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Obsessive Compulsive Neurosis

The obsessive compulsive neurosis is a psychiatric condition in which the patient has a totally irrational desire to undertake a repetitive task. It is more common in women than in men and occasionally related to previous brain injury or infection (eg. encephalitis).

The desire to perform a task constantly intrudes into the patient's thoughts, and even after completing the task they feel that they must do it again and again. One of the most common desires is hand washing, when a patient cannot be convinced that his/her hands are clean, and must scrub them repeatedly, often to the point where serious dermatitis of the hands develops. Other repetitive desires include constantly checking that a tap is turned off, a door is closed, the fly is zipped up, a window is locked, or innumerable other similar routine tasks have been carried out.

Compulsive exercise or running to the point of total exhaustion is another form of obsessive compulsive neurosis. The patient may feel that by performing the rituals, s/he will regain control of a personality and emotions that are felt to be out of control. The patient is well aware that the habit is abnormal, but is powerless to stop it. More frightening compulsions may occur such as the constant desire to hit or hurt someone else, to steal, to vandalize or to injure oneself in some way. In extreme cases, these desires may lead to criminal acts or suicide.

Another form is the body dysmorphic disorder, in which patients are obsessed with their appearance, and particularly their facial appearance, and constantly check in mirrors for any abnormality in the way they look. Treatment involves psychotherapy, behavioral therapy and medication (eg. antidepressants such as paroxetine, sertraline). Long term treatment usually required, and the control of symptoms is only reasonable.