Obsessive-Compulsive Disorder (henceforth OCD) is an anxiety related disorders and is a potentially disabling condition that can persist throughout a person's life. The key features of OCD are obsessions and compulsions. Obsessions can be defined as persistent ideas, thoughts impulses or images that are experienced as inappropriate and intrusive. This then causes the person high levels of anxiety and distress. Compulsion on the other hand, Are repetitive behaviors like hand washing, ordering and checking. The reason for doing this is to prevent or to reduce the anxiety or distress felt.

The cause of OCD is no longer solely attributed to the attitudes the patient learnt as a child. The search for cause now focuses on the interaction of neuro-biological factors and environmental influences and cognitive processes.

It has been fond that OCD affects 1 to 2 % of the population in Malaysia and the United States. It cuts across all ethnic groups and effects both males and females. The onset of OCD is earlier in males i.e. between 6 to 15 years of age while the disorder affects females in the age range of 20 to 29.

" Bob saw his psychiatrist for treatment of depression for six months befor

Although the time course of clonazepam's antiobsessional effect has not been formally studied, there are suggestions that its effects may be evident within days, rather than weeks, as with SSRIs.

In an effort to identify specific biological factors that may be important on the onset or persistence of OCD, investigators from the National Institute of Mental Health (NIMH) have used a device called the Positron Emission Tomography (PET) scanner to study the brains of patients with OCD. Findings from the PET scan suggests that OCD patients have pattern of brain activity that differs from those without mental illness or with some mental illness. 'Brain imaging studies of OCD showing abnormal neuro-chemical activity in regions known to play a role in certain neurological disorders suggest that these areas may be crucial in the origins of OCD.' (Internet 3) There is also evidence that treatment with medication or behavior therapy induce changes in the brain coincident with clinical improvement. (Internet 3)

Step 4 : Consider monotherapy trial of clonazepam

He feels it is important that the family of the client is present at the therapy sessions. This would help them to be better equipped in dealing with a family member with OCD such as providing them with reassurance. Most often clients who come in for therapy would also be seeing psychiatrist for medication. He medication most commonly used here is Prozac.

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