Obsessive-compulsive disorder causes
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [5]; Associate Editor(s)-in-Chief: Priyanka Kumari, M.B.B.S[6] Sonya Gelfand, Abhishek Reddy
Overview
Overview
It is generally agreed that neurotransmitters, biological, psychological, and environmental factors all play a potential role in causing obsessive–compulsive disorder.
Causes
Causes
Behavioral
- Compulsions, according to learning theorists, may be a person’s response to anxiety or discomfort. Compulsions, in particular, are thought to be responses that help a person avoid or reduce the anxiety and discomfort associated with a particular obsession or urge.[1]
- Some theorists also believe that misinterpretation of intrusive thoughts leads to obsessive and compulsive behaviors. People with OCD misinterpret these intrusive thoughts as being important, personally significant, or having disastrous consequences, and as a result, engage in compulsive behavior to combat, resist, or neutralize the distress they cause.[1]
Psychological
- Different species have evolved to protect themselves by gathering or hoarding food and constantly scanning the environment for potential threats. These evolutionary traits, which have been passed down through generations, could be a psychological cause of OCD.[2]
Biological
- OCD has been linked to abnormalities in the neurotransmitter serotonin. Individuals suffering from OCD may have serotonin receptors that are understimulated, according to a theory. This theory is supported by the fact that many OCD patients benefit from the use of selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant that increases serotonin availability to serotonin receptors.
- In unrelated families with OCD, a mutation in the human serotonin transporter gene, hSERT, has been discovered.[5]
- People with OCD had higher volumes of regional grey matter extending from bilateral lenticular nuclei, to the caudate nuclei, and lower volumes in bilateral dorsal medial frontal/anterior cingulate gyri.[6]
- PANDAS, a syndrome linked to Group A streptococcal infections, or immunologic reactions to other pathogens may cause rapid onset of OCD in children and adolescents. [7]
Neurotransmitters role
- People with OCD have a different pattern of brain activity than people without OCD, as per brain scans. The scans also reveal different circuitry functioning in the striatum.[8]
- Individuals with OCD have abnormal dopamine and serotonin activity in various brain regions, which can be classified as dopaminergic hyperfunction in the prefrontal cortex and serotonergic hypofunction in the basal ganglia.[9]
Stress
- OCD is not caused by stress, but it can be triggered by a stressful event. If OCD is not treated, anxiety and stress in one’s life will significantly worsen symptoms. Problems at school or at work, as well as problems in everyday relationships, could all contribute to a person’s OCD becoming more frequent and severe.[10]
Trauma
- According to researchers, people who have experienced physical or sexual trauma are more likely to develop OCD.[11]
Overview
Overview
Disease name] may be caused by [cause1], [cause2], or [cause3].
OR
Common causes of [disease] include [cause1], [cause2], and [cause3].
OR
The most common cause of [disease name] is [cause 1]. Less common causes of [disease name] include [cause 2], [cause 3], and [cause 4].
OR
The cause of [disease name] has not been identified. To review risk factors for the development of [disease name], click here.
Causes
Causes
- ymptom/manifestation] include [cause1], [cause2], and [cause3].
- [Cause] is a life-threatening cause of [disease].
Common Causes
Common causes of [disease name] may include:
- [Cause1]
- [Cause2]
- [Cause3]
OR
- [Disease name] is caused by an infection with [pathogen name].
- [Pathogen name] is caused by [pathogen name].
Less Common Causes
Less common causes of [disease name] include:
- [Cause1]
- [Cause2]
- [CauseCauses by OrganList the causes of the disease in alphabetical order:
- Cause 1
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]
Synonyms and keywords: IBD ;
Overview
Inflammatory bowel disease (IBD) is a chronic inflammatory disease of the gastrointestinal tract that represents 2 distinctive disorders, Crohn’s disease and ulcerative colitis. Both disorders are characterized by unpredictable exacerbations and remissions. Genetic and environmental factors are believed to play a key role in the pathogenesis of IBD. A dysregulated immune response to environmental factors in a genetically susceptible host results in activation of cytokines, triggering a cascade of reactions ultimately bowel inflammation. Common symptoms of inflammatory bowel disease include persistent diarrhea, abdominal pain, rectal bleeding/bloody stools, weight loss and fatigue. IBD can be diagnosed using a combination of endoscopy for Crohn’s disease or colonoscopy for ulcerative colitis and imaging studies, such as contrast radiography, magnetic resonance imaging, or computed tomography. The goal of medical therapy is to induce remission initially with medications, followed by the administration of maintenance medications to prevent a relapse of the disease. Sulfasalazine along with steroids are the main stay of treatment for IBD. Immunosuppressive agents such as infliximab or 6-mercaptopurine and azathioprine are recommended alternatives to steroids.
Causes
While the causes of inflammatory bowel disease is unknown, several possibly interrelated studies have been suggested following causes:
Common causes
Genetic factors
- Mutations in the CARD15 gene (also known as the NOD2 gene) are associated with Crohn’s disease.
- Mutations of the transporter proteins such as OCTN1 and OCTN2 and scaffolding proteins such as the MAGUK family are believed to cause ulcerative colitis.
Environmental factors
- Alterations in normal bacterial flora of the intestinal tract is responsible for Crohn’s disease.
- Smoking: Unlike Crohn’s disease, ulcerative colitis has a lesser prevalence in smokers than non-smokers.
- Use of NSAIDs
- Stress
- Red meat consumption
Rare causes
- Hemolytic uremic syndrome
- Connective tissue disease
- Vasculitis
- Radiation therapy to the prostate or pelvic area
- Chemical or physical trauma to anorectal area
- Amyloidosis
- Behçet syndrome
- Chronic lymphocytic leukemia
- Lymphoma
- Lipid proctocolitis
- Tuberculosis
- Syphilis
- Infection with Entamoeba histolytica or Giardia lamblia, most often seen in patients with acquired immune deficiency syndrome.
- Infection with C difficile
Classification
Inflammatory bowel disease can be classified into Crohn’s disease and ulcerative colitis.
| Inflammatory Bowel Disease | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Crohn’s Disease | Ulcerative colitis | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Based on Region involved | Based on Severity | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Ileocolic Crohn’s disease | Crohn’s ileitis | Crohn’s colitis | Stricturing disease | Penetrating disease | Inflammatory disease | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Based on Region involved | Based on Severity | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Distal UC | Proximal UC | Mild | Moderate | Severe | Flumiant | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Differential diagnosis
Inflammatory bowel disease must be differentiated from other diseases that present with abdominal pain, fever and diarrhea which include appendicitis, diverticulitis, Whipple’s disease, mesenteric ischemia, Tropical sprue, hepatitis and spontaneous bacterial peritonitis.
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Abbreviations: RUQ= Right upper quadrant of the abdomen, LUQ= Left upper quadrant, LLQ= Left lower quadrant, RLQ= Right lower quadrant, LFT= Liver function test, SIRS= Systemic inflammatory response syndrome, ERCP= Endoscopic retrograde cholangiopancreatography, IV= Intravenous, N= Normal, AMA= Anti mitochondrial antibodies, LDH= Lactate dehydrogenase, GI= Gastrointestinal, CXR= Chest X ray, IgA= Immunoglobulin A, IgG= Immunoglobulin G, IgM= Immunoglobulin M, CT= Computed tomography, PMN= Polymorphonuclear cells, ESR= Erythrocyte sedimentation rate, CRP= C-reactive protein, TS= Transferrin saturation, SF= Serum Ferritin, SMA= Superior mesenteric artery, SMV= Superior mesenteric vein, ECG= Electrocardiogram
References
References
- ↑ 1.0 1.1 Maia TV, Cooney RE, Peterson BS (2008). “The neural bases of obsessive-compulsive disorder in children and adults”. Dev Psychopathol. 20 (4): 1251–83. doi:10.1017/S0954579408000606. PMC 3079445. PMID 18838041.
- ↑ Bracha, H. (2006). “Human brain evolution and the “Neuroevolutionary Time-depth Principle:” Implications for the Reclassification of fear-circuitry-related traits in DSM-V and for studying resilience to warzone-related posttraumatic stress disorder”. Progress in Neuro-Psychopharmacology and Biological Psychiatry 30 (5): 827–853. doi:10.1016/j.pnpbp.2006.01.008. PMID 16563589.
- ↑ BBC Science and Nature: Human Body and Mind. Causes of OCD. [1]
- ↑ Abramowitz, Jonathan; et al, Steven; McKay, Dean (2009). “Obsessive-compulsive disorder”. The Lancet 374 (9688): 491–9. doi:10.1192/bjp.bp.108.055046. PMID 19880927.
- ↑ Ozaki, N., D Goldman, W. H., Plotnicov, K., Greenberg, B. D., J Lappalainen, G. R., & Murphy, D. L. (2003). Serotonin transporter missense mutation associated with a complex neuropsychiatric phenotype. Molecular Psychiatry, Volume 8, 933-936. [2]
- ↑ PMID 19880927 [3]
- ↑ “PANDAS studies are no longer recruiting patients”.[4] Bethesda, MD: National Institute of Mental Health, Pediatrics and Developmental Neuroscience Branch. 24 February 2009. Retrieved 13 December 2009.
- ↑ “Obsessive-Compulsive Disorder (OCD) – Cause”. 2010-06-21. Retrieved 2011-12-10.
- ↑ “New approach to obsessive-compulsive disorder: dopaminergic theories”
- ↑ What causes OCD
- ↑ Abramowitz JS, Taylor S, McKay D (2009). “Obsessive-compulsive disorder”. Lancet. 374 (9688): 491–9. doi:10.1016/S0140-6736(09)60240-3. PMID 19665647.
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