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Obsessive-compulsive disorder (OCD) is characterized by intrusive, persistent thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) that are time-consuming and cause significant distress.
Quick Answer
Obsessive-compulsive disorder (OCD) is characterized by intrusive, persistent thoughts (obsessions) and repetitive behaviors or mental acts (compulsions) that are time-consuming and cause significant distress. Dr. Ruja Shrestha (NMC 19766, Experienced clinical practice in psychiatry and mental health) evaluates obsessive-compulsive disorder at Kathmandu Neurology Clinic & Cognitive Center, Durbar Marg, Opposite of Yak & Yeti Hotel, Kathmandu 44600, Nepal — evidence-based, medically reviewed.
OCD involves a cycle of obsessions � unwanted, distressing thoughts, images, or urges � and compulsions � behaviors performed to reduce the anxiety caused by obsessions. Common obsessions include contamination fears, harm-related thoughts, and need for symmetry. Common compulsions include washing, checking, counting, and ordering. OCD affects approximately 2-3% of the population and can be severely impairing. Evidence-based treatment combines exposure and response prevention (ERP) with pharmacotherapy.
Clinical diagnosis based on DSM-5 or ICD-11 criteria: presence of obsessions, compulsions, or both, that are time-consuming (more than one hour per day) or cause clinically significant distress. The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is used to assess severity. Differential diagnosis includes anxiety disorders, body dysmorphic disorder, and tic disorders. Medical causes (autoimmune, neurological) should be considered in acute-onset cases.
Exposure and response prevention (ERP) is the first-line psychotherapy. SSRIs (fluoxetine, fluvoxamine, sertraline) at higher doses than those used for depression are first-line pharmacotherapy. Clomipramine (a tricyclic antidepressant) is an alternative. For treatment-resistant OCD, augmentation with low-dose atypical antipsychotics (aripiprazole, risperidone) or deep brain stimulation may be considered.
Management is individualized and discussed with benefits, limitations, and follow-up.
Early intervention for emerging OCD symptoms, stress management, and maintaining a balanced lifestyle. For PANDAS-related OCD, prompt treatment of streptococcal infections is important. Psychoeducation for patients and families reduces the burden of the condition.
No. OCD involves distressing obsessions and compulsions that are time-consuming and impairing. Perfectionism is a personality trait that does not typically cause the same level of distress or functional impairment.
Exposure and response prevention (ERP) involves gradually facing feared situations (exposures) without performing compulsions. It is the most effective psychotherapy for OCD, with response rates of 60-80%.
SSRIs are effective in approximately 40-60% of patients. Higher doses than those used for depression are often needed. Combining ERP with medication produces better outcomes than either alone.
Yes � Dr. Jitendra Prasad Yadav (NMC 8029) provides OCD assessment and treatment at Kathmandu Neurology Clinic & Cognitive Center.
OCD is often chronic, but many individuals achieve significant symptom reduction with appropriate treatment. Some may experience periods of remission. Ongoing management strategies may be needed.
Intrusive thoughts are a normal part of mental life. In OCD, these thoughts are perceived as more threatening, and compulsions develop to neutralize them. ERP helps break the cycle by teaching that the thoughts can be tolerated without performing compulsions.
Comprehensive psychiatric evaluation for mood, anxiety, psychosis, and other mental health concerns, including medication assessment and long-term care planning.
Structured, evidence-based cognitive behavioral therapy for anxiety, depression, insomnia, and related conditions.
Evaluation and management of generalized anxiety, panic disorder, social anxiety, and phobias.
Generalized anxiety disorder (GAD) involves persistent, excessive worry about everyday matters that is difficult to control and may cause physical symptoms.
Bipolar disorder is a chronic mood condition characterized by alternating episodes of mania or hypomania and depression, causing significant disruption to daily life.
Social anxiety disorder (social phobia) is characterized by marked fear or anxiety about social situations in which the individual may be scrutinized by others, leading to avoidance or endurance with intense distress.
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Cognitive Behavioral Therapy: How It Works and What to Expect
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Psychiatry
Obsessive-Compulsive Disorder: Understanding Its Impact on Daily Life
How OCD manifests in everyday routines, the distinction between obsessions and compulsions, and what current evidence says about effective treatments.
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Reviewed by Dr. Jitendra Prasad Yadav • Last reviewed: 2026-09-04
Content is educational and aligns with standard medical references; individual evaluation may vary. External links provide context and do not imply endorsement.
Doctor — medically reviewed
Dr. Ruja Shrestha
Consultant Psychiatrist & CBT Therapist • MBBS, MD (Psychiatry) • NMC 19766
This condition guide was medically reviewed by Dr. Ruja Shrestha.
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