The basic symptoms of obsessive-compulsive disorder are obsessive-compulsive thinking, obsessive-compulsive thinking, obsessive-compulsive emotion, obsessive-compulsive intention, compulsive action or behavior, which can be one of them or several of them coexist.
1. Clinical manifestations of obsessive-compulsive thinking or obsessive-compulsive thinking.
Common are forced doubt, forced association, forced exhaustion, forced memory and so on.
(1) Obsessive doubt refers to the patient's repeated doubts about the correctness of his words and deeds, knowing that it is unnecessary, but it is difficult to get rid of it. If you doubt whether you have signed a letter when sending it, doubt whether you have written the wrong address after throwing it into the mailbox, and so on.
(2) Forced association means that when you see a sentence or a word, or an idea appears in your mind, you can't help but associate it with another idea or phrase. If the associated ideas or words are contrary to the original intention, it is called compulsive opposition.
(3) Compulsive failure refers to thinking repeatedly about some things or natural phenomena in daily life and asking questions, knowing that there is no need to lack practical significance, but it is uncontrollable. For example, why the leaves are green, why 1+ 1 equals 2, and so on.
(4) Forced recall refers to the patient's unconscious repetition of the experienced events in his mind, which he can't get rid of and feel distressed. If this memory reaches the level of representation, it is called forced representation.
2. Forced emotions
Worry about or dislike something unnecessarily, knowing that it is unnecessary, but you can't get rid of it.
3. Forced intention
Repeatedly experience a strong inner impulse to do things against your will. Knowing that it is unnecessary, I try to control myself from doing it, but it is difficult to get rid of this impulse, which is commonly known as the compulsive fear of losing my self-control ability.
4. Compulsory actions and behaviors
It is often involuntary compliance caused by compulsive thinking, in an attempt to alleviate the anxiety caused by compulsive thinking. Clinical common: repeated washing, forced examination, forced inquiry, forced ritual movements. If ritual actions or behaviors lead to slow action, it is called compulsive delay. For example, if you read the first line of a book repeatedly, you can't continue reading.
5. Self-awareness
Patients have a certain degree of self-knowledge of obsessive-compulsive symptoms, know that such thinking or behavior is unreasonable or unnecessary, and try to control but fail.
6. Symptoms and characteristics
Obsessive-compulsive symptoms should have the following characteristics: they must be regarded as patients' own thoughts or impulses; At least one thought or behavior must still be resisted in vain by the patient; The idea of carrying out action is unpleasant in itself; Forced thoughts or impulses are bound to reappear unpleasantly. The obsessive-compulsive symptoms found in schizophrenia, Tourette's syndrome and organic mental disorders should be regarded as part of these disorders. Patients are forced to think or exhausted, which can be manifested as thoughts, psychological representations or behavioral impulses. Although the content is different, it always makes patients suffer. The relationship between obsessive-compulsive fatigue and depression is particularly close. Obsessive-compulsive disorder can only be diagnosed if there is no depression or exhaustion. Most compulsory actions include washing (especially hand washing) and repeated inspections to prevent potentially dangerous situations and keep them orderly and tidy. There are often feelings of fear, such as fear of danger or fear of danger caused by oneself.
7. Personality characteristics
Most of them have compulsive personality characteristics, which are ruthless, indecisive, too cautious, and strive for perfection and accuracy. But there are also 16% ~ 36% patients without obsessive-compulsive personality.
8. Course of disease and prognosis
Obsessive-compulsive disorder usually starts slowly in teenagers or early adulthood, without obvious reasons, and the course of the disease is prolonged. Some stress factors can aggravate the symptoms. Symptoms fluctuate with time, and rarely relieve themselves without proper treatment. Moderate to severe social function damage often occurs, and the quality of life is reduced. Patients rarely establish and maintain normal interpersonal relationships, and their learning and professional functions are disturbed. About 15% patients showed that their occupational and social functions were gradually deteriorating. Generally speaking, after one year, about two-thirds of the patients' symptoms are relieved, and those with a course of more than one year often fluctuate. Follow-up of patients with severe symptoms showed that 3/4 patients remained unchanged after 13 ~ 20 years. The main influencing factors of poor prognosis are: severe symptoms; Have serious personality defects before illness; Psychological stress persists.