ADHD medication increases obsessive-compulsive disorder

Obsessive-compulsive disorder

What is Obsessive Compulsive Disorder?

Obsessive-compulsive disorder is characterized by recurring obsessive-compulsive thoughts and / or compulsive actions. Obsessive-compulsive thoughts are intrusive ideas, thoughts or images that those affected experience as uncomfortable or frightening. Frequent examples are thoughts of having come into contact with pathogens, of harming others through your own inattention, or thoughts related to religious or sexual content. Obsessive-compulsive actions are recurring and often senseless or exaggerated actions that the person concerned feels pressured to (e.g. because of an obsessive thought). Frequent compulsions are excessive washing rituals, excessive control actions, compulsions to order, compulsions to count and compulsions to collect. As a rule, those affected are well aware of the absurdity of their behavior. Nevertheless, they do not manage to change the compulsive behavior that is sometimes associated with considerable expenditure of time and / or high stress.


How does obsessive-compulsive disorder develop?

Various causes contribute to the development of obsessive-compulsive disorder. It seems certain that neurobiological as well as learning and life history experiences play a decisive role. The exact interaction of the factors discussed is the subject of intensive scientific research.


Neurobiological models

The results of neurobiological research on obsessive-compulsive disorder suggest the involvement of genetic factors, changes in brain function and a disturbed balance of important messenger substances in the brain:

Studies show that relatives of affected people are at increased risk of developing OCD themselves. This result is interpreted as an indication of genetic involvement. What is certain is that obsessive-compulsive disorder is not inherited directly, but only a risk of becoming ill. Several genes, which have not yet been clearly identified, are probably involved in the development of obsessive-compulsive disorder.

In modern studies on abnormalities in brain functions, impaired activation of the forebrain and deeper lying areas in obsessive-compulsive patients has been reported. These are brain centers that play an important role in the execution and control of actions and in the control of thoughts. In particular, the orbitofrontal cortex appears to be overactive in people with OCD. This is viewed as a possible basis for obsessive-compulsive thoughts that are experienced as uncontrollable and obsessive-compulsive actions that are difficult to interrupt. Interestingly, the abnormal brain activation normalizes itself through successful treatment with medication or behavioral therapy.

In the brain, information is passed on between the nerve cells by messenger substances. A disturbance in the messenger system leads to a disturbed information transmission, which can be compensated for by medication. The effectiveness of drugs of the class of selective serotonin reuptake inhibitors (SSRIs), which has been clearly proven in numerous studies, indicates a role of the messenger substance serotonin in the development of obsessive-compulsive disorder. Other messenger substances such as dopamine and glutamate are probably also involved in the development of an obsessive-compulsive disorder.


Psychological explanatory model of obsessive-compulsive disorder

According to the psychological model, people with obsessive-compulsive disorder attach too much importance to intrusive and unpleasant thoughts. While healthy people are not further influenced by such "disturbances" in their flow of thoughts, obsessive-compulsive illnesses report one Sticking of such thoughts. By evaluating the thoughts as dangerous, for example, they trigger strong fears and tension. Compulsive acts serve to reduce the fear and tension experienced and to create a feeling of security or correctness. The calming achieved in this way increases the likelihood of showing the obsessive-compulsive behavior again later, and the obsessive-compulsive disorder solidifies.


What is the treatment for Obsessive Compulsive Disorder?

According to the current state of research, a combination treatment consisting of drug and behavioral therapy for obsessive-compulsive disorder appears to be the most promising.

Well-proven drugs for the treatment of obsessive-compulsive disorder are the so-called serotonin reuptake inhibitors (SSRIs) and the tricyclic antidepressant clomipramine. Under certain circumstances, the effect of these drugs can be further increased by administering other, well-balanced drugs. The drugs approved for the treatment of obsessive-compulsive disorder are not addictive and do not limit performance.

In structured, multimodal behavior therapy, those affected learn to counter their obsessive thoughts and compulsive actions and to regain control over their behavior. For this purpose, individual confrontation exercises are planned and carried out in which non-compulsive behavior can be practiced. The Clinic and Polyclinic for Psychiatry and Psychotherapy at the University of Bonn offers two therapy groups specially tailored to obsessive-compulsive disorders. The outpatient therapy program comprises 25 group sessions.
There are still places available in the group that will start soon!

A special offer of our clinic is a regular one Event for relatives and helpers of data subjects. At the open meeting, we impart basic knowledge about constraints and give recommendations on how to deal with those affected. There is plenty of room for your own questions and personal examples. Participation is free. If you are interested in this offer, please do not hesitate to contact us.


What does the treatment look like?

If you are interested in our range of treatments, you can call Ms. M.Sc. Katharina Bey (0228 287-16859) turn. You can reach our psychiatric outpatient clinic on 0228 287-15732.

You can find more information about our special outpatient department for obsessive-compulsive disorder in our flyer (PDF).