Though a great deal more is known about neurotransmission today than was known at the beginning of the research associated with the initial biological discoveries of neurotransmitters and the neurotransmission process there is still a great deal to be discovered. Neurotransmission disorganization and impairment is clearly identified as a pervasive aspect of many psychological disorders. This is particularly true of the anxiety disorders and OCD. There is no doubt that increased understanding of the various mechanisms of OCD and normal neurotransmission will add to a greater research understanding of the biological causalities and modalities of OCD.
Though the most simplistic and earliest neurotransmission disturbance theories have been largely discounted the research has created ample evidence of disturbances in neurotransmission function (in more complex terms) as the root cause of several psychological disorders including various forms of anxiety disorders the subgroup which OCD falls into.
…this research has revealed the staggering complexity of integrated CNS response systems. & #8230; include the identification of dozens of additional peptide and amino acid neurotransmitters, recognition that neurons can express receptors for several different types of neurotransmitters (enabling direct "cross -- talk" between various neuronal systems), and elucidation of intracellular mechanisms of gene transduction. (Howland, 2005, p. 110)
More tailored drug research that effects newly discovered neurotransmitters as well as the interactions of the other two major neurotransmitters (secondary to Serotonin) will likely be added to the pharmacopeias of available drug treatments for OCD as more research becomes available on OCD and its specific neurotransmitter dysfunctions. Pharmacological treatment for the most part demonstrates most effectively in patients with OCD when SSRIs are used and prove effective.
Secondary disorders as well as other contraindications, such as age below 18 are fundamentally contraindicative of SSRI treatment and some patients where SSRI is contraindicated are simply non-responsive to this drug treatment regimen. Studies on augmentation are limited, and need additional long and short-term development. Ultimately OCD is considered a biologic disorder with only limited environmental causation. For this reason pharmacology is the primary and sometimes singular treatment modality though like a lot of other psychological disorders behavioral or alternative treatments augment psychotropic intervention. In other words behavioral treatment is rarely if ever a feasible alternative to pharmacological treatment of OCD.
Continued discoveries and treatment options, in the form of new and ever expanding lists of psychotropic and anti-depressant drugs including new multi-neurotransmitter affective drugs will likely begin to be researched as alternative drug treatments in OCD. Adding to the research associated with neurotransmission and vice versa.
Trycyclic antidepressants, monoamine oxidase (MAO) inhibitors, and most antipsychotic drugs have been used in the past to alter neurotransmission in anxiety/OCD...
(Goodman, Rudorfer, & Maser, 2000, p. 31)
Challenges to clinicians may develop as a result of the fact that OCD often exhibits and impairs function in childhood and adolescence and SSRI and other anti-depressant medications have been linked to a small number of cases of suicidal ideations in these populations. Clinicians and parents must carefully weigh concerns of symptoms vs. potential alternative psychotic outcomes. (Liebowitz et.al. December 2002, p. 1433)
Goodman, W.K., Rudorfer, M.V., & Maser, J.D. (Eds.). (2000). Obsessive-compulsive disorder contemporary issues in treatment. Mahwah, NJ: Lawrence Erlbaum Associates.
Hollander, E. Allen, A. Steiner, M. Wheadon, D.E. Oakes, R. Burnham, D.B. (September 2003) Acute and long-term treatment and prevention of relapse of obsessive-compulsive disorder with paroxetine. Journal of Clinical Psychiatry 64(9) 1113-1121.
Howland, R.H. (2005). Chapter 6 Biological bases of psychopathology. In Psychopathology: Foundations for a Contemporary Understanding, Maddux, J.E. & Winstead, B.A. (Eds.) (pp. 109-119). Mahwah, NJ: Lawrence Erlbaum Associates.
Liebowitz, M.R. Turner, S.M. Piacentini, J. Beidel, D.C. Clarvit, S.R. Davies, S.O. Graae, F. Jaffer, M. Lin, S. Sallee, F.R. Schmidt, A.B. Simpson, H.B. (December 2002) Fluoxetine in Children and Adolescents With OCD: A Placebo-Controlled Trial Journal of the American Academy of Child & Adolescent Psychiatry 41(12) 1431-1438.
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OCD in Childhood Obsessive-Compulsive Disorder (OCD) is a common psychological, anxiety disorder that is characterized by repetitive and intrusive thoughts and stereotypic behaviors frequently associated with dread and compulsion (Walitza). These intrusive thoughts can be scary and the behaviors are often disruptive to the development of social relationships and therefore debilitating especially to children and adolescents. OCD affects approximately 3% of the population and an early age of symptoms onset during
Here is what is known for now: Patients who are found to have OCD generally display symptoms along the lines of having compulsions, obsessions, doubting, hyper-vigilance and the need to control their environment. No one is completely certain what it is that causes OCD, although there are two trains of thought on the matter. Some people believe that OCD is a psychological disorder and others believe that it is
These studies show the importance of confronting feared stimuli for extinguishing anxiety. However, at the same time, other research has found that the cognitive methodology has had equal results to the ERP in OCD treatment. Hackman and McLean report that they have as positive results with thought-stopping as those found with ERP. Once again, however, the number of studies has been very small (Abromowitz). It has only been in the
OCD is in many ways a homogeneous disorder. The disorder has a prevalence of around 2% to 3% of the population, and this prevalence is likely underestimated in many different countries / and descriptions of obsessions and compulsions have been remarkably consistent over time and place. Neurobiological studies have consistently found evidence that cortical-striatal-thalamic-cortical (CTSC) circuits play a crucial role in mediating the disorder and treatment research has invariably demonstrated
Diagnosis in children is sometimes difficult since they often try to mask symptoms. The following questions are a good indicator that the child needs to be evaluated by a professional: Do you have worries, thoughts, images, feelings, or ideas that bother you? Do you have to check things over and over again? Do you have to wash your hands a lot, more than most kids? Do you count to a certain number or
The resulting anxiety then is managed by training children to use strategies that help them work with their anxiety in a more effective and less disruptive way. Anxiety management techniques may include relaxation training, distraction, or imagery. Often, OCD is personified as something that makes the child perform an action. Thus, children learn to assess situations and ask themselves if they really want to do something, as opposed to the