John is a 28-year-old man obsessed by thoughts of getting contaminated by germs and blood.
He avoids all objects in red in case they contain traces of blood, uses gloves and wipes to avoid directly touching objects and has little human contact because he fears being infected through other people's cuts and scratches.Susan is a 32-year-old stay-at-home mom paralyzed with thoughts she will harm her baby so she avoids being alone with the child.Brent is a 42-year-old lawyer who fears making a mistake or hurting others. He checks the stove, other appliances and door locks four to five times a day, has 17 alarm clocks to prevent sleeping in, and makes excessive attempts to ensure his environment is safe.The composite sketches of three patients were presented at a seminar on obsessive compulsive disorder and hoarding at Sunnybrook Health Sciences Centre on Tuesday, Jan. 17.More than 420 residents attended the event, one of the largest crowds ever for the hospital's speakers series, aimed at making medical issues understandable to the general public.The seminar saw Sunnybrook experts address issues including an overview of OCD and hoarding, what happens in the OCD brain, OCD in pregnancy and post-partum, and current treatments for OCD and hoarding.Patients with OCD are obsessed with persistent and unwanted thoughts, images or impulses, said Dr. Neil Rector, director of the mood and anxiety treatment and research program. The most common obsessions are aggressive thoughts, fear of contamination, and symmetry or needing to have things in a certain order.In order to relieve the anxiety caused by the obsessions, patients are consumed by compulsions such as performing repetitive behaviours or mental actions in a ritualistic manner. The most common compulsions are checking, washing and repeating behaviours.Everyone can at times have unwanted thoughts or perform unreasonable acts such as double-checking they have turned off the stove, Rector said.But in order to be diagnosed with OCD, the obsessions and compulsions must cause marked distress and occupy at least an hour of the patient's day or significantly interfere with their functioning, he said. About two to three per cent of the general population has OCD, but symptoms are found in up to 10 per cent of psychiatric outpatients, Rector said.The average patient begins experiencing symptoms just shy of his or her 21st birthday but diagnosis usually takes five to 10 years. Often, the condition is life-long but can be treated through therapy and/or medications, Rector said.Patients with OCD often suffer from other conditions such as depression and anxiety disorders, he added.Once rarely discussed, OCD is becoming more talked about, especially as celebrities such as Howie Mandel, Donald Trump, David Beckham, Cameron Diaz and Billy Bob Thornton open up about their symptoms, Rector said.Hoarding has some similarities to OCD, including patients' obsessions and compulsions with their belongings, Rector said.Also, the causes of both likely include genetic, biological and psychological factors.But the obsessions are not unwanted or distressing and patients generally enjoy collecting things, he said.Between 2.3 and five per cent of the general population are hoarders, although about 30 per cent of OCD patients are hoarders.Hoarding increases with age. About 2.3 per cent of people aged 34 to 44 are hoarders, which jumps to 6.2 per cent of people over the age of 55.Education levels vary widely among hoarders, who tend to be single and live alone.Meanwhile, there is growing recognition that anxiety disorders are common in pregnancy but have been under-detected, said Dr. Sophie Grigoriadis, head of the women's reproductive transitions, mood and anxiety clinic.The most common obsessions in pregnant women are fears about contamination and the need for symmetry while the most common compulsions are washing/cleaning and checking, she said.Sometimes, new moms are so anxious about obsessive thoughts that they may somehow harm their babies that they begin to avoid the child, which interrupts the mother-child bond, said Grigoriadis, adding a team approach to treatment is best.The seminar also included Dr. Peggy Richter, director of the mood and anxiety treatment and research program, detailing what happens in the OCD brain, and Dr. Nikola Grujich, a psychiatrist in the mood and anxiety program, discussing medical and therapeutic treatments.Sunnybrook's next seminar, called a Heart Healthy Evening, will be held Feb. 22 from 6:30 to 8:30 p.m. in the McLaughlin auditorium. Admission is free and audience members will be given a coupon for free parking in garage one.RSVP your attendance by Feb. 21 by emailing speaker.series@sunnybrook.ca or calling 416-480-4117.