Obsessive-Compulsive And Related Disorder Due To Another Medical Condition

Per the Diagnostic and Statistical Manual of Mental Disorders, signs and symptoms of obsessive-compulsive and related disorder due to a medical condition are similar to the symptoms of primary OCD. Both often center on a specific fear, such as the fear of germs or contamination, the fear of losing control over one’s behavior, or the fear of losing or misplacing an item. OCD can also cause intrusive thoughts about taboo subjects that can involve harming oneself or others. OCD fears are often based on one’s morals or values.

Obsessions 

Examples of OCD obsessions include:

• Wanting everything to be symmetrical or orderly
• Having extreme difficulty tolerating uncertainty
• Intrusive thoughts about sex, religion, or harm to others
• Aggressive thoughts
• Fear of touching items others have touched
• Fear of contamination
• Frequently doubting whether you have locked a door or turned off the stove
• Fear that you have done something illegal without knowing it 
• Obsessive thoughts that others dislike or hate you, accompanied by an urge to ask for reassurance
• Fear that you have a serious illness despite evidence to the contrary 

People who experience obsessive fears and thoughts may change their behavior to avoid their fears. For example, someone fearing contamination may avoid hugs and handshakes. 

OCD can also cause intrusive thoughts, which are severe, repeated thoughts or mental images involving themes that go against one’s morals. For example, they may include thoughts about severely harming another person or oneself or violent or sexually explicit images or phrases that don’t disappear from the mind despite one’s attempts. These thoughts can cause significant distress and are not the same as nonclinical impulsive thoughts, which are “silly” impulsive urges like the desire to randomly throw an item or put your hand in food. 

Compulsions

OCD involves obsessive thoughts and compulsive, repetitive behaviors used as coping mechanisms² for these thoughts. Per the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), OCD compulsions are time-consuming, often taking an hour or more per day, and can include things like:

• Checking excessively (doors locked, oven off, curling iron unplugged, etc.)
• Washing hands until they are raw
• Body-focused repetitive behaviors, like skin picking or hair pulling
• Cleaning items or one’s body to an extreme and repetitive degree
• Following a strict routine and becoming upset if the routine is disturbed
• Demanding reassurance 
• Counting in specific patterns
• Silently repeating a word, phrase, or prayer
• Arranging items to face the same way

Some people with obsessive-compulsive disorder or obsessive-compulsive and related disorder due to another medical condition may only experience the condition for a short time, while others may live with it for years. The severity of OCD varies from person to person, and for some people, their OCD symptoms get worse in periods of high stress. However, there are treatment options available that may make the condition less distressing and disruptive. 

For any form of obsessive-compulsive disorder to be diagnosed per the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, obsessions or compulsions must cause marked impairment in daily functioning, such as difficulty socializing, working, or caring for oneself. OCD compulsions and obsessions are highly distressing and not simply a form of “cleanliness” or “organization.”

The cause of obsessive-compulsive and related disorder due to a medical condition is a medical condition that causes OCD symptoms. Medical conditions that can cause OCD symptoms include, but are not limited to:

• Anemia: Anemia can lead to poor circulation and itching sensations, which may lead to compulsive picking or itching.
• Allergic reactions causing a rash: An allergy can lead to compulsive picking or itching.
• Body dysmorphic disorder: This mental illness can lead to obsessive thoughts about one’s appearance. Body dysmorphic disorder can also be comorbid with OCD, though body dysmorphic disorder is its own distinct condition.
• Excoriation disorder: This condition involves repetitive skin-picking.
• Seborrheic dermatitis: Dermatitis can lead to hair pulling or scalp picking.
• Psoriasis: This skin disease can lead to scalp picking.
• Wilson’s disease: Wilson’s is a genetic neurodegenerative disorder that can cause liver disease and mental health conditions, including OCD.
• Pica: Pica is a condition that involves hunger cravings for non-food items such as dirt and clay, which may cause OCD symptoms.
• PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection): When caused by strep throat, PANDAS can lead to OCD and OCD symptoms. 
• Stroke: In some cases, a stroke can cause severe personality changes that may lead to OCD symptoms. 
• Cancer: Some people may develop OCD as a side effect of certain types of cancer or due to experiences of medical trauma. 

Someone may also develop OCD as a result of having experienced a minor illness. For example, someone who catches a cold may become obsessed with avoiding getting sick in the future, leading them to develop OCD symptoms, like excessive cleaning and handwashing, which can cause significant distress in daily life. 

The cause of primary OCD is still being researched. Possible causes may include:

• Changes to brain chemistry
• Genetics
• Learned behaviors (e.g., growing up around someone with OCD)

Risk factors for OCD include:

• Having a family history of OCD
• Having a history of stressful or traumatic events, which may cause OCD symptoms
• Having other mental health conditions such as anxiety, depression, or a substance use disorder

Per the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the first line of treatment for obsessive-compulsive and related disorder due to a medical condition is to treat the medical condition causing OCD symptoms. Those experiencing OCD symptoms related to psoriasis, for example, may find that treating their psoriasis leads to a lessening or ceasing of their OCD symptoms. OCD due to a medical condition can also often be treated with the same interventions used for primary OCD. These treatments include the following. 

Medication

Some people find that medications, such as antidepressants, are helpful in improving OCD symptoms. Consult a medical doctor before starting, changing, or stopping a medication for any condition. The information in this article is not a replacement for medical advice or diagnosis. 

Other treatment options

Some people experience treatment-resistant OCD, which is when their OCD symptoms don’t improve with medication or therapy. In these cases, alternative treatment options per the Diagnostic and Statistical Manual of Mental Disorders may be considered. One such treatment option is deep brain stimulation (DBS). This FDA-approved treatment involves putting electrodes on the head that are designed to target specific areas of the brain to regulate the impulses that drive OCD symptoms.  

Transcranial magnetic stimulation (TMS) is another FDA-approved, noninvasive intervention that uses magnetic fields to stimulate nerve cells and improve OCD symptoms. Finally, intensive outpatient and residential treatment programs can be helpful resources for individuals whose OCD symptoms make it difficult for them to function in their day-to-day lives.

Self-care

Any mental or physical health condition can be challenging to cope with. Prioritizing self-care is one way to care for yourself when you’re going through a difficult time. You can practice self-care by getting enough sleep, eating nutritious meals, exercising regularly, and partaking in hobbies. You may also find online or in-person OCD support groups helpful when working through symptoms.

Therapy can be a helpful resource for those living with OCD related to a medical condition or primary OCD. A trained mental health professional can help you develop a treatment plan to address your symptoms, whether you try cognitive behavioral therapy, exposure therapy, or another avenue for treating your OCD.

For some people with OCD, their symptoms affect their ability to complete daily tasks, which could result in barriers to receiving treatment. For example, symptoms can make attending in-person appointments difficult, especially if it requires commuting or long wait times. In these cases, online therapy through a platform like BetterHelp can be a more convenient alternative, as it allows you the same high-quality therapy that you would receive from in-office therapy from the comfort of your home.

Other resources for obsessive-compulsive and related disorder due to another medical condition can be found online and in person. If you’re looking to learn more about OCD symptoms, treatment, and research, consider the International OCD Foundation, which offers a plethora of educational materials, personal OCD stories, and other resources. You may also find Obsessive Compulsive Anonymous to be a helpful resource. It is a website dedicated to providing information about OCD support groups, which can be found in person and online.

For help with substance use, contact SAMHSA’s National Helpline at 1-800-662-HELP (4357).

Please see our Get Help Now page for more immediate resources.

Research on OCD is ongoing, and new discoveries into the causes of and treatments for the disorder offer promising insight. One recent study from Cambridge University suggests that an imbalance in brain chemicals could be a driving factor behind OCD. This knowledge can be key in developing treatments for the disorder.

When it comes to medication, antidepressants are often used to treat OCD symptoms, with some people noting improvements while others have no response. A new study suggests that ketamine, an anesthetic, provided study participants with relief from their OCD symptoms, even after the medication had been metabolized by their bodies. While this result may be promising, more research is needed to determine ketamine’s potential long-term efficacy for OCD.

Current research at Yale’s OCD Research Clinic suggests that OCD may be caused by an imbalance of the neurotransmitter glutamate. Though research is ongoing, this study could indicate that medications that regulate glutamate could be effective treatments for OCD, particularly for individuals who do not respond to SSRI or therapy treatment interventions.

Below are a few key statistics on obsessive-compulsive and related disorder due to another medical condition, as well as general OCD: 

• The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) states that the prevalence of OCRD in the United States falls between 1% and 6%. 
• Obsessive-compulsive and related disorders due to another medical condition can be comorbid with other conditions like body dysmorphic disorder and excoriation disorder. OCRD occurs in 2.4% of individuals with body dysmorphic disorder and 1.4% of people with excoriation disorder.
• Women are three times more likely to be affected by OCD than men.
• Studies suggest that cognitive-behavioral therapy can lead to full remission of OCD symptoms for some people.