The phenomenology of obsessive-compulsive disorder

Abstract

Obsessive-compulsive symptoms have been described by British, French, and German authors. While different clinical aspects were emphasized by different authors, it was recognized during the second half of the last century that obsessive-compulsive symptoms have cognitive, volitional and emotional facts: the patient experiences recurrent and persistent thoughts, impulses, or images as forced upon him or her, recognizes the content as unreasonable and is markedly distressed by it. Once delineated, defined and named, the obsessive-compulsive syndrome was described in a number of clinical studies with the main result of an astonishing homogeneity of content and form across culture, time and space. Symptoms fluctuate in severity and may change in content over time. In most cases, the content regards dirt and contamination, while aggression, religion, and sex also play a noticeable role. Patients spend a lot of time either yielding to, or fighting the thoughts and behaviors. As obsessive-compulsive disorder is defined differently from obsessivecompulsive personality disorder and, of course, from delusional disorder, clinical comorbidity and transitional phenomena are now subject to empirical investigations. The marked homogeneity of the symptoms suggests that obsessive compulsive symptoms are deeply rooted in human nature.