Obsessive-compulsive disorder (OCD) is usually treated as a stand-alone mental illness. A growing body of research is now finding that some cases of OCD may stem from trauma. For these patients, successful treatment may hinge on targeting the coexisting post-traumatic stress disorder (PTSD).

Over the past decade researchers have discovered that for some people, obsessive behaviors such as repetitive washing or hoarding may be a way of coping with post-traumatic stress. In a 2003 study of patients with both disorders, psychiatrist Beth R. Gershuny of Bard College found that as OCD symptoms decreased with treatment, PTSD symptoms—such as flashbacks and nightmares—became worse. She more recently showed that 82 percent of treatment-resistant OCD patients reported a history of trauma, with 39 percent of those meeting the criteria for PTSD. A picture of the interplay began to emerge: if a patient's past trauma is not addressed, targeting his or her OCD will not restore mental health.

Most recently, a study of 1,000 adults with OCD supported the idea of a post-traumatic subtype of OCD. Published in the March Journal of Anxiety Disorders, the study compared the symptoms of three groups: those who developed OCD after PTSD (referred to in the study as post-traumatic OCD), those who developed OCD before PTSD, and those who did not have a history of trauma. People with post-traumatic OCD tended to have a more severe collection of symptoms than those in the other groups, including more thoughts of suicide, higher levels of anxiety and depression, and greater hoarding and compulsive spending.

Leonardo F. Fontenelle of the Institute of Psychiatry at the Federal University of Rio de Janeiro, and lead author of the March article, says it is difficult to say for sure whether some cases of OCD are actually caused by trauma, “but there are an increasing number of OCD cases being reported after traumatic events.”

Currently clinicians do not routinely ask whether an OCD patient has experienced trauma, a potential obstacle to recovery. Both OCD and PTSD are anxiety disorders and are treated with similar drugs, but cognitive therapies for the two disorders differ. Cognitive-behavior therapy, a popular and effective type of talk therapy, treats OCD with mental exercises designed to curb its characteristic urges and ruminations. For the post-traumatic subtype of OCD, treatment “may be improved by the addition of anti-PTSD strategies,” says Fontenelle, such as recalling the traumatic events systematically in a safe setting until the emotional power of the memories is diminished.

2 Comments

1. 1. ironjustice 11:03 AM 10/9/12

   This could be due to the fact when a person has trauma , blood is released , and in the blood is the metal iron , and iron has been shown to be linked to OCD.
   "OCD onset and iron deposition"
   "Basal Ganglia MR Relaxometry in Obsessive-Compulsive Disorder: T2 Depends Upon Age of Symptom Onset."
   "The results suggest a possible relationship between age of OCD onset and iron deposition in the basal ganglia."
   

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2. 2. Air Force Veteran 04:18 AM 10/10/12

   I as a 53 year old male had three traumatic experiences by the age of 16 years old. Aproximately 8-10 years old, witnessing my father rape my mother. Where she was crying out to me, "Peter help me". Of which I then called the State Police. And I waited at the door, for them to appear. They arrived, and I specifically said to my mother, "tell them what he did to you". As this was the 1960s and he was an FBI agent, nothing happened.
   Second was at the age of 10 years old, I've read the records. I was tolf by my father we were going to visit a friend of his in the "hospital". I innocently wanted to go along. I had distinct reservations prior and ran off. My older brother and sisters found me and brought me back to the house. It was a state hospital [one flew over the cuckoos nest]. Forcefully taken inside, cried until I cried myself to sleep. Prior to that was put in a straitjacket and put in an isolation room. I stayed there for a year. Third event was at 15-16 years old, had gotten into a fight with a younger brother. Afterwards, he went down into the basement and loaded a .410 shotgun. Of which after hearing it, I flew out the door. And went around the house across the street and into their side door. Thankfully at that time people didn't lock their doors. I would say in 2000, I distinctly starting buying items of multiple things. It had a control over me, things I had no use for. Possibily related to a very traumatic childhood, school related. I had bought an incredible amount of school supplies, elementary. And it was such a profound release and positive thing. To give these to 4-5 different schools, children in need. I have had three series of 8 acupuncture sessions. And believe my OCD has been lessened a great deal by them. I still buy multiple items, but a much lesser degree. My anxiety has been greatly reduced. And my PTSD symptoms have been lessened also. I have had to rent a storage unit, 6X10 for all the items, I've brought, obsessively. Unfortunately the US Dept.Veteran's Affairs has been a failure in providing me mental healthcare. For my Depression, Anxiety, PTSD and yet to be recognized, OCD. They have tried Cognitive Processing Therapy for my PTSD, it didn't work. Here are treatments I have read through YahooAlerts that are working for PTSD. Emotional Freedom Technique-Rapid Eye Technology-EMDR-Accelerated Resolution Therapy and the latest, Healing Touch. Not at all surprised, none of these are available at the VA. Probably, because they haven't been "proven to work", but they are working. I will keep fighting.

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