OCD

Introduction

Obsessive-compulsive disorder is a widely prevalent condition that was documented as early as the 15th century (Kramer and Sprenger, 1951). In an early description of the disorder, William Shakespeare recounts what might be viewed as a classic description of a compulsive washer, Lady Macbeth:

A different type of obsessive-compulsive symptom emerges from contemporary reports about the 18th century literary figure Dr. Samuel Johnson. Johnson made “extraordinary gestures or antics with his hands when passing over the threshold of a door,” and he refused to step on cracks between paving stones and touched every post he passed while walking, going back if he happened to miss one.

A more modern public figure with OCD was the legendary Howard Hughes. From childhood, Hughes was obsessed with avoiding germs. He devised a system of “insulations” of papers towels and tissues for protection and demanded that everything be brought to him wrapped in these materials. He also insisted that doors and windows be sealed to prevent germs from entering his home. Ultimately, Hughes was overwhelmed by these efforts and ended his life in filth and neglect (Sasson et al., 1997).

Although the most prevalent obsession is concerned with contamination, as was the case with Lady Macbeth and Howard Hughes, the content of the obsessions adapt with the changing times to thoughts about leprosy, cholera, tuberculosis, syphilis, and, more recently, AIDS.

This disease has recently been highlighted in the film “As good as it gets” for which Jack Nicholson won an Academy Award for his portrayal of an author with OCD. His obsessions ranged from contamination to checking and habitual rituals. For these sufferers such symptoms lead to a great deal of suffering, while these and other unusual habits lead to a certain isolation from society.