MEDICAL SURFARI: OBSESSIVE DISORDERS EXPLAINED

Washers, checkers, cleaners, hoarders, repeaters, orderers and pure obsessives -- these are generally accepted subdivisions of obsessive-compulsive disorder (OCD).

"Cleaners" feel that nearly everything is contaminated or dirty, and they spend inordinate amounts of time cleaning and recleaning their surroundings.

"Checkers" have an overwhelming need to repeatedly check things. For instance, a checker might turn off the stove and be compelled to check it 20, or even 100, times to be sure that it is indeed turned off.

"Hoarders" collect almost anything. They may even have difficulty throwing away garbage, saving soup cans, empty boxes, milk cartons, pieces of paper and cardboard.

"Repeaters" are people who feel overwhelmingly compelled to do things a "right" number of times. These people generally fear that if they do not do something the "right" number of times, that something bad will happen. For instance, they may feel that they must always do everything seven times, because seven is a lucky number.

"Orderers" are generally reluctant to let anyone touch their possessions, lest they will be misarranged. Orderers might spend hours just aligning a piece of paper on a desktop to get it exactly right.

"Pure obsessives" may be troubled with recurring thoughts of a disturbing nature. For instance, these people may constantly obsess about hurting someone that they love. Even though they know that they would not do such a thing, they cannot stop worrying about this possibility.

OCD is an anxiety disorder characterized by involuntary thoughts, ideas, urges, impulses or worries that run through one's mind repeatedly (obsessions) followed by a behavioral response (compulsion) that result in time-consuming rituals. Many OCD sufferers often attempt to hide their disorder rather than seek help. The unfortunate consequences of this secrecy is that people with OCD usually do not receive professional help until many years after the onset of their disease.

OCD affects not only the sufferer but the whole family. It can be treated with behavior therapy and/or pharmacotherapy programs. Family education is also very important to help manage anger and resentment that may develop from poor understanding of this disorder.

Although this disorder was formerly thought to be quite rare, the National Institute of Health has estimated that OCD affects more than 2 percent of the population. Males and females are equally affected, and OCD strikes people of all ethnic groups. The symptoms typically begin in teen-age or early adult years although some studies have indicated that at least a third of the cases of OCD in adults began in childhood. There are about 1 million children and adolescents in the United States that suffer from OCD. Suffering from OCD during early stages of the child's development can cause severe problems for the child.

If you believe that you may have OCD, you should seek the help of your family physician initially and if this diagnosis seems likely, a referral to a mental health professional may be necessary.

World Wide Web Resources

National Institute of Mental Health

www.nimh.nih.gov/publicat/ocd.htm

This is an excellent publication on OCD, which includes treatment options, current research and resources for further information.

National Alliance for the Mentally Ill

ocd.nami.org/helpline/ocd.htm

This Web site has some very good information on OCD, particularly related to children and adolescents.

Internet Mental Health

www.mentalhealth.com

This Web site includes the formal classification of OCD, medical and psychosocial treatment and research.

Dr. Scott Gibbs is a Cape Girardeau neurosurgeon and editor-in-chief of Mosby's Medical Surfari. You may e-mail questions to him at drgibbs@semissourian.com or write in care of the Southeast Missourian, P.O. Box 699, Cape Girardeau, Mo., 63701.