Major Psychiatric Disorders

Obsessive-compulsive disorder (OCD) is a disorder in which patients experience either obsessions (intrusive, senseless and anxiety provoking thoughts) alone or a combination of obsessions and compulsions (anxiety releasing rituals) due to which an individual's level of functioning is affected. Genetic factors, a proposed biological model, and a proposed cognitive behavioral model are seen to play a role in the pathogenesis of OCD. The diagnosis of OCD is purely clinical and no investigations are needed. A thorough history of the patient's obsessions and compulsions and their comparison with certain 'identifiable themes' will aid in diagnosis. The management of OCD can be done with a combination of cognitive behavior therapy and physical treatments (tricyclic anti-depressants, selective serotonin reuptake inhibitors, anti-glutamatergic agents, deep brain stimulation and psychosurgery) and OCD is related to a number of medical comorbidities.

A panic disorder is when recurrent and episodic panic attacks occur abruptly without a trigger. Diagnosing a panic disorder may become challenging because panic attacks can also occur with other anxiety and mental disorders. However, by following the correct approach, which first includes ruling out other disorders (by taking a thorough history and performing relevant investigations) and then following the proposed diagnostic criteria for panic disorder, one can reach a diagnosis. The pathogenesis of panic disorder is a combination of an underlying predisposition that triggered by a life stress (e.g. separations during childhood or interpersonal loss in adulthood). Management includes both psychological treatments as well as medical treatment.

Cognitive therapy changes a person's thinking towards a situation by telling him the other less negative possibilities he can think of. Behavioral therapy changes a person's thinking towards a situation by modifying the way he behaves in that situation. Therefore, both cognitive and behavioral therapy aims at changing the way a person thinks. Cognitive and behavioral therapies can be used singly or combined to treat a number of psychiatric conditions. The specific techniques in cognitive behavioral therapy include relaxation, exposure, social skills training (assertiveness training and anger management), enuresis alarms and dialectic behavioral therapy.

Major depressive disorder (MDD) is a unipolar mood disorder characterized by persistent low mood and loss of interest in association with somatic symptoms. The overall incidence of the disease is 6.7 % with prevalence increasing with age. Monoamine oxidase deficiency and amine neurotransmission abnormalities are the incriminated causes of the disease. Psychotherapy, pharmacotherapy and electroconvulsive therapy (ECT) are the modalities used to treat the disease. Its leading cause of mortality is suicide, which is more common among the elderly population.