New Developments

Hello dear visitors -

apologies for the periods of silence. There are new developments in the scientific exploration of OCD that asked for intense attention. I stopped temporarily at the point where alterations in the visual tracts were discussed as being a potential factor in the etiogenesis of OCD.

The plot thickened considerably. I found material that also linked other disorders, related to OCD, to the visual system. Take the OCD spectrum of mental disorders: if one considers attention-deficit/hyperactivity disorder (ADHD), and Tourette's Disorder (TD), then one learns that these also have conspicuous relations with the occipital and parietal lobes. Well, not always, in science there is the odd 'odd man out', so to speak (pun intended). But the positive findings are compelling in their structural, endophenotypical and phenomenological features.

Well, I realize full well that I am in grave danger of losing myself in the wealth of material. Also there is the problem of taking the text to the other blog I mentioned.

Plans: I must disentangle, or deconstruct if you will, what I have got so far, and present it in another format. And I will take the new info step by step, so that I can go from the general to the special many times over without confounding the reader.

Stay tuned for more chart hits in the chequered history of OCD, folks!

This Blog Will Move Shortly...

...to another home address.

Hello everyone -

the blog will be relocated to a new address; the reason is that this new home offers more technical possibilities.

For the moment: thank you for dropping by, writing in, and also: I'll try to add new material more frequently.

Byebye!

(oh, I'll give the new address soonish; so stay tuned!)

New topics, and more

Dear readers -

it's been a while. I will shortly continue with my current topic, namely alterations in visual tracts in OCD patients. It may seem odd that the visual system is implicated in the disorder... why should a hoarding or checking obsession be linked to the way we perceive things?

Now, patients often observe a special characteristic in themselves, that other people don't seem to have: staring intensely at objects that frighten and worry them so. For example: someone has trouble discarding useless stuff, and has some rationalizations for this worry. 'I might want to use it in the future', or: 'perhaps there's something inserted in that old newspaper that is very important'. Therefore the objects become of extreme importance and have a great potential value and/or danger if discarded wrongly. The fantasy lends an importance to the things that they don't possess. The only tactic for the patient is: staring, staring and staring again, sometimes in strange patterns over the surface of the object, for a set number of times. It takes a lot of time and trouble... and even then he or she may not be able to throw it in the bin.

This staring habit may have something to do with the visual system (of course), and perhaps the brain has an incapacity to really trust that which is perceived. The eyes see it, but the 'self', the integrative systems, can't really believe it. The picture that I showed presents a possible way to explain this deficit, of which more later. Patients also can call to arms other senses to aid in a proper decision-making: tactile (to run over an object to make sure that nothing is attached or inserted in the old paper), and speaking to oneself (hearing your own normal speaking voice telling you that it's OK can be helpful sometimes to reach a decision about discarding.

Again we see: the 'natural flow' is completely missing in the deciding proces. It is a troublesome, wearying affair, movements (also of the eyes) seem to be 'saccadic', i.e. structured in short, stop-and-start procedures in stead of a simple, flowing reassuring observation process that 'it's all safe'.

Let me address another striking inconsistency in OCD: in a devilish way, the checker/washer/hoarder can be misguided by his/her own brain. Because, he/she invests so much trouble in controlling whether the front door is closed, is so insecure, and so involved with the safety of personal territory, so that 'nothing can happen'... yet the same person may subsequently step into a sportscar and drive at maximum speed, easily negotiating dangerous curves in the road, and decide at a glance whether a traffic light is red or green. It's highly illogical. Because a little household accident ( by a leaky faucet, or something similar) won't cause the slightest harm for life, yet he/she checked it endlessly... and driving through a red light could cause death! Do you see the 'devilishness' I was aiming at?

Cost Estimate for OCD (interlude)

Hi everyone -

I could not update the blog for some time. Here's a brief report on the costs of OCD, which I wrote for a related website:

I found an estimate of the total cost of OCD in the U.S.A., in: DuPont, R.L. et al (1995), for the year 1990, in Medical Interface, 8(4): pp. 102-109.
* direct total costs: $ 8.4 billion* this represents 18.0% of the costs for all anxiety disorders ($ 46.6 billion)* indirect costs from lost jobs, personal suffering, and people dying form the disorder, presumably by suicide: $ 6.2 billion
So, total costs: $ 14.6 billion. Mind, I am talking 1990 here... which means that total costs nowadays will be much higher.
I also checked the population statistics for the U.S. and the U.K. for around 1990. The U.K. populations formed 1/4 of that in the U.S.
Assuming that health care coverage is the same in both countries, the U.K. would have paid $ 3.6 billion way back then. But I made the educated guess above that total costs in the U.K. will have been much higher (20% of people in the U.S. is not insured at all). Add to that that the estimate of the part of OCD patients as a ratio of the general population in the U.S. in that article was on the low side (2.1%), and that there is a dark figure that we won't know but which will be considerable, the end conclusion must be:
OCD is very costly. To patients and society alike.

I'll be back soon with some more anatomy. Stay tuned!