Pure obsessive-compulsive disorder: symptoms and treatments

In this disorder there are obsessions, but there are no visible compulsions, only mental rituals.

When we think about the symptoms of obsessive compulsive disorder (OCD), we usually focus on those that are more typical of this disorder. Such as constant cleaning or the excessive need for order. However, not all OCD manifests itself in the same way.

Although compulsions are a very important aspect of this condition, there are cases in which people experience obsessions without manifesting any compulsion at all. That is, no visible behavioral symptoms. This subtype of OCD is known as pure obsessive-compulsive disorder..

What is pure obsessive compulsive disorder?

Pure obsessive compulsive disorder is a subtype of OCD characterized by the presence of thoughts (obsessions) that appear in the person's mind in a repetitive, intrusive and uncontrollable manner. appear in the person's mind in a repetitive, intrusive and uncontrollable manner..

Unlike traditional OCD, the person with this type of condition does not engage in visible physical rituals or behaviors (compulsions) related to the obsessions, so the obsessions are accompanied by hidden mental rituals.

Pure obsessive-compulsive disorder has been mistakenly regarded as a less severe variant of OCD. However, those who experience the symptoms of this condition report that the intrusive thoughts can become extremely disturbing and distressing.

Although these individuals are given the diagnosis of pure obsessive-compulsive disorder, this variant does not appear in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) as a separate or distinct diagnostic label from traditional OCD.

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What symptomatology does it present?

People with the exclusively obsessive variant of obsessive-compulsive disorder experience a Wide range of OCD symptoms, although obvious or behaviorally visible compulsions are absent..

To better understand what this disorder consists of, we will take a brief look at the symptoms of a clinical picture of OCD. According to the DSM-V, OCD is characterized by the presence of obsessions and compulsions.

The person may experience the obsessions in the form of intrusive and repetitive images and thoughts. The content of these thoughts may be focused on somatic, sexual, religious, or aggressive themes; as well as on control, symmetry, cleanliness or hygiene, and organization, among many others.among many others.

As a result of these obsessive thoughts, the person feels the need to carry out a series of repetitive actions known as compulsions. These actions can be behavioral or mental, as in the case of pure obsessive-compulsive disorder, and are intended to reduce the distress caused by the obsessions.

Once we know these we can ask ourselves, what symptoms then characterize the pure obsessive-compulsive disorder? There are two specific symptoms that can be used to distinguish pure OCD from traditional OCD. These symptoms are materialized in the presence of mental rituals and in the constant search for consolation..

1. Mental rituals

In pure obsessive-compulsive disorder, the person carries out a series of mental rituals designed to reduce distress. Such rituals may include constant mental review of memories or information, mental repetition of words or information, mental repetition of words or information, mental repetition of words or information.mental repetition of words, or mentally undoing and redoing certain actions.

2. Constant search for comfort

In addition to mental compulsions, these people tend to repeatedly and constantly seek comfort. However, patients do not recognize this behavior as a compulsion.

Such behavior may involve a need and search for security in oneself, constant avoidance of anxiety-provoking objects or situations, and demanding security from others.

An added complication of this symptom is that people close to the patient may not understand these behaviors. and interpret these demands as needs, not as symptoms of a disorder, so they may become tired or annoyed by these constant requests for reassurance.

Some studies conducted with people diagnosed with pure obsessive-compulsive disorder found that these persons considered obsessive thoughts as taboo or unacceptable thoughts..

Finally, we can conclude that in this variant of OCD compulsions do appear, but that they take a different form than in the traditional diagnosis and, moreover, they are much less obvious because of the fact that the compulsions are much less obvious, are much less obvious due to the cognitive nature of these compulsions..

Is it, therefore, a distinct variant of OCD?

While it is true that some research points to the possibility that there are different forms of OCD, others suggest that the term "pure" is inappropriate. The reason is that people who experience these obsessions without visible behavioral compulsions, do engage in occult mental rituals..

According to these studies, recognizing these mental rituals as compulsions is very important, as it can be helpful in making a more accurate diagnosis and treatment.

By understanding that such rituals exist, therapists and mental health professionals can ask patients about these symptoms. Without such inquiries patients may try to hide them or even not really be aware of their existence.

Is there a treatment?

Treatments for obsessive-compulsive disorder, including its "pure" variant, usually involve administration of drugs in combination with psychological therapy, support groups and psychological education.

1. Psychological intervention

Traditionally, cognitive-behavioral therapy has traditionally been considered the most effective treatment for OCD. for OCD. However, in pure OCD it is vitally important that the therapist understands the need to address the underlying mental rituals as well.

On the contrary, if it is considered that the patient only experiences obsessions, the treatment will not be really complete and effective.

2. Pharmacological therapy

In terms of pharmacological therapy, medications indicated for the treatment of OCD include selective serotonin reuptake inhibitors (SSRIs) or antidepressants (SSRIs) or tricyclic antidepressants such as clomipramine.

The choice of pharmacological treatment will depend both on the patient's condition and on the patient's willingness and collaboration in cognitive therapy.