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 b

OCD is an anxiety related disorder and is a potentially disabling condition that can persist throughout a person's life. An individual who suffers from OCD becomes trapped in a pattern of repetitive thoughts and behaviors that are senseless and distressing but are extremely difficult to overcome. OCD occurs on a continuum from mild to severe. At the severe continuum, if left untreated, it can destroy a person's capacity to function at work, at school or even at home.

An interview with Dr. Edward Chan from the Taman Desa Psychological Counseling center revealed that treatment methods used here to treat OCD are similar to that used in the US. Dr. Chan uses cognitive behavior therapy in treating his clients with OCD. He has found this to be the most effective form of treatment. He uses flooding and systematic desensitization in particular and emphasizes the importance of the client mastering a relaxation technique before being subjected to this form of therapy. When asked if he uses thought-stopping, he answered saying that he has not found it to be helpful.

There is a great need for more psychologists and psychiatrists in Malaysia. According to Dr. Chan, there is one clinical psychologist who attends to the needs of 1000 patients in Hospital Bahagia. One actually wonders, if patients are actually getting the help they so badly need. I agree with Dr. Chan that therapeutic communities should be set up to make therapy more accessible and less threatening to the common people. Therapy using a combination of medication, individual therapy, family therapy and support groups would be ideal for an OCD patient. Not only would the patient's biological needs be met but the patient would be able to maintain resilience with the help of support groups and the family. Cognitive-Behavior therapy should be used as it seems to be the most effective treatment so far, but I would not go so far as to use flooding unless the case is very severe. I would prefer to use systematic desensitization where the patient is exposed to the anxiety provoking situation gradually. For homework, I would have the client keep a diary of all the efforts he/she has made to overcome the disorder. Then if ever the client feels discouraged, the diary can be used to encourage the client further. Also it helps keep tab on the progress the client is making.

As Sandy's exposure therapists points out, "OCD is frightening. People think they are no longer in control of their thinking and behavior. And that, in our culture, is associated with being crazy." (Internet 5)

There are some evidence that additional of buspirone to fluoxetine or another SSRI is beneficial. Neuroleptics has been shown to be particularly useful in patients where OCD is accompanies tics and Frank Tourette's disorder, body dysmorphic disoeder or trichotillpmania.

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