Week of April 5, 1999 (Originally aired week of January 11, 1999)First we hear from broadcaster Marc Summers, a former host of Nickelodeon's children's show Double Dare, and currently host of Great Day America on PAX-TV. He had known he was different since early childhood, when he became obsessed with erasing pencil marks completely and thought that his parents might come to harm if his actions weren't perfect. But it wasn't until he interviewed an OCD expert on television that he realized he had the condition. With medication and behavioral therapy, his life, as he puts it, has been turned around.
Next Dr. Goodwin is joined by Dr. Lorrin Koran, professor of psychiatry at Stanford University and head of the OCD clinic there, and by Janis McClure, the head of the Obsessive-Compulsive foundation of Jacksonville, Florida. Ms. McClure began suffering from OCD at the age of six.
Dr. Koran discusses the difference between obsessions and compulsions. The former are persistent and recurring ideas, thoughts, and images--usually senseless and repugnant to the person experiencing them. Fears of violence to loved ones are common. Compulsions are repetitive behaviors, such as counting, hoarding, washing, and arranging. In response to Dr. Goodwin's question, Dr. Koran explains how OCD differs from an obsessive personality disorder. OCD's obsessions are confined to certain areas while a personality disorder affects nearly all aspects of a person's life.
Ms. McClure tells how her OCD at first came and went, but grew more constant and severe as she grew older, until in her mid-20s it became debilitating. It took years of visits to doctors before she was correctly diagnosed: now she is able to live a normal life.
Dr. Koran takes a question from Rachel in Michigan about the episodic nature of OCD. While for most people it is fairly constant once it sets in, about 20% experience gaps between episodes, sometimes for years at a time. The symptoms differ too: there may be obsessions at one point and compulsions at another.
Another caller, from New Jersey asks about nature vs. nurture when it comes to OCD. How heritable is it? If a child is brought up with a caretaker who has the condition, are they at greater risk?
Dr. Koran responds that about 4-10% of the close relatives of a person with OCD will have it. Caretakers tend not to have an impact. There is a discussion of the links between OCD and other mental illnesses such as depression.
A third caller, from upstate New York is interested in the long-term prognoses for young people with OCD. Both Dr. Koran and Ms. McClure discuss behavioral therapy and new medications in some detail.
You can reach Dr. Koran or the Stanford OCD Clinic at 650-723-5154. To reach Ms. McClure in Jacksonville, call the Obsessive-Compulsive Foundation there at 904-726-0918. The National Obsessive-Compulsive Foundation is at 203-878-5669.
Free test for OCD
To take a free, anonymous self-assessment test for OCD, offered by the National Institute of Mental Health, click here.
In the second half of the program, Dr. Goodwin talks with Dr. Judith Rapoport and Dr. Susan Swedo of the National Institute of Mental Health about their research into child-onset OCD. Dr. Rapoport is the head of child psychiatry at the NIMH and author of the best-selling book about OCD, "The Boy Who Couldn't Stop Washing". Dr. Swedo is head of pediatrics and developmental psychiatry at the NIMH.
Compared with other serious mental illnesses like schizophrenia and manic depression, OCD strikes a high percentage of children--nearly 50% of people with OCD get it in childhood and adolescence. And many of these cases are linked to untreated or partially treated strep throat infections.
Just as rheumatic fever develops when antibodies to strep produce an autoimmune reaction that attacks the heart, OCD can develop when a similar autoimmune reaction attacks the circuits in the brain, particularly the links between the frontal lobe and the basal ganglia.
By preventing strep infections in the first place and with treatments that cleanse the blood of antibodies, symptoms of OCD in children can be dramatically alleviated. And perhaps 70-80% of people with OCD can now live a normal life with these and other treatment advances. More work is needed, however, to find effective treatments for the other 20-30%.
You can reach Dr. Swedo at the NIMH by calling 301-435-6650. Dr. Rapoport can be reached at 301-496-6081. And more information about their work is available from the web site of the National Institute of Mental Health.
Finally, John Hockenberry weighs in on our current national obesssion -- the Y2K bug.
