Obsessivno-kompulsivnoye frustration

Description:

The obsessions and aspirations causing to the patient discomfort and breaking its social or individual functioning belong to manifestations of obsessivno-compulsive frustration if  they are not result of other mental disorders.
Average age of patients with obessive and compulsive frustration makes 20 years, 70% the beginning aged up to 25 years, 15% after 35 years. Among men and women the disease comes to light in equal ratios. Prevalence: 0,5-2% of the total number of the population.

Reasons of Obsessivno-kompulsivnogo of frustration:

Neurochemical theory: disturbance of regulation of 5HT of system, or 5HT/DA of interactions.
The immunological theory indicates possible communication of a disease with cellular autoimmune factors.
Researches by KT and MPT methods reveal bilateral reduction of the caudal size at patients of ROC. The positron emission tomography and an odnofotonny emission computer tomography reveals a hypermetabolism in an orbitofrontalny crinkle and basal gangliya (a kernel having a tail) which is normalized after successful treatment (pharmacological or psychological therapy).
The genetic theory says about family predisposition of ROC (3-7% of relatives of the first degree of relationship), however the gene which is responsible for incidence still is not found.
The psychological theory – disturbances in system of excitement and/or inability to control negative internal experiences. Obsessions are caused by irritants (events) connected with alarm.  Kompulsiya always acquired as they are a form of avoiding of alarming situations.

Symptoms of Obsessivno-kompulsivnogo of frustration:

A. Obsessions:
1. periodic and constant thoughts  or images which bring discomfort to the patient for a long time;
2. thoughts or images in the form of excessive alarm concerning real vital problems;
3. the aspiration of the person to ignore or suppress similar thoughts or images, or to neutralize them by means of other thoughts or action;
4. the person recognizes that the notions of compulsion, impulses or images are a product of his own mind, but is not imposed from the outside, as at endogenous diseases.

Kompulsiya:
1. the repeating actions (for example, washing of hands, check something) or mental acts (for example, persuasive desire to pray, to keep count). At the same time the person points to emergence of feeling of "ovladevaniye" at which persuasive operations shall be performed;
2. the behavior or mental acts directed to reduction or prevention of possible disaster,  unpleasant events or situations.
At some point the person realizes that obsessions or actions are excessive and unreasonable.
The sick person has obsessions or actions cause the expressed distress, take away a lot of time (takes more than 1 hour a day), or significantly disturb normal human life, professional functioning, or usual social activity and the relations.

Treatment of Obsessivno-kompulsivnogo of frustration:

Psychological aspects of therapy: the psychotherapy in which members of the family of the diseased are quite often involved is carried out, the group technique is applied. Psychoanalytic psychotherapy: there are no unambiguous proofs of its efficiency, however the insayt-oriented psychotherapy can be useful at some patients. Behavioural and cognitive psychotherapy are applied rather seldom.
Pharmacological means for treatment of ROC: SIOZS antidepressants - fluoxetine, флувоксамин, or пароксетин it is necessary to consider sertraline drugs of the first line (without clear superiority of some one drug, usually at ROC high doses are required, for example, 40-60 mg of fluoxetine within 4-12 weeks render positive effect on the course of a disease). Klomipramin (for example, 200-300 mg) has specific "anti-persuasive" action and is drug of the first or second line of the choice. Fenelzin it is necessary to consider as drug of the third line if the patient is steady to 2 various SIOZS, or a klomipramina and SIOZS.  The accompanying therapy: буспирон if the disease is followed by noticeable concern; antipsychotic drugs (рисперидон, a haloperidol, Pimozidum) if there are  psychotic signs, tics, or are defined shizotipichesky lines; lithium drugs if mood swings are expressed.
Physical aspects of treatment: carrying out EST is possible.