the first one:
Linguistic_intelligence
Verbal_fluency_test
Wechsler_Adult_Intelligence_Scale#Verbal_IQ_.28VIQ.29

Personally I find it absurd that an entire article is 99% negative. "OCD" is a different brain type that results in good things and bad things. Isn't a verbal IQ a great thing to have? Wouldn't some people wash their hands more in exchange for a higher verbal/linguistic ability? This is my general beef with abnormal psychiatry, but even factoring it out, the article should do more to promote the positives of the OCD brain type. Squish7 (talk) 02:25, 31 December 2014 (UTC)

Sorry! As myself having OCD, I find Linguistic Intelligence is not the sufficient word to express the general character which was prevalent before that edit. Of course, Linguistic Intelligence is one form of intelligence. But with that one, all other types go unnoticed, if you know what I mean. I think I should put back the earlier edit with some modifications! :)

Robin Mathew Rajan (talk) 22:51, 2 February 2015 (UTC)

Kudos to whoever changed "verbal IQ" to "intelligence"! (Robin Mathew Rajan?) This is more considerate and accurate (at least if the positives of the OCD brain-type have to be summed up in one phrase; personally I'd go with "superpower" but then I'd re-write the whole DSM to be less cruel). If anyone feels this phrase should be specified, please re-write in a manner that at least maintains the minimal positivity the article currently harbors. Squish7 (talk) 07:46, 1 May 2015 (UTC) Include [[User:Squish7]] to ping me in replies.

Sorry, but articles, particularly medical articles, are not written according to a few opinions on the talk page or to "maintain positivity". The statement in the article is based on a reliable source, so unless someone comes up with another reliable source that contradicts the current statement, it stays as is. Sundayclose (talk) 00:03, 2 May 2015 (UTC)

Wikipedia's goal to reflect medical consensus. Contrary opinions only get brief mentions, if at all. There is most certainly a link between OCD and some positive traits, such as above average intelligence, that should be mentioned. Andrea Carter (at your service | my good deeds) 09:17, 20 August 2015 (UTC)

I wondered how this works out. The wikipedia article also states that people with OCD have wide-ranging cognitive deficits (in progressing speed, memory, etc.) Even if there are some above average tendencies in some subtests, shouldn´t these deficits counterbalance those? - Michel — Preceding unsigned comment added by 212.89.219.184 (talk) 11:52, 28 November 2015 (UTC)

Semi-protected edit request on 29 December 2015

In the first line of the description of OCD, it reads "or feel they need". The "they" should be "the". 1.211.235.77 (talk) 02:39, 29 December 2015 (UTC)

The relevant part of the sentence reads "people feel the need to check things repeatedly, have certain thoughts repeatedly, or feel they need to perform certain routines repeatedly" (italics added). "They" could be a pronoun that refers to the noun "people" from earlier in the sentence; or it is equally plausible that "the" could be an article that precedes "need". Either is grammatically correct. As I interpret it, it should be "they". If others disagree, please respond. Thanks for raising the question. Sundayclose (talk) 02:47, 29 December 2015 (UTC)

It tripped me up a little bit the first time I read it a while ago, but I thought it was just me since it's technically correct the way it is. Since we're talking about it, I guess I think "the" is better for the parallel structure of the sentence. I'm more or less indifferent though. Permstrump (talk) 02:59, 29 December 2015 (UTC)

 Fixed The relevant grammatical misstep is a lack of parallelism, as Permstrump mentioned. I have now changed the sentence to read: ... where people feel the need to check things repeatedly, to have certain thoughts repeatedly, or to perform certain routines repeatedly. Mz7 (talk) 04:12, 7 January 2016 (UTC)

Mrs. Pleis would be so proud that I remembered what that was. :) Permstrump (talk) 04:47, 7 January 2016 (UTC)

Notes

Remission rates need to be incorporated.

The whole section which says symptoms persist for moderate amounts evne with therapy is false and harmful. http://www.ncbi.nlm.nih.gov/pubmed/23561228

According to this remission is way more common

OCD is listed by WHO as one of the top ten debilitating illnesses when you look at years lost to disability per illness. OCD requires treatment. Most cases do not just go into remission. 82.132.222.241 (talk) 18:37, 8 January 2016 (UTC)

Change to first sentence?

Currently "Obsessive–compulsive disorder (OCD) is a mental disorder where people feel the need to check things repeatedly, perform certain routines repeatedly, or have certain thoughts repeatedly.". Proposed "Obsessive-Compulsive Disorder is a mental disorder where people have obsessions (intrusive thoughts) and compulsions (a set of repetitive behaviour). The thoughts range from feelings of being contaminated by germs to feelings that you might hurt someone. (Although people with OCD never actually do hurt people as a result of their illness). Behaviours might include frequent hand-washing, to the point where skin is damaged, or repeated checking that a door is locked, or repeating a thought in your head to protect a loved one from being harmed". This description is a more accurate version of what OCD is. Here are two good quality sources. The first is a national UK charity that gets government funding and provides some MH services in some aprts of the UK. The second is from the English National Health Service. http://www.mind.org.uk/information-support/types-of-mental-health-problems/obsessive-compulsive-disorder-ocd/#.VpADk7aLS00 http://www.nhs.uk/Conditions/Obsessive-compulsive-disorder/Pages/Introduction.aspx

82.132.222.241 (talk) 18:52, 8 January 2016 (UTC)

Remember, this is written for general readership, not for people who already understand the terminology. I see no difference in meaning between the article's current first sentence and your first sentence; the article's first sentence is written in plain English, but it is accurate. The terminology is presented and explained later in the article and isn't necessary for the lead. You then go on to add examples, but the current first paragraph also does that after the first sentence. I don't think the current version is less accurate. Also, the first source you link doesn't seem to me to fulfill the criteria for WP:MEDRS, which is needed for a medical article. Thanks for making your suggestion; I don't think it's incorrect or less accurate, but I also don't consider it an improvement. Let's see if others weigh in. Sundayclose (talk) 19:52, 8 January 2016 (UTC)

Agree with User:Sundayclose Doc James (talk · contribs · email) 23:01, 8 January 2016 (UTC)

Aspergers picture

The section on Associated conditions lists Asperger's syndrome as an associated condition. A picture of a child with AS who is stacking cans was added. The picture was reverted on the grounds that AS symptoms do not pertain to OCD. However, the pic was added to illustrate AS, not OCD. Perhaps I will read the edit summary again and better understand the reversion. : ) ThanksOnBeyondZebrax • TALK 00:35, 22 February 2016 (UTC)

The Associated conditions section begins "People with OCD may be diagnosed with other conditions, as well or instead of OCD,..." and then it lists varying conditions. It does not seem to me that this section is saying that the other conditions necessarily have OCD symptoms. It appears that an illustration of an individual with one of the conditions listed, such as ASD, would be appropriate.OnBeyondZebrax • TALK 00:42, 22 February 2016 (UTC)

IMHO the picture of someone with ASD displaying non-OCD symptoms adds more confusion than anything else. I think mentioning it in the associated conditions section is sufficient. Permstrump (talk) 01:21, 22 February 2016 (UTC)

Clomipramine

Newly added information from a 2006 psychopharmacology book about clomipramine, which called it the most studied, and the "gold standard" treatment for OCD, was partially reverted, with an edit summary stating that the goal was to summarize. These two points of information do not appear elsewhere in the article, and they arguably give the reader more information about clomipramine. The first point is probably the most important ("most studied"). The second point is arguably more subjective ("gold standard"), since it has a WP:Peacock tone, but the authors of the text did use this specific term.OnBeyondZebrax • TALK 00:46, 22 February 2016 (UTC)

It is typically better in my opinion to paraphrase than add quotes. Have left the gold standard bit. By the way do never sources also state it is a the primary treatment? That is 10 years ago now. Doc James (talk · contribs · email) 01:13, 22 February 2016 (UTC)

I've checked a few sources that are more recent than 2006 and clomipramine does not appear to be considered the gold standard. The treatment guidelines from the UK National Institute for Health and Care Excellence (NICE) suggest the following standard of care procedure: (1) CBT with ERP (Exposure response prevention) (2) CBT/ERP + SSRI (3) CBT/ERP + clomipramine (4) (a) adding an antipsychotic to an SSRI or to clomipramine (b) combining clomipramine and an SSRI (specifically citalopram). The same order of medication trials is the current recommendation of the American Psychiatric Association (APA) and this article from 2011 by researchers Israel as well.

All of the papers say that benefits of of augmenting SSRIs with antipsychotics are limited and are much more positive toward clomipramine, so IMHO the lede should mention clomipramine as a second-line intervention for treatment-resistant OCD instead of atypical antipsychotics and then we can mention antipsychotics as an option later on in the body. The 2 sources in the lede that are currently supporting the claim about atypical antipsychotics actually suggest clomipramine before antipsychotics too. Thoughts? Permstrump (talk) 01:52, 22 February 2016 (UTC)

Okay agree and added to the lead. Doc James (talk · contribs · email) 02:13, 22 February 2016 (UTC)

@Doc James: re:Your recent edit. It's not exactly what I was trying to say, because the recommendation is strongly SSRI first across the board and only clomipramine if there's no response to several SSRI trials. I had in mind something more like this...

Treatment for OCD involves the use of behavioral therapy and sometimes selective serotonin reuptake inhibitors (SSRIs) or clomipramine.[5][6] The type of behavior therapy used involves increasing exposure to what causes the problems while not allowing the repetitive behavior to occur.[5] Clomipramine Atypical antipsychotics may be useful when used in addition to an SSRIs have been ineffective in treatment-resistant cases but are associated with an increased risk of side effects.[7][6] Without treatment, the condition often lasts decades.

Since antipsychotics are pretty far down on the list of recommended treatments, I was thinking it would be fine to take it out of the lede completely. If people want to leave it in, I just think it needs to be made clear that it's basically the last resort and keep the bit about side effects. Permstrump (talk) 03:56, 22 February 2016 (UTC)

Ref says "The National Institute of Clinical and Health Excellence (NICE) Guidelines for Obsessive Compulsive Disorder (OCD) in 2006 [1] recommended that for adults with OCD, with no response to a full trial of at least one Selective Serotonin Reuptake Inhibitor (SSRI) or clomipramine alone, and a full trial of combined treatment with Cognitive Behaviour Therapy (CBT) – that includes exposure and response prevention (ERP) as well as an SSRI, the following treatment options should be considered: (1) Additional CBT of increased intensity, (2) Adding an antipsychotic to an SSRI or clomipramine, (3) Combining clomipramine and citalopram."

We than have the 2014 NEJM paper which states "In addition to exposure and response prevention, pharmacotherapy with the tricyclic antidepressant clomipramine or a selective serotonin-reuptake inhibitor (SSRI; paroxetine, fluvoxamine, fluoxetine, citalopram, escitalopram, and sertraline) has shown efficacy in OCD" So clomipramine is reasonable to state as an option to SSRIs... Although data are limited, comparisons between different SSRIs or between an SSRI and clomipramine have shown no significant differences in efficacy. . The SSRIs are recommended as first-line pharmacologic treatment for OCD (over clomipramine) owing to their better adverse-event profile." Doc James (talk · contribs · email) 14:41, 22 February 2016 (UTC)

So clomipramine appears to now (as of 2014) be second line rather than first line with SSRIs being first line. The 2006 source is a little old. Doc James (talk · contribs · email) 14:47, 22 February 2016 (UTC)

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OCD and anxiety

Hi,

I have sufferd from this disorder and want to comment on the article. First of all, I think there is written to litte about the anxiety part of the illness. Psychologists and health personnel often try to help their patients by making them confront their fears. Like touching dirt or visiting situations they fear. Making their minds fully understand that there is nothing to fear. A very high percentage get cured by this or other methods.

I think the part about "causes" were very empty of psychological causes (biological are ok) 129.177.147.70 (talk) 16:21, 12 January 2016 (UTC)

Thanks for your comments. Unfortunately, our knowledge of causes for many psychiatric conditions such as OCD is limited. I think the article presents a fair summary of what we know about causes. Beyond that, Wikipedia articles on medical topics cannot include information unless it is supported by reliable medical sources (see WP:MEDRS). Do you know of information from such sources that is not included in the article? Sundayclose (talk) 22:07, 12 January 2016 (UTC)

No, unfortunately I don,'t, and dubt I have the competance to select a paper. But I still think the part of anxiety/fear are ignored in the article. The reason why OCD were categorized as an anxiety disorder before were because of the effects anxiety had. It were moved from there because they belived it would be better with a "obsessive compulsive and related disorder" category, there are many kinds. 129.177.147.70 (talk) 16:19, 13 January 2016 (UTC)

I read through the article again, and anxiety is mentioned throughout the article, including relationship of OCD to anxiety disorders. I think if more is added it would put undue weight on one aspect of a discussion of the disorder that includes not just symptoms, but also diagnosis, management, prognosis, and other issues related to OCD. And, as I said, we are limited by the extent of conclusions based on the available research. I'm sure if other editors with knowledge of this topic feel differently than I do they will express themselves here. Thanks again for your comments. Sundayclose (talk) 18:38, 13 January 2016 (UTC)

Everyone with ADHD has a bit of OCD Crazycraft316 (talk) 00:21, 5 May 2016 (UTC)

Use of the word Normal

In this sentence "unpleasant thoughts or images, most "normal" people have some disquieting sexual thoughts at times, but people with OCD" there is no need for the word normal. It would still read the same, however it is stigmatizing to those with Mental Illness as it reinforces societies standard of we are not normal and should be treated as such. Otakugenx (talk) 13:57, 10 June 2016 (UTC)

Adjusted Doc James (talk · contribs · email) 14:27, 10 June 2016 (UTC)

Ugly trichollitamania photo

I have ocd and i'm not unattractive fix pl0x — Preceding unsigned comment added by .................zsdfv (talk • contribs) 04:50, 23 July 2016 (UTC)

The only photo that references trichotillomania is this one of a ribbon, which I don't see a problem with. Are you talking about this image of dermotillomania? The article isn't suggesting that all people with OCD have skin-picking or hair-pulling disorders, so I think it's fine. —PermStrump(talk) 04:05, 24 July 2016 (UTC)

Wonder if those with OCD More likely become addicts?

Have OCD and on fringe of addictition to!? Are OCD suffers more likely becoming drug addicts alcholics etc? Thannks! edson andre Johnson104.34.181.144 (talk) 06:27, 30 August 2016 (UTC)

psychostimulant content

User: Petergstrom please justify the sourcing here. Thanks. Jytdog (talk) 05:22, 23 November 2016 (UTC)

Need proper sources so reverted. Doc James (talk · contribs · email) 04:09, 24 November 2016 (UTC)

WP:MEDRS doesn't say that secondary or tertiary sources are necessary, there is a section on wording primary sources. It says that they generally should not be used. Generally. — Preceding unsigned comment added by Petergstrom (talk • contribs) 18:59, 25 November 2016 (UTC)

in the rare cases when they are used, their use needs to be justified. please justify. Jytdog (talk) 06:30, 26 November 2016 (UTC)

Reference to add

Hello! I recently found a reference for this article, if somebody wants to add it. It relates to the causes of OCD, so it may be better to add it to the main article on this subject. Here it is:

• Zhang, Zhong-Ming; Zhang, Zhong-Liang; Li, Hong (2010). "Double conflicts model and anxiety ratification therapy hypotheses of obsessive–compulsive disorder" (PDF). Medical Hypotheses. 75 (6): 586–589. doi:10.1016/j.mehy.2010.07.039. ISSN 0306-9877.

Hopefully it helps. RileyBugz^{Yell at me} | _Edits 23:26, 19 March 2017 (UTC)

Sentences are poorly written and don't make sense, plus: Deleted content

So you say, thus, please feel free to change the wording, as you can't change the reality of the content in the edition, and if you want, explain to all about your language background, how old is it, where do you come from, what are your medical credentials,... if somebody suffers or has his or her improvement delayed or gone out because you deleted an useful comment, you'll end paying, and it won't be me who will make pay anybody. See you later, crocodile...Regards, + Gesund--Caula (talk) 18:17, 9 March 2017 (UTC)

In March 20, 2017, somebody deleted the text below, by Sigmund Freud:

Sigmund Freud in: 'A kid is beaten' (1919), proposes 'a component in sexual function having gone ahead of others in its evolution, becoming prematurely independent, and stuck, escaping this way to further evolutionary processes...If the sexual component prematurely independent is the sadistic one (active), it should be expected, based in our previous analytic experience, that its ulterior repression brings up a disposition to obsessive neurosis'.

added quotation is about origins of Obsessive disorder. If a quotation by S Freud si not appropriate in an article about a mental disorder, please tell us what is accurate and right adding there. The acceptable attitude for WP reviewers is blocking vandalism, this deletion approaches a Vandalic edition, and eliminating content in a way out of the scientific knowledge about the field, in this case, the deletion means the reviewer is acting as owner, not only of the article, but of some kind of absolute truth, it's supposed that WP is a cooperative work, aimed at the best interest of readers, and in the medical fields, to the best interest of patients, even if it's not a web medical office and should never be; if the author of deletion is so sure about his/her infallibility, it would be better giving his/her name to WP, or start a web encyclopedia being the sole and only author.

Please review the whole affaire; from the very beginning, this entered the personal aggression field, and don't make any comment in the style of 'suspicion', 'aggressiveness', I never requested an appointment to no one in WP about any issue in my health; to issue a diagnosis, you need being a certified and registered physician, admonitions are the exclusive tasks of courts, and this only after a regulated process. Fully unacceptable, sad for WP and worse for WP users. Regards, Salut †--Caula (talk) 14:50, 25 March 2017 (UTC)

Semi-protected edit request on 5 August 2017

For the section 'Origin/ Causes of Obsessive-Compulsive Disorder', include the following:

-Sigmund Freud, in his 1919 work: 'They beat a kid', II; stated/ proposed: 'One of the components of sexual function would have anticipated the others in the evolution, would have become prematurely independent, and would have fixed, escaping this way the ulterior evolutive processes, and testifying an altered special constitution of the corresponding individual....If the prematurely independent sexual component is the sadistic component, we will have to expect, based in our analytical experience, that the ulterior repression cause a disposition towards obsessive neurosis arising'

No need to provide evidence that S Freud is considered a trustable authority in mental disorders, the text could be checked in any English translation of his work, and is more than enough referenced; even if the more recent DSM editions deliberately omitted most psychoanalytic terminology, this is a basic statement in the history of OCD understanding and treatment, that deserevs a place in Wikipedia, its presence there could be also good for patients, as a surrogate/ substitutive/ preparation for: 'Psychotherapy', 'Psychoanalysis', 'Wild psychoanalysis', or: 'Auto-analysis'. Thanks, regards, Salut +--Hijuecutivo (talk) 14:02, 5 August 2017 (UTC) Hijuecutivo (talk) 14:02, 5 August 2017 (UTC)

Not done: please establish a consensus for this alteration before using the {{edit semi-protected}} template. Thanks for your interest in improving the article. I wouldn't call Freud a "trustable authority in mental disorders"; psychiatry has evolved enormously since his day. For that reason, I don't think it would be appropriate content for the Causes section, which summarizes current thinking and needs to be MEDRS-compliant. His views on behaviors associated with psychiatric disorders, including this one, are certainly relevant, and he is already mentioned in the History section. Perhaps that should be expanded, but I have concerns about synthesis and think this should be discussed, and consensus reached, before doing that. A better translation would also be needed, since the one found above is close to incomprehensible. Rivertorch^FIRE_WATER 16:04, 5 August 2017 (UTC)

Your comment is funny. So you say that psychiatry has evolved a lot since the Sigmund Freud days, and that he's no longer a trustable author?

No need to remark his discovery of unconscious is still considered a major advance, also that: 'transfer', the repetition of the patient's attitude towards authority figures, initially, the parents, in front of therapist, is in the basis of most psychotherapies; even if analytic terms were expelled from recent DSM editions, probably because no evidence in the classical way can be presented for his theories, psychoanalytic theory is still used today in comparative trials, and it produces results, dismissing Sigmund Freud is a bit like saying the Archimede's work is of no interest in physics. Please reconsider!

The text I proposed is short, crystal clear, with a huge historical value, at least; it fits the 'ethiology/ causes' section, and doesn't require a highly specialized knowledge of neuroanatomy and neurophysiology, as do require the very long comments about structural and functional neuronal changes in OCD, that are part of article.

I can't stablish a consensus, because I have no polling facilities, also, ballots, votes, don't make facts true or false. In the absence of evidence in the contrary, I'd say the best approach in Wikipedia is applying the principle of 'presumption of innocence', from which the 'reversal of the evidence load' comes, it's those who oppose an assertion who must provide evidence that it's false, untrue, innacurate, contrary to the state of the art, not those who propose the comment, that must always be considered 'in bona fide'. The well acknowledged fact that OCD improves with marriage is also missing in the main article. Some elements are so basical, that no references are provided for it, you won't find a reference for: 'A body temperature higher that 37º C is almost always fever', in any medical publication about infectious and other diseases inducing fever. Denying that a writing by Sigmund Freud is cited in an article about a mental disorder belongs rather to the 'ideological' side of psychiatry. Credentials of editors taking this decission? Thanks, regards, Salut +--Hijuecutivo (talk) 20:41, 14 August 2017 (UTC)

Hijuecutivo, I didn't say that—you misquoted me. Author" is not the same word as "authority", and it doesn't have the same meaning. I also wrote that "[Freud's] views on behaviors associated with psychiatric disorders, including this one, are certainly relevant, and he is already mentioned in the History section. Perhaps that should be expanded...." If you think that constitutes "dismissing" Freud, then you evidently are finding it difficult to read plain English. The text you proposed is not plain English; it is anything but "crystal clear". In addition to indicating that you're having some difficulties in writing and comprehending English, your latest comment indicates that you really don't understand the most basic elements of how Wikipedia works. (Consensus, for instance, has nothing to do with polling facilities or ballots.) That's perfectly all right: Wikipedia has a steep learning curve, and some of its rules are very confusing at first. I'll leave a welcome note on your talk page presently, with some links you may find helpful. In the meantime, if there is one thing you can take away from this discussion, let it be this: all Wikipedia content must be verifiable and supported by reliable sources, and in the case of articles on medical topics, there's a more specific guideline that we follow. The exceptions to this policy are few and far between, and this isn't one of them. Rivertorch^FIRE_WATER 20:56, 14 August 2017 (UTC)

Thanks. As the title and year of article where the quotation I proposed appears is stated, and for sure many English translations exist, I suggest taking the text I quoted from one of it, just the term: 'abnormal' used in the Spanish translation I handle deserves a change, for the good of patients, this is why I used: 'altered'.

You know that the translation of Freud's work into Spanish made by Ballesteros, and reviewed by psychiatry professor Ramón Rey-Ardid, is the only one approved by Freud, as he learned Spanish in order to be able reading: 'Don Quijote', the novel by Miguel de Cervantes, in its original language.

Please feel free to add yourself a version of the text I proposed, that you consider an acceptable translation, in the section of article you consider appropriate; 'History of OCD', is good. I don't have an English version of S Freud work at hand to do this myself. Have a good academic year. Regards, Salut +--Hijuecutivo (talk) 21:09, 14 August 2017 (UTC)

Ah, sorry, no. Unless the meaning is perfectly obvious or it's just a question of the syntax being messed up, the only language I will attempt to translate is French. It's too easy to miss a nuance. If we get to the point where we need a better translation, there are bilingual editors who can help, but first I'd like to see some support from other editors for adding this. Rivertorch^FIRE_WATER 21:36, 14 August 2017 (UTC)

Typo "superior parental lobule"

"superior parental lobule" should be "superior parietal lobule" ClaDan (talk) 09:52, 16 August 2017 (UTC)

 Done. Thanks. Martinevans123 (talk) 11:30, 16 August 2017 (UTC)

Not signs or symptoms

This text thus dose not belong in the section in which it was placed. Doc James (talk · contribs · email) 13:34, 28 August 2017 (UTC)

"Symptom Structure OCD is a heterogeneous disorder, which has possibly reduced the power of genetic and neuroimaging studies. Through studying the symptom structure of OCD using YBOCS symptoms, most studies report between 3 and 5 factors that explain OCD symptoms. A meta analysis observed the most robust factor structure was a four factor structure, involving a symmetry factor, a forbidden thought factor, a cleaning factor, and a hoarding factor.

The symmetry factor had high loadings of symmetry, ordering, repeating and counting symptoms across all age groups. However in children, the checking symptom also highly loaded onto this factor as well. In the forbidden thought factor, aggression, sexual, and religious symptoms all had high loadings across all age groups, but in adults also had high loadings from somatic and checking symptoms. The cleaning factor involved contamination and cleaning symptoms, but in children also had high loadings for the somatic symptom cluster. Both hoarding obsessions and hoarding compulsions had high loadings onto the hoarding factor, and was consistent across all age groups.

The four factor symptom structure has demonstrated associations with specific findings related to comorbid disorders, genetics, and neuroimaging. Bipolar disorder and Major depressive disorder have both been observed to relate to the forbidden thought factor of OCD, while ADHD, alcohol dependence, and bulimia have been related to the symmetry factor. fMRI studies of OCD subtypes has found the right caudate activity to inversely correlate with with symmetry and cleaning factors, while left orbitofrontal activity is directly correlated to the forbidden thought factor. The hoarding subtype of OCD is also associated with poorer long term outcomes and treatment response to SSRIs and CBT."

I originally created a new section, but it was reccomended to me that I make it a subsection. Where else would it best fit as a subsection?Petergstrom (talk) 14:58, 28 August 2017 (UTC)

Text need to be significantly simplified. What does "Symptom Structure OCD is a heterogeneous disorder, which has possibly reduced the power of genetic and neuroimaging studies." mean?

Doc James (talk · contribs · email) 19:24, 28 August 2017 (UTC)

Perhaps I did a poor job explaining. OCD can present with a wide variety of symptoms. However, many of these symptoms largely appear together, and their variance can be described from an inferred factor in a lower dimension. These higher order factors correlate with different biomarkers and treatment responses. Petergstrom (talk) 01:25, 29 August 2017 (UTC)

The first sentence "OCD can present with a wide variety of symptoms" is understandable. Next how are we going to write "their variance can be described from an inferred factor in a lower dimension" in easier to understand En. Doc James (talk · contribs · email) 09:40, 29 August 2017 (UTC)

Would an explanation in the context of cluster or dimensions be better? "How about OCD can present with a wide variety of symptoms. Many of these symptoms correlate with each other, and through factor analysis can be explained by a more fundamental shared factor. While the interpretation of factors in not strictly agreed upon by researchers, they are sometimes viewed as fundamental structure, dimensions, or clusters that reflect a superordinate process. The standard assessment tool for OCD, the YBOCS, has 13 categories of symptoms. Studies that examine the factor structure of these 13 categories have observed between three and five factors. However, one meta analysis determined a four factor structure to be the most robust solution."

Or "OCD can present with a wide variety of symptoms. Certain groups of symptoms typically occur together. These groups are sometimes viewed as dimensions or clusters that may reflect an underlying process. The standard assessment tool for OCD, the YBOCS, has 13 categories of symptoms. These symptoms fit into three to five groupings." Doc James (talk · contribs · email) 23:03, 29 August 2017 (UTC)

Sounds good.Petergstrom (talk) 06:07, 30 August 2017 (UTC)

References

Aversion to particular numbers

Been meaning to state this: The article used to mention "aversion to particular numbers" in the lead, and the following in the Compulsions section: "Some common compulsions include counting specific things (such as footsteps) or in specific ways (for instance, by intervals of two), and doing other repetitive actions, often with atypical sensitivity to numbers or patterns."

Currently, the lead states "counting of things" instead, but the Compulsions section doesn't note anything about counting; I don't see that any other section in the article does either. Since favoring even numbers and counting are significant aspects of obsessive–compulsive disorder, we should re-add something on these aspects. Flyer22 Reborn (talk) 22:59, 30 September 2017 (UTC)

I will go ahead and note that people in general (meaning even those who don't have obsessive–compulsive disorder) favor even numbers as well. Flyer22 Reborn (talk) 23:02, 30 September 2017 (UTC)

Source says "Compulsive counting"[1]. How do we want to write that in easy to understand language? Doc James (talk · contribs · email) 03:17, 4 October 2017 (UTC)

WP:Preserve

Petergstrom, do stop removing important stuff without preserving it afterward. Stuff that is important should be retained. What you removed can be replaced with better sources. I have pointed you to the WP:Preserve policy multiple times now. Flyer22 Reborn (talk) 01:52, 11 December 2017 (UTC)

My bad you're right I should have preserved it. As a side note, I couldn't find any legitimate refs to support that material, in fact I found some sources(albeit primary) that dispute it. For example this and this contradict the notion of Pure-O, as well as the claimed prevalence.Petergstrom (talk) 03:15, 11 December 2017 (UTC)

Let's see, you removed this source as non-academic. It's called "Coping with OCD: Practical Strategies for Living Well with Obsessive-Compulsive Disorder," from New Harbinger Publications. The authors and publication are not the strongest source (well, unless one views the second author as a very strong source on the matte at hand), but the authors -- Troy DuFrene, Bruce Hyman -- are academics. One specializes in psychology. The other specializes in obsessive–compulsive disorder. And what they stated are not simply their arguments. To review:

The text stated, "Primarily obsessional OCD has been called one of the most distressing and challenging forms of OCD." This is supported by this 2014 "Cognitive Behaviour Therapy: A Guide for the Practising Clinician, Volume 1" reprint source, from Routledge, page 143. It states, "A special case of challenging beliefs is considered when working with patients who are primarily obsessional. The beliefs (and the appraisals) typically reflect some personal significance about the person. These people typically believe that the presence of the thoughts says something about their value as a human being. For example, we treated a female patient who had sexual obsessions and believed that she was a 'totally depraved person'. Although they are generally considered to be more challenging to treat, compared to people who have primary compulsions, obsessionals do benefit from CBT that focuses on changing the meaning of the intrusive thought (e.g., Freeston et al., 1996)."

The text in the article also stated, "People with this form of OCD have distressing and unwanted thoughts emerging frequently, and these thoughts typically center on a fear that one may do something totally uncharacteristic of oneself, possibly something potentially fatal to oneself or others. The thoughts may likely be of an aggressive or sexual nature." This aspect is partly covered by the "Cognitive Behaviour" source and is already covered by the "Obsessions" section. More sources are in the Primarily Obsessional OCD article. From what I've studied of OCD, "primarily obsessional OCD" seems to be nothing but an aspect of intrusive thoughts. The "primarily obsessional OCD" material is already covered by material that talks about obsessions and intrusive thoughts with regard to OCD. Flyer22 Reborn (talk) 08:36, 11 December 2017 (UTC)

I don't care about the "Nicknamed 'Pure-O'" aspect. Flyer22 Reborn (talk) 08:36, 11 December 2017 (UTC)

The concept of OCD without the "C" is disputed, but even so the statement that the purported subtype is one of the most "distressing" forms of OCD is not directly stated in the CBT guides. Perhaps if there was a source examining the QoL or subjective distress in each subtype, that kind of statement would be warranted, but I don't feel too strongly about it. I wouldn't dispute the addition of the content with the new citations.Petergstrom (talk) 01:20, 13 December 2017 (UTC)

I'm saying that the content you removed is already essentially covered in the article because what is stated of "primarily obsessional OCD" is, for the most part, what is stated of the obsessive and intrusive thoughts aspect of obsessive–compulsive disorder. The "Obsessions" section also links to the Intrusive thought and Primarily Obsessional OCD articles. So it's fine for now on this matter. Flyer22 Reborn (talk) 02:47, 13 December 2017 (UTC)

Telugu

change ((Telugu)) to ((Telugu language|Telugu)) — Preceding unsigned comment added by 2601:541:4304:E6B0:218:8BFF:FE74:FE4F (talk) 14:24, 15 January 2018 (UTC)

Not done for now: - IMHO it would be better directed to Telugu cinema - I'll let another editor decide, - Arjayay (talk) 15:07, 15 January 2018 (UTC)

Done I'm fine with piping to "Telugo language", that's common before a film title, and I have complied with the request. If someone thinks "Telugo cinema" is better, feel free to change it. What we do not want to have is a redirect to a DAB page. :-) Sam Sailor 22:13, 15 January 2018 (UTC)

Semi-protected edit request on 13 September 2017

Change the sentence: There is tentative evidence that OCD may be associated with above-average intelligence or at least a small increase in intelligence to A myth propagated by Sigmund Freud regarding above-average intelligence in OCD was recently refuted. NietzschesBrain (talk) 03:58, 13 September 2017 (UTC)

Done SparklingPessimist ^{Scream at me!} 04:35, 13 September 2017 (UTC)

References

THIS IS ALL A LIE PLEASE DO NOT BELIEVE IT MNTASE KHAYA!! — Preceding unsigned comment added by 169.0.98.139 (talk) 08:47, 1 March 2018 (UTC)

Religious Association

I am noticing 3 problems:

• Exorcisms as a technique are mentioned, but leans toward "insanity" which is not precisely accurate in comparison to:
• Scrupulosity is the proper religious association, but does not necessarily incur:
• Child Abuse in ALL cases? (Infobox)

This cluster needs serious work! — Preceding unsigned comment added by 97.43.240.227 (talk) 06:48, 14 March 2018 (UTC)

DA hyper vs hypofunction change

Giving the comorbidities between ADHD and OCD, the frequency of OC behavior in parkinson and huntingtons, inability to inhibit impulses, poor performance on neuropsychological testing of executive function and findings of decreased D1/D2 receptor binding as well as increase DAT binding implicated hypoactivity of mesocorticolimbic DA pathways not the opposite. However many authors, contrary to ADHD researchers take the BP changes as the opposite.

Don't forget the psychostimulant studies

References

Ritual or Compulsion

I am taking abnormal psychology at my college this semester and my teacher and my text book says that the repetitive behavior can also be called a compulsion. I just figured I point this out so the definition is more accurate. Too many people use OCD to describe people who are extremely cleanly when that is not the correct definition of OCD. GentleCatFish (talk) 06:02, 20 March 2018 (UTC)

Semi-protected edit request on 24 April 2018

'The condition is associated with tics, anxiety disorder, and an increased risk of suicide'---- The portion of the line, '... and an increased risk of suicide is misleading based on the actual study by Angelakis et al. It should be noted as mentioned in the abstract by the researchers that this is the first 'systematic study' to attempt to link suicidality with OCD. Suicidality in and of itself comprises ideation and thoughts as well as completion. However, Angelakis et al do not find any definite connection between OCD and suicide primarily since in tandem with comorbidities such as major depression or anxiety, the pathology is ambiguous.

I think a better way to put it based on the study would be to say, '...increased suicidality due to comorbid depression.'

The original line jumped out as being perhaps a bit odd considering the tentative nature of the researchers' conclusion:

In conclusion, this study presented the first comprehensive quanti- tative synthesis of the literature concerning suicidality and OCD. Our findings suggest that suicidality in those with OCD, especially in OCD subgroups with concurrent comorbidities, is a valid problem which has not yet received appropriate research attention. At present, the depth and quality of research evidence about the psychological drivers of suicidality in patients with OCD are low and hence, there is a dearth of theory-guided prospective studies to improve understanding of suicidality in OCD.

Suicidality in Obsessive Compulsive... (PDF Download Available). Available from: https://www.researchgate.net/publication/274078651_Suicidality_in_Obsessive_Compulsive_Disorder_OCD_A_systematic_review_and_meta-analysis [accessed Apr 24 2018]. Nzemeks (talk) 23:54, 24 April 2018 (UTC)

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. Somewhat of a change X to Y format but please can you make it much more clear and then follow this by explanation and references. Thanks Waddie96 (talk) 11:00, 26 April 2018 (UTC)

Ref says "The pooled effect size across 30 independent comparisons revealed a moderate to high, significant association between suicidality and OCD (Hedges' g=0.66, 95% confidence interval 0.49-0.82) which persisted across different types of suicidality including suicidal ideation and suicide attempts." https://www.ncbi.nlm.nih.gov/pubmed/25875222

So not sure the issue? Doc James (talk · contribs · email) 14:14, 26 April 2018 (UTC)

 Not done: please provide reliable sources that support the change you want to be made. The source given contradicts the requested change, as mentioned by other editors above. Eggishorn (talk) (contrib) 20:00, 4 May 2018 (UTC)

Suggestion for media portrayals

In Season 3, Episode 12 of "Scrubs" the character Dr. Kevin Casey appears and is shown suffering from OCD severely. He mentions the severity of his OCD causing him to drop out of school and repetitively spend all day reading medical textbooks, and generally his behavior is a very realistic version of the condition. At the end of the episode he first appears in, "My Catalyst," he is shown still in the operating theater for surgery washing his hands over and over again and becoming frustrated and distressed at his inability to stop himself from giving in. At the beginning he is shown walking inside the front door of the hospital several times as well.

For more about the character's compulsions I posit a link to his Scrubs wikia entry that talks about his condition more.

--2600:1700:1A10:68F0:F8B4:892D:EEB4:14CA (talk) 21:49, 10 August 2018 (UTC)

Semi-protected edit request on 20 November 2018

About the following sentence: The relationship between the short and long allele of the 5-HTTLPR gene has been examined in OCD, and a meta analysis found that the S allele was associated with OCD in females only.[41]

This meta-analysis does not show statistically that the S allele is associated to OCD in females. It shows there is no significance, only an observed trand. However, a meta-analysis is performed to find out if findings from multiple articles are robust enough when combined. Single articles could find significance due to chance or the experimental setup. A meta-analysis will find robust findings if they are not based on chance. When results from a meta-analysis are not significant, the variable (S allele) studied is therefore not correlated/associated enough with the disease (OCD). Therefore, I was wondering if you could remove this sentence from the OCD page.

Reference is the reference on the page: [41] Mak, L; Streiner, DL; Steiner, M (June 2015). "Is serotonin transporter polymorphism (5-HTTLPR) allele status a predictor for obsessive-compulsive disorder? A meta-analysis". Archives of Women's Mental Health. 18 (3): 435–45. doi:10.1007/s00737-015-0526-z. PMID 25896187. Non-canonical is the new canonical (talk) 16:57, 20 November 2018 (UTC)

Yes, the abstract says "However, when stratified by sex, there is an emerging sex-specific relationship. There was a trending association between the S-allele and OCD status in females (Z = 1.62, p = 0.10) but not in males (Z = 0.69, p = 0.49)." So I'd agree that the sentence should either be removed or corrected. Martinevans123 (talk) 17:06, 20 November 2018 (UTC)

 Done Removed, with no prejudice to a rewrite instead. Izno (talk) 19:36, 22 November 2018 (UTC)

Semi-protected edit request on 16 December 2018

Please chng hoarding related to hoarding-related Letateal (talk) 22:19, 16 December 2018 (UTC)

 Done – Jonesey95 (talk) 01:57, 17 December 2018 (UTC)

Recent changes to the lead

IiKkEe, you need to discuss your changes because you are changing the context or meaning of some material. Keep in mind that this is a medical article, which is why WP:MEDRS has high standards. Why not just to stick to what the sources state? When reverting you here, I stated that checking things repeatedly is not necessarily performing certain routines repeatedly. For example, a person with OCD might feel the need to repeatedly check for an email reply. But this doesn't mean that doing so is a routine for them. After all, that is just one email reply. Once the other person replies, that matter is over. The person with OCD might not communicate via emails enough for repeatedly checking emails to become a routine. You went back to changing the lead. You made it so that the lead states "the need to perform certain routines repeatedly such as checking on the status of something (rituals)," which led Doc James to remove "checking on the status of something (rituals)." It's best to just leave the lead as it was and include "feel the need to check things repeatedly," just like we do in the infobox.

When you are reverted on something like this, don't just go back to tinkering with the lead, especially when an editor suggests that you discuss the matter on the talk page. Take it to the talk page and discuss. If you reply to me on this, I ask that you don't ping me. Flyer22 Reborn (talk) 14:05, 8 March 2019 (UTC)

It is important to be actively reading the sources when text is adjusted. Doc James (talk · contribs · email) 14:13, 8 March 2019 (UTC)

Semi-protected edit request on 31 May 2019

Please change "A myth propagated by Sigmund Freud regarding above-average intelligence in OCD was recently refuted"

to something more accurate eg,

"There is evidence and a consensus among psychiatrists that people with OCD have a higher average intelligence quotient than the general population. However, a recent study has questioned this."

Here is a large study that supports this opposing view: https://www.sciencedirect.com/science/article/pii/S0160289616303324 Dom.uk.1 (talk) 20:36, 31 May 2019 (UTC)

 Not done: please establish a consensus for this alteration before using the {{edit semi-protected}} template. MrClog (talk) 16:21, 6 June 2019 (UTC)

Semi-protected edit request on 3 December 2019

I would like to add additional information to the Neurobiological section of this page. I have integrated my research into the existing paragraph as below, with new information bolded.

Requested text

From the observation of the efficacy of antidepressants in OCD, a serotonin hypothesis of OCD has been formulated. Serotonin, or 5HT, is a monoamine that is produced in the Raphe Nuclei. 5HT is known to be involved in a variety of bodily functions, including mood, digestion, memory, and sexual desire. 5-HT1 receptors act by inhibiting protein kinases and opening potassium channels to hyperpolarize the cell. 5-HT1 receptors are thought to promote feelings of happiness and calm when activated, while 5-HT2 receptors can lead to feeling overwhelmed. Studies of peripheral markers of serotonin, as well as challenges with proserotonergic compounds have yielded inconsistent results, including evidence pointing towards basal hyperactivity of serotonergic systems. The basal ganglia is responsible for planning and executing movements, receiving input from across the cortex and sending excitatory glutamate signals into the striatum. Serotonin receptor and transporter binding studies have yielded conflicting results, including higher and lower serotonin receptor 5-HT2A and serotonin transporter binding potentials that were normalized by treatment with SSRIs. Despite inconsistencies in the types of abnormalities found, evidence points towards dysfunction of serotonergic systems in OCD. The orbitofrontal cortex, or OFC, is responsible for causing feelings of worry, preventing poor decisions, and changing behavior as appropriate to a new situation. Damage to the OFC leads to impulsivity and lack of inhibition. Orbitofrontal cortex overactivity is attenuated in people who have successfully responded to SSRI medication, a result believed to be caused by increased stimulation of serotonin receptors 5-HT2A and 5-HT2C. Ahmari et al. (2018) studied how activating inputs from the OFC into the striatum affect OCD-like behaviors. They injected wild-type mice with channelrhodopsin, a light-gated ion channel that stimulates a brain region when blue light is shined on it. Half of the mice had their OFC to striatum connection stimulated five times a day for 5-10 days, while the other half received no stimulation. Upon measuring spontaneous grooming when no blue light is being shined, they found that mice that received repeated activation exhibited obsessive-compulsive grooming while controls did not. These findings provide evidence that excessive OFC to striatum signaling causes OCD. This persistent overactivity may underlie the obsessions that are characteristic of the disease, which are intrusive, repeated thoughts that cause anxiety and worry. A complex relationship between dopamine and OCD has been observed. Dopamine is produced in the substantia nigra and ventral tegmental area, which are adjacent in the brainstem. Dopamine produced in the substantia nigra and sent to the striatum increases desire to move. Dopamine produced in the VTA can be sent to the frontal lobes, where it aids in attention and motivation, or to the nucleus accumbens, where it results in feelings of pleasure. Although antipsychotics, which act by antagonizing dopamine receptors may improve some cases of OCD, they frequently exacerbate others. Antipsychotics, in the low doses used to treat OCD, may actually increased the release of dopamine in the prefrontal cortex, through inhibiting autoreceptors. Further complicating things is the efficacy of amphetamines, decreased dopamine transporter activity observed in OCD, and low levels of D2 binding in the striatum. Furthermore, increased dopamine release in the nucleus accumbens after deep brain stimulation correlates with improvement in symptoms, pointing to reduced dopamine release in the striatum playing a role in generating symptoms. Abnormalities in glutaminergic neurotransmission have implicated in OCD. Findings such as increased cerebrospinal glutamate, less consistent abnormalities observed in neuroimaging studies, and the efficacy of some glutaminergic drugs such as riluzole have implicated glutamate in OCD. Welch et al. (2007) utilized mice with the Sapap3 gene knocked out to study how synaptic inputs from the cortex into the striatum differ in OCD. Sapap3 is an excitatory protein that is highly expressed in the striatum, and caused mice to groom compulsively when removed. Researchers electrically stimulated inputs from the cortex into the basal ganglia, measuring the rate of grooming and size of the postsynaptic response in striatal cells. They found that there was weaker signaling in the Sapap3 knockout mice than in controls, suggesting that mice with obsessive-compulsive behaviors have less glutamate receptors in the cortex to striatum connection. OCD has also been found to have high rates of comorbidity with a variety of other disorders, including depression and Tourette Syndrome. Pauls et al. (1996) investigated the possibility of a common genetic mechanism between OCD and Tourette Syndrome. They compared probands with Tourette’s to their relatives and controls, measuring the rate of Tourette’s, rate of OCD, and rate of both diseases in all comparison groups. The researchers found that the relatives of the probands also showed increased rates of OCD and Tourette’s, suggesting that there exists a common genetic risk factor both both diseases that may manifest in different ways. OCD has been associated with reduced N-Acetylaspartic acid in the mPFC, which is thought to reflect neuron density or functionality, although the exact interpretation has not been established.

Juliakim2 (talk) 01:42, 3 December 2019 (UTC)

 Not done. Please provide reliable sources that support this information. –Deacon Vorbis (carbon • videos) 01:59, 3 December 2019 (UTC)

Remove unreliable information in Research section with dubious citation

Please remove claims of the usefulness of vitamin and mineral supplements for OCD patients in the Research section. The only cited source (Lakhan SE, Vieira KF (2008)) fails to verify these claims, makes additional claims of a particular brand of supplement being effective for OCD, and supports this by citing studies which mention neither OCD nor the supplement.

The claim "Nutrition deficiencies may also contribute to OCD and other mental disorders." cites no sources and should be removed unless a reliable source can be found to verify it.

The claim "Vitamin and mineral supplements may aid in such disorders and provide nutrients necessary for proper mental functioning.[126]" should be removed because it cites Lakhan SE, Vieira KF (2008) which fails to verify this claim. It repeatedly makes general claims of "deficiencies" contributing to "mental disorders" but supports this with multiple citations focused solely on Omega3/Folate intake in Depression and a single study on L-Tryptophan and Mania - no citations are directly relevant to OCD. It also contains fear mongering about the side effects of drugs used to treat "these disorders" but only supports this with citations related to lithium toxicity in Bipolar Disorder, an extreme example which does not apply to other disorders.

In Table 1, the only "Proposed Cause" of OCD listed is "St. John's wort deficiency" - St. John's wort is an exogenous substance not normally present in the human diet; deficiency is therefore impossible.

In the section focused on OCD in Lakhan SE, Vieira KF (2008) first paragraph, the following claim is made:

"...the amino acid tryptophan is a precursor to serotonin, and tryptophan supplements (which are better than 5-Hydroxytryptophan) will increase serotonin levels and treat OCD [68]."

The citation [68] is: Yaryura-Tobias JA, Bhagavan HN. L-tryptophan in obsessive-compulsive disorders - 1977

This is a 42-year-old preliminary study with n=7. It does not contain the term 5-Hydroxytryptophan. Patients did not receive tryptophan alone but a combination of tryptophan, nicotinic acid, and pyridoxine HCL. The study also noted increased aggression in 2 cases (28%) as a result of this regimen which is not mentioned in the citing article.

The second paragraph in the OCD section of Lakhan SE, Vieira KF (2008) is significantly more dubious and reads like an advertisement:

"A commercially available supplement called Amoryn has recently proven to help patients suffering from depression, anxiety, and OCD [69,70]."

The citations supporting this claim are:

[69]: Acute treatment of moderate to severe depression with hypericum extract WS 5570 (St John’s wort): randomised controlled doubleblind non-inferiority trial versus paroxetine

[70]: A Double-blind, Randomized Trial of St John’s Wort, Fluoxetine, and Placebo in Major Depressive Disorder

Neither of these studies pertain to OCD but rather to MDD. A text search for the terms OCD, Obsessive, Compulsive, Intrusive, and Ritual yielded 0 results in both papers. In addition, neither paper contains the term "Amoryn" even though their citations ostensibly confirm that Amoryn specifically has been proven effective by these studies. The first study excluded patients with acute anxiety disorders from the study population, yet Lakhan SE, Vieira KF cite this to support the claim that it is "proven to help patients suffering from ... anxiety". The second citation does not even contain the term anxiety.

The second paragraph of the OCD section in Lakhan SE, Vieira KF goes on to claim that this supplement is superior to SSRIs for OCD:

"Two double-blind, placebo-controlled studies were recently performed that compared the affects of a 900 mg daily dose of St. John's wort extract to 20 mg daily doses of Paroxetine (Paxil) or Fluoxetine ... In comparison to patients taking Paxil, those who took the St. John's wort supplement showed a 57% decrease in OCD symptoms and were 47% less likely to exhibit side effects [69]. In comparison to patients taking Fluoxetine, consumption of the St. John's wort extract reduced 48% of OCD patient's symptoms [70]. These results clearly depict how the use nutritional supplements can be effective treatments for mental disorders."

Again, neither of these citations even mention OCD, and one study specifically excluded patients with acute anxiety disorder, making any generalization to OCD highly suspect.

Jamedeus (talk) 03:26, 6 December 2019 (UTC)

 Done After having read this request and the cited sources, I agree these statements failed to be verified by the cited source. I have removed them as requested. Eggishorn (talk) (contrib) 18:02, 8 December 2019 (UTC)

OCD vs delusions :: Semi-protected edit request on 25 Jul 2020

Let me suggest to add very important detail about OCD which describes which condition is not OCD. I suggest to insert this text after the first paragraph. Personally, I urge to add this change to stop people judge what is OCD based on their false understanding of personal hygiene.

Requested text
It should be noted that a person may deliberately perform certain routines repeatedly, but those may be driven by false personal belief (delusion) rather than obsession. Delusional parasitosis is one of many examples of non-OCD condition.

— Preceding unsigned comment added by Barabanus (talk • contribs) 11:13, 25 July 2020 (UTC)

References

That text is copyrighted, would need to be reworded. – Thjarkur (talk) 12:16, 25 July 2020 (UTC)

@Þjarkur: Thanks, I updated the requested text Barabanus (talk) 18:21, 25 July 2020 (UTC)

 Not done: The lead makes it clear that compulsions in OCD are typically not driven by delusions with the sentence "Most adults realize that the behaviors do not make sense." In the "Insight" section, it's stated that most of the time delusions aren't present, but that delusional disorders are not mutually exclusive with OCD: "Poor insight is characterized by the belief that obsessive-compulsive beliefs are probably true. Absence of insight makes obsessive-compulsive beliefs delusional thoughts, and occurs in about 4% of people with OCD." So, it would be incorrect to treat delusions as mutually exclusive with OCD. They are not a main feature of OCD, but the lead does not imply that they are. The current text appropriately conveys the nuanced relationship between OCD and delusional disorders; this proposed additional text would reject that relationship altogether. Furthermore, I think it would be WP:UNDUE to have the lead explicitly differentiate OCD, a common disorder, from delusional parasitosis, which is quite rare. — Tartan357  ^(Talk) 09:34, 26 July 2020 (UTC)

Semi-protected edit request on 29 September 2020

Add this to the summary

According to the DSM-5 "The obsessive-compulsive and related disorders differ from developmentally norma-tive preoccupations and rituals by being excessive or persisting beyond developmentally appropriate periods. The distinction between the presence of subclinical symptoms and aclinical disorder requires assessment of a number of factors, including the individual’s level of distress and impairment in functioning." 46.159.8.205 (talk) 14:54, 29 September 2020 (UTC)

References

 Not done Such a detailed quotation is not appropriate for the WP:LEAD. Sundayclose (talk) 15:11, 29 September 2020 (UTC)

You can omit the second sentence, but you have to add an info in any way, because it gives an explanation of the term. According to DSM-5 simptoms like preoccupations can be normal and means nothing if they are adequate to the situation, that should be said.— Preceding unsigned comment added by 46.159.8.205 (talk) 2020-09-29 17:29:46 (UTC)

 Partly done: added a qualification to the first sentence which covers the issue with a citation to the DSM-5. Goldsztajn (talk) 08:35, 11 October 2020 (UTC)

Lead misleading

Hey, I'd like to start a discussion on the topic of the lead, especially the beginning of it. It is true that OCD "... is a mental disorder in which a person feels the need to perform certain routines repeatedly (called "compulsions"), or has certain thoughts repeatedly (called "obsessions"), to an extent which generates distress or impairs general functioning."

However, placing "person feels the need to perform certain routines repeatedly" as the first sentence (together with the picture of washing hands -- but that itself is not an issue), and playing the "or" word before the obsessions sentence, leads people to think of this disorder as it would be something typical that they show you in the movies (Monk), where a person just has a compulsion to do something, when in reality the nature of the disorder is obsession first->compulsion second.

Over-all, with the following sentences of the lead also playing heavily on the compulsions part, the lead is out of balance and gives the wrong idea of the disorder.

I would suggest we follow the logic of the International OCD Foundation: Obsessive compulsive disorder (OCD) is a mental health disorder (that affects people of all ages and walks of life,) and occurs when a person gets caught in a cycle of obsessions and compulsions. Obsessions are unwanted, intrusive thoughts, images, or urges that trigger intensely distressing feelings. Compulsions are behaviors an individual engages in to attempt to get rid of the obsessions and/or decrease his or her distress. - https://iocdf.org/about-ocd/#:~:text=Obsessive%20compulsive%20disorder%20(OCD)%20is,that%20trigger%20intensely%20distressing%20feelings.

BTW - I'm not even sure if OCD has a variant where a compulsion happens without an obsession?

What do you think? Wikiekke (talk) 19:40, 29 October 2020 (UTC)

I fail to see how the image is an issue. It's an infobox image that illustrations one possible aspect of OCD. The fact that the infobox is adjacent to the lead is irrelevant. Illustrating a psychiatric disorder with an image is difficult because of the complexity of a disorder, and Wikipedia is limited in the images that are available to use. If you have a better idea for an image feel free to suggest it, but read WP:NFC and WP:COPYRIGHT first. Sundayclose (talk) 00:16, 30 October 2020 (UTC)

As I said, the image itself is not an issue. Wikiekke (talk) 08:27, 30 October 2020 (UTC)

I agree! However, we should simply flip the obsession and compulsion portions of the first sentence. Furthermore, there are variants in which people have solely compulsions or obsessions. Spyder212 (talk) 02:28, 31 October 2020 (UTC)

I'd suggest to change the "or" to "and/or". Simply "or" does not define the disorder correctly.Wikiekke (talk) 13:41, 31 October 2020 (UTC)

Neurodevelopmental disorder

@Sundayclose: Personally I think WP:MEDRS – or at least the way it is enforced – is stupid. In articles on non-medical topics it is fine to say "Some researchers think X" and drop in a few cites to papers arguing that X. It isn't claiming that X is an established fact, that X is true, or even that X is the majority opinion – it is simply letting people know that some researchers believe X is true, and the readers can read the cite to find out who those researchers are and why they think this. It is exposing people to more of the research literature, which in my view is a good thing. (And I don't see why two cites is a problem for justifying "some researchers say X"–I can find more than two if you want, how many do we need?) But then suddenly on medicine, we say that we don't want to expose people to the full breadth of views in the research literature? This special rule for medicine, which applies to no other topic – it just seems silly. Anyway, the other point is what you said about being limited to children – well obviously if paediatric OCD is neurodevelopmental, some adults with OCD have had it ever since they were children, so those cases of adult OCD would be neurodevelopmental too. The question is more around adult-onset OCD. Maybe that is neurodevelopmental, maybe that isn't. Many researchers believe that adult-onset schizophrenia is neurodevelopmental, so we can't say that it can't be neurodevelopmental simply because it is adult-onset. But we don't need to resolve that question here. My point is simply, the entirely true fact, that some researchers view OCD as being (in at least some cases) a neurodevelopmental disorder – it might be one in all cases, some cases, or no cases, but whichever may be true, it remains true that some (indeed I would even say many) researchers believe it is one. Finally, you mention they aren't review articles – I'm not sure how much relevance review articles have here. If we are talking about the question of whether an intervention is effective – well, a systematic review / meta-analysis of its effectiveness across many studies is much more convincing than a single study claiming it is effective. However, you can't do a meta-analysis to determine whether something is a neurodevelopmental disorder. That is fundamentally a qualitative rather than quantitative question. Mr248 (talk) 21:10, 17 February 2021 (UTC)

"Personally I think WP:MEDRS – or at least the way it is enforced – is stupid." "This special rule for medicine, which applies to no other topic – it just seems silly": You may think it's stupid or silly, but WP:MEDRS is the standard for medical articles. Take a few minutes to read WP:Why MEDRS.

"I don't see why two cites is a problem for justifying "some researchers say X"": That's why MEDRS emphasizes review articles, so one or two studies don't get so much WP:WEIGHT which, in a medical article, can lead to erroneous conclusions. Again, read WP:Why MEDRS.

"well obviously if paediatric OCD is neurodevelopmental, some adults with OCD have had it ever since they were children": Except your edit states "Some researchers classify OCD as a neurodevelopmental disorder". If a researcher classifies it as a developmental disorder based only on pediatric patients, that is not a justification for the broad claim that OCD is a developmental disorder. That's also why your use of the phrase "some researchers" is misleading. As for your comment about adults' OCD starting out as a developmental disorder, that's a simplistic conclusion that is based on poor logic ("if the adult had OCD as a child, then that must mean that OCD is a developmental disorder") and flies in the face of the scientific method. Again, read WP:Why MEDRS.

"you can't do a meta-analysis to determine whether something is a neurodevelopmental disorder": That comment reflects a profound misunderstanding of how biological research is conducted. Metanalyses can certainly be conducted on longitudinal research that follows OCD from childhood to adulthood, or possible neurological links between OCD and developmental disorders. Meta-analyses may not provide definitive evidence for medical conclusions (which itself is rare in science), but they certainly are more persuasive than individual studies on restricted populations. Again, read WP:Why MEDRS.

I understand that you may not like having to respect WP:MEDRS in your edits to medical articles, but MEDRS has been standard procedure for editing medical articles since it was created after extensive discussion. MEDRS exists for good reasons, and has helped keep medical articles from becoming bloated with unscientific conclusions based on misunderstandings of medical research. Sundayclose (talk) 21:47, 17 February 2021 (UTC)

Semi-protected edit request on 14 April 2021

Per the International OCD foundation and the APA OCD treatment guidelines, SSRI's and CBT are both first-line treatments, and thus should be considered equal. Hence I would like to remove the word "sometimes" for antidepressants in the article. Hpbeaver6301 (talk) 02:06, 14 April 2021 (UTC)

 Done ScottishFinnishRadish (talk) 14:14, 14 April 2021 (UTC)

I disagree with this edit, at least partially. The statement in the article is not just about what is recommended. It refers to actual clinical practice. OCD sometimes is treated successfully without medication. And sometimes it is treated with only medication. The current edit says "Treatment involves", suggesting that both modalities are always used. I changed it to "Treatment may involve". The details about what is front-line treatment is discussed later in the article. Sundayclose (talk) 22:26, 14 April 2021 (UTC)

Semi-protected edit request on 7 June 2021

2605:A601:5599:3100:8033:6E0B:D4D9:CA57 (talk) 16:41, 7 June 2021 (UTC)

Frequency should be at 2.4 or 5 nothing less.

 Not done: please provide reliable sources that support the change you want to be made. --Ferien (talk) 17:15, 7 June 2021 (UTC)

edit conflict. The cited source in the infobox says 2.3. You will need to provide a source to support your suggested change. RudolfRed (talk) 17:17, 7 June 2021 (UTC)

Dash or hyphen?

DSM-5 seems to use a hyphen? Thanks. Martinevans123 (talk) 10:31, 24 June 2021 (UTC)

Notable cases

FYI to maintainers: The § Notable cases section mentions cases that are not mentioned in those individuals' articles. (not watching, please {{ping}}) czar 20:04, 31 July 2021 (UTC)

Semi-protected edit request on 3 August 2021

My edit request is how the illness OCD is defined; it is slightly vague

and is not sufficient enough to summarize OCD in one sentence. I suggest in the first sentence to edit as such "Obsessive Compulsive Disorder (OCD) is a Mental disorder of the neurodevelopmental type. 172.58.19.122 (talk) 19:26, 3 August 2021 (UTC)

 Not done for now: please establish a consensus for this alteration before using the {{edit semi-protected}} template. That does not seem to be an improvement. ScottishFinnishRadish (talk) 19:44, 3 August 2021 (UTC)

Research section ammendments

In the "Research" section, various substances (inositol, n-acetylcysteine, memantine etc) that have been researched as potential treatment/management/augmentation modalities are mentioned but no specific research is cited. I think there is enough research now to include more information about each of them individually, which I would be willing to do. Is there something I'm missing that would make an update on them using the latest available scientific literature inappropriate?

Dave dwbi (talk) 16:34, 4 October 2021 (UTC)

Have a look at WP:MEDRS. On Wikipedia we wait for systematic reviews rather than citing the latest stuff. - MrOllie (talk) 16:45, 4 October 2021 (UTC)

Semi-protected edit request on 22 November 2021

The third sentence of the third paragraph ("Compulsions done to achieve relief from the distress caused by obsessions.") was most likely intended to read "Compulsions *are* done to achieve relief from the distress caused by obsessions." 108.16.137.249 (talk) 06:44, 22 November 2021 (UTC)

Well that's embarrassing. It's been fixed now, thanks.--Megaman en m (talk) 08:07, 22 November 2021 (UTC)

Began as an edit request, asking for help finding specific resolutions

In paragraph 2, and/or is redundant. "Some common obsessions include but are not limited to fear of contamination, obsession with symmetry, and unwanted thoughts about religion, sex, and/or harm."

In paragraph 3, the idea of the statement "Many adults with this disorder are aware that the behaviors do not make sense" exists under the Obsessions subsection as well, in a more formal and respectful phrasing "Most people with OCD understand that their notions do not correspond with reality; however, they feel that they must act as though their notions are correct."

In paragraph 3, "These compulsions occur to such a degree that the person's daily life is negatively affected" seems to be a rephrasing of the initial definition: "to an extent where it induces distress or impairs one's general functioning."

In paragraph 4 "Some cases have been documented to occur following streptococcal infections.", it currently links to the article Infection, when linking to the Wikipedia article Group A streptococcal infection would be more specific. Additionally, the Group A streptococcal infection article currently has a section on PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections).

Paragraph 3 and 4 end with repetitive information again, "The condition is associated with tics, anxiety disorder, and an increased risk of suicide" and "Other disorders with similar symptoms include anxiety disorder, major depressive disorder, eating disorders, tic disorders, and obsessive–compulsive personality disorder", respectively.

In paragraph 5, for clarity the fourth and fifth sentences, "While clomipramine appears to work as well as do SSRIs, it has greater side effects and thus is typically reserved as a second-line treatment. Atypical antipsychotics may be useful when used in addition to an SSRI in treatment-resistant cases but are also associated with an increased risk of side effects", should be moved to follow the second sentence, or potentially even the first.

In paragraph 6, the clauses in the sentence "It is unusual for symptoms to begin after the age of 35, and half of people develop problems before 20" could be more clear if it followed the order of the source material: "Most people are diagnosed by about age 19, typically with an earlier age of onset in boys than in girls, but onset after age 35 does happen." (NIMH)

Also in paragraph 6, the statement "The phrase obsessive–compulsive is sometimes used in an informal manner unrelated to OCD to describe someone as being excessively meticulous, perfectionistic, absorbed, or otherwise fixated" is missing a source, later in the Signs and symptoms section it appears again, this time with a source.

In the second paragraph of the Signs and symptoms section, the first sentence is remarkably dense/technical: "While OCD has been considered a homogeneous disorder from a neuropsychological perspective, many of the putative neuropsychological deficits may be the result of comorbid disorders."

In the Insight subsection "The DSM-V contains three specifiers for the level of insight in OCD. Good or fair insight is characterized by the acknowledgment that obsessive-compulsive beliefs are or may not be true", are not or may not would provide more clarity.Anthropologeethanks (talk) 17:26, 4 December 2021 (UTC)

Excellent points! Please consider unleashing your inner Bold Wikipedian and making those smart edits yourself! :O) Mark D Worthen PsyD (talk) [he/his/him] 03:28, 5 December 2021 (UTC)

Wiki Education Foundation-supported course assignment

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Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 05:32, 17 January 2022 (UTC)

Semi-protected edit request on 25 March 2022

Hello,

I was hoping to add the following citation under "causes" - "drug induced OCD" in the citation needed portion of the page. I'm a medical librarian enrolled in the NLM course Wikipedia + Libraries. This is my first edit request on Wikipedia. I'm passionate about all things related to mental health, and I hope to be able to edit this page in the future. Thank you for considering my request. Guacamolly87 (talk) 23:12, 25 March 2022 (UTC)

Welcome to Wikipedia Guacamolly87 :0) - It's great to have a medical librarian join our ranks! I will add DSM-5 as a reference in that section. // If you want to cite references on a talk page, this handy template—Template:Reflist-talk—places your references in a nicely bordered list. All the best - Mark D Worthen PsyD (talk) [he/him] 04:49, 26 March 2022 (UTC)

References

Semi-protected edit request on 21 April 2022

In the Management paragraph the two types of medications should be abbreviated as SSRI and SNRI instead of SRI and SSRI as these are incorrect. 188.143.98.10 (talk) 22:00, 21 April 2022 (UTC)

 Done Thanks. Martinevans123 (talk) 22:12, 21 April 2022 (UTC)

Can someone remove the hell image? It can easily trigger compulsions for those suffering with OCD.

The image is under compulsions. 208.104.196.251 (talk) 06:25, 9 August 2022 (UTC)

Wiki Education assignment: Technical and Scientific Communication

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Semi-protected edit request on 28 September 2022

The line in the Associated conditions section which reads:

"It has been found that between 18-34% of females are currently experiencing or will experience OCD in their lifetime.[63] Of that 18-34%, 7% are likely to have an eating disorder.[63] Roughly 0-5% of males have OCD and an eating disorder.[63]"

is misrepresenting the results of the article it cites. Especially want to highlight how inaccurate the first sentence in this section is.

The more accurate way to say that is:

One study indicated that 12.7% of total participants (34% of all females in the study, 3.5% of all males in the study) who were diagnosed with OCD in childhood meet screening criteria of an eating disorder in a follow up study on average 5 years after OCD diagnosis [2]. Another study indicated 8.7% of female study participants with OCD (versus 1.3% in the control group) met probable ED diagnosis criteria via the Eating Disorder Examination-Questionnaire coupled with behavioral characteristics [3]. No male study participants there met probable ED diagnosis criteria. [4]. 152.16.191.141 (talk) 19:36, 28 September 2022 (UTC)

I think that's a paraphrase of this paper paraphrasing some other paper (pdf page 7, right column, starting from "A previous study found that 18–34% (depending on cut-off score)"). We should probably just cite that directly:

18. Tyagi H, Patel R, Rughooputh F, Abrahams H, Watson AJ, Drummond L. Comparative prevalence of eating disorders in obsessive-compulsive disorder and other anxiety disorders. Psychiatry J. 2015;2015. 3mi1y (talk) 06:27, 18 October 2022 (UTC)

 Done per the above suggestion. BlueNoise (Désorienté? It's just purple) 21:13, 27 October 2022 (UTC)

calling Greta

"world renowned" is wildly biased and inappropriate 12.180.242.100 (talk) 16:06, 29 March 2023 (UTC)

Wiki Education assignment: Equitable Futures - Internet Cultures and Open Access

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OCSD?

I recently encountered (https://neurosciencenews.com/microglia-ocd-anxiety-23395/) the term OCSD for "obsessive-compulsive spectrum disorder". This article could use a good definition of that term if it is becoming widely accepted. (Also to modify the current redirect from OCSD → Orange County Sheriff's Department (California). Theodore Kloba (☎) 20:21, 5 June 2023 (UTC)

Edit inquiry about sub-section "Associated Conditions"

Currently don't have the ability to actually edit it, so putting this in here:

> It has been found that between 18 and 34% of females are currently experiencing or will experience OCD in their lifetime. Of that 18-34%, 7% are likely to have an eating disorder. Fewer than 5% of males have OCD and an eating disorder.

This is super ambiguous in the second sentence. "Of that 18-34%, 7% are likely to have an eating disorder"... so, is it suggesting 7% of that 18%-34%, or 7% of all females? I actually looked through the source and I honestly couldn't find anything that directly affirms the "7%" statistic. The best I could find was: "Again, estimates are higher for females, and the few available studies report that between 7 and 18% of female and 0–5% of male patients have a current comorbid ED." But if this was where the 7% came from, then why was the 18% omitted?

I'm not that good at looking at long papers and statistics. If my findings are true, please add in the 18% and make sure it actually, unambiguously states "7% of all females" in that sentence. Unrealgaming (talk) 18:39, 13 April 2023 (UTC)

There are so many things I could say right now. – AndyFielding (talk) 19:42, 25 July 2023 (UTC)

Semi-protected edit request on 28 August 2023

I think the cover photo of this article referencing excessive hand washing is a horrible example of OCD due to the common misconceptions that this disorder revolves around being a clean freak or is simply a quirky type A personality. OCD can of course involve any kind of obsession and accompanying compulsions. It is not inaccurate that many people with OCD do have clinical obsessions with cleanliness or the idea of contamination, but it needs to be firmly shown that OCD can be exhibited in so many different ways with behavior that is not representative of society’s inaccurate stereotype of it. There are many infographics about OCD online that would work or if you can’t use those images, many different obsessions and compulsions could be explained with an relevant accompanying image or collage of images. Thank you. 76.82.36.226 (talk) 01:24, 28 August 2023 (UTC)

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. M.Bitton (talk) 16:46, 28 August 2023 (UTC)

To add to that, it is impossible to represent every aspect of OCD in one image. As for online graphics, we can't use them if they are under copyright. Feel free to suggest anything that is free to use for us to consider. If readers really want to know about OCD, they will read the article and not just look at the image. Sundayclose (talk) 18:32, 28 August 2023 (UTC)

Depiction of hell

The medieval picture selected to illustrate hell includes a cauldron which is anti-Semitic. This may be valid in a history topic, but perhaps inappropriate for an article on OCD? Howsonpj (talk) 05:03, 20 October 2022 (UTC)

Sorry if this sounds dumb but how is a cauldron anti-semitic? Urchincrawler (talk) 01:35, 27 April 2023 (UTC)

A cauldron itself is not anti-Semitic. Zoom into the image and notice the cauldron on the left. It looks like it's labeled "Juden". I think it may be difficult to find an artistic depiction of hell without bringing along the artist's ideas of who belongs there. Since the image caption in this article relates to intrusive thoughts about the devil, maybe no photo of hell is really necessary. Theodore Kloba (☎) 20:30, 5 June 2023 (UTC)

No it is not. Stop victimizing peoples. 99.68.41.239 (talk) 22:50, 26 September 2023 (UTC)

Semi-protected edit request on 10 October 2023

Reference to US FDA, New management is available. In details : https://www.fda.gov/news-events/press-announcements/fda-permits-marketing-transcranial-magnetic-stimulation-treatment-obsessive-compulsive-disorder Diy7t (talk) 04:44, 10 October 2023 (UTC)

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. JTP ^{(talk • contribs)} 05:31, 11 October 2023 (UTC)

According to Transcranial magnetic stimulation#Obsessive–Compulsive Disorder (OCD). I request edit on Obsessive–compulsive disorder. By "Insert X after/before Y" format, I want to insert Transcranial Magnetic Stimulation after Obsessive–compulsive disorder#Procedures to up-to-date. The reliable sources are from U.S. Food and Drug Administration official website and medical news agencies. The reliable sources url are

1. https://www.fda.gov/news-events/press-announcements/fda-permits-marketing-transcranial-magnetic-stimulation-treatment-obsessive-compulsive-disorder
2. https://www.clinicaltmssociety.org/news/2020-08/magventure-receives-fda-clearance-ocd-0
3. https://www.healio.com/news/neurology/20230613/fda-clears-ocd-motor-threshold-cap-for-transcranial-magnetic-stimulation-system

Best Regards,

Diy7t Diy7t (talk) 02:41, 12 October 2023 (UTC)

Semi-protected edit request on 13 October 2023

I think the data of this page is not update. I want to change "Procedures" to "Electroconvulsive therapy", "Transcranial magnetic stimulation"[TMS] and "Surgery". And also want to update the TMS Therapy to recent information.

TMS has 2 sub-topics by randomized-controlled trial research by 2023. 1. Deep Transcranial Magnetic Stimulation that the United States FDA Approved in 2018. 2. Transcranial Magnetic Stimulation that the United States FDA Approved between 2019 - 2023.

Thank you Ss3014 (talk) 01:18, 13 October 2023 (UTC)

 Not done: I'm not quite sure what exactly your concern is. There is a section heading of "Procedures", which in my opinion is a good heading for the section that contains the three procedures you list. I don't think changing "Procedures" to a list of the three is a productive change.

Second, I'm not sure adding the TMS detail is necessary on this page, but there is a link to the TMS page, which has info on Deep TMS.

-- Pinchme123 (talk) 04:24, 13 October 2023 (UTC)

Wiki Education assignment: WikiProject Medicine Fall 2023 UCF COM

This article was the subject of a Wiki Education Foundation-supported course assignment, between 23 October 2023 and 19 November 2023. Further details are available on the course page. Student editor(s): Rachnasann (article contribs).

— Assignment last updated by DLEMERGEBM (talk) 13:38, 3 November 2023 (UTC)

WikiProject Medicine Elective UCF

I agree with including more information specifically about deep TMS as listed above, particularly in the pediatric population (which is being done in other countries like India). SSRIs in children have unknown prepubertal sexual effects in children and the therapeutic dosages in the pediatric population for OCD are often much higher than for MDD (40mg vs 10-20mg of Prozac). I think these specific details would be worth mentioning and I plan to cite relevant review articles regarding pediatric dosing and interventional options like TMS. The research in this area is rapidly growing and I would like to include more than one line about this in the article.

The subheading "Children" would benefit from more information. I would like to change this heading to "Pediatric OCD" and cite more recent work. There is work cited from 1989 which would be supported by more recent review articles. The POTS study (https://pubmed.ncbi.nlm.nih.gov/15507582/) is one of the most heavily cited and referred to in pediatric OCD treatment, but it is not yet included. Additionally, I would want to include the CY-BOCS measurement tool under pediatric OCD. Y-BOCS is already included as the measurement tool in adults, but I also want to mention the tool for children for completeness.

I would like to edit "Some patients fail to improve after taking the maximum tolerated dose of multiple SSRIs for at least two months; these cases qualify as treatment-resistant and can require second-line treatment such as clomipramine or atypical antipsychotic augmentation." to better explain dosing and other interventional treatment options which are now considered at the treatment-resistant stage.

I would like to update the current rates and trends of OCD by the pediatric and adult populations. The current citations regarding rates of OCD (2.3% overall, 1.2% in any given year) are from about 10 years ago, and I would like to update them. I intend to use pubmed searches and my university library to make edits to the article. My intention is to avoid medical jargon. I want to help introduce the topic of OCD in a way that is accurate, up to date, and easily digestible by a non-medical audience. To this end, please let me know if my future edits could be further improved.

Thank you – Rachnasann (talk) 04:26, 26 October 2023 (UTC)

Pediatric OCD section was added, and the intended section improved. The data on trends was presented but maybe expanding on the trends with some historical background could benefit from it. Showing trends throughout the years could be beneficial to other readers. All in all good job with the sections added, and my only area of improvement is that. 2600:1700:6A32:A600:B9FE:E7B8:2D42:951E (talk) 21:33, 15 November 2023 (UTC)

Thank you for the feedback! I will find more data regarding trends. Rachnasann (talk) 02:32, 17 November 2023 (UTC)

Basic spelling error in the research section

The last word of the research section, "ongoing" is misspelled as "ongling". Minor fix, but I can't fix it due to page protection. ProteinFromTheSea (talk) 21:23, 19 December 2023 (UTC)

Fixed. Kimen8 (talk) 22:16, 19 December 2023 (UTC)