Jul 27th 2023
Obsessive-compulsive disorder (OCD) is a mental health condition that causes intrusive and unpleasant thoughts that result in compulsive behaviors. The symptoms of OCD can vary significantly, so the condition is often described in 4 subtypes, which can be treated with therapy, medication, and self-care.
OCD is defined as a single condition in the DSM-5  with a list of criteria that can present as several different symptoms. As such, any two people diagnosed with OCD could display different variations of symptoms. OCD-related fears and anxieties commonly fall under different categories. For this reason, many have attempted to define OCD subtypes, which may occur alone or in combination .
This is the most common type of OCD and affects around half of those with the condition. It is characterized by intense fear or disgust of uncleanliness, dirt, germs, or illness. People with this type of OCD might engage in excessive cleaning rituals, which can lead to physical harm, such as irritated, chapped, or bleeding skin on the hands or body .
This subtype of OCD is characterized by the obsession with things being perfect or ‘just right’. People with this type of OCD may engage in counting, arranging, and tapping rituals.
While many people may prefer things to look a certain way, this type of OCD causes an overwhelming need rather than preference. It can cause intense unease or discomfort if items are not aligned or arranged correctly .
Research shows that this type of OCD may be linked to more severe and long-lasting symptoms of OCD .
Often referred to as ‘checking OCD’, this subtype is characterized by repeated thoughts of accidental harm resulting from careless actions or negligence. People with this type of OCD may spend several hours per day engaging in checking rituals due to persistent doubts and fears around safety .
This type of OCD is characterized by intense intrusive thoughts that go against the individual’s moral values, such as thoughts of a violent, sexual, or blasphemous nature. The individual does not wish to act upon these thoughts and tries to avoid thinking about them, thereby drawing further attention to them, and increasing their severity .
People with this type of OCD may be less likely to engage in rituals, although they often experience more severe obsessions than the other subtypes .
Several conditions may share similarities with OCD. For example, anxiety and stress-related disorders may share symptoms such as intense fear, avoidance, and unwanted obsessions or thoughts .
Currently, there is limited research and evidence relating to treatments specific to various subtypes of for OCD. As such, interventions for OCD aim to generally treat the condition, as opposed to specific symptoms or subtypes .
While these treatments can be very effective for some, there are a large proportion of individuals with OCD who do not respond well to treatment. Therefore, further research into individualized treatment options is required, focusing on subtype symptoms and presentations .
OCD is typically treated with medication, therapy, or both.
A type of antidepressant medication called selective serotonin reuptake inhibitors (SSRIs) is often the first choice of medication to treat OCD. Studies show that SSRIs are effective in around 40-60% of people with OCD .
Typically, cognitive behavioral therapy (CBT) is used to treat OCD, as it can help to restructure thought processes and associated behaviors. A type of CBT called exposure and response prevention therapy (ERP) is considered the most effective treatment plan for many with OCD and can be applied to the various subtypes .
ERP works by gradually exposing the individual to their fear or cause of distress while avoiding the use of compulsive behaviors as a solution or safety mechanism. This helps the individual to become increasingly tolerant of their fear, gradually reducing their anxieties and OCD symptoms .
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