Who Gets OCD?
While the etiology and pathophysiology of OCD are still not completely clear, the causes likely include some combination of biological factors, psychosocial factors, and behavioral factors. Research has shown that there is likely a genetic component to OCD. This genetic influence likely involves specific mutations or inherited traits. Studies have shown that people with a first-degree relative with OCD are more likely to develop it. Environmental stressors likely also influence who develops OCD.
Furthermore, brain imaging has shown that those who suffer from OCD usually have differences in the frontal cortex and subcortical structures of the brain, which affect the capacity to control emotional and behavioral responses. Abnormal activity in the cortico-striatal-thalamic loop is often associated with those who suffer from OCD.
There are many other possible explanations for why someone gets OCD. For example, some studies have shown that people who have experienced childhood trauma may be more likely to develop OCD symptoms. Moreover, some research indicates that more introverted children, who frequently experience negative emotions and show signs of anxiety and depression, could be more likely to develop OCD.
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Studies have linked the body's stress response to significantly higher levels of cortisol and DHEA in females suffering from OCD. In males suffering from OCD, studies have shown increases in cortisol levels and reductions in testosterone. This makes sense, as cortisol and testosterone are both derived from cholesterol, meaning they compete with each other for production. Higher levels of DHEA are known to inhibit the action of GABA, an inhibitory neurotransmitter that plays a crucial role in reducing anxiety and maintaining balance in various neural circuits. Higher levels of testosterone can lead to a slight increase in GABA transmission. People with OCD often have lower levels of GABA, leading to the heightened excitation of certain brain circuits, such as the cortico-striatal-thalamic loop. Therefore, females with higher levels of cortisol and DHEA or males with higher levels of cortisol and lower levels of testosterone may be more prone to developing OCD symptoms.
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The onset of OCD typically occurs between late childhood and young adulthood, with most individuals being diagnosed when they are young adults. Symptoms of OCD often appear gradually, fluctuating in severity over time. Oftentimes, OCD symptoms appear around puberty, and it is rare for people to develop OCD very late in life. Interestingly, hormonal changes during menopause are sometimes associated with OCD, leading to either a worsening of OCD symptoms in individuals with OCD or a relapse of OCD symptoms in those who have previously experienced OCD symptoms.
If a child exhibits new or intensified OCD symptoms following a streptococcal infection, they may be diagnosed with Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS). PANDAS is very different from other types of childhood OCD, mainly in that it results in sudden symptoms. PANDAS can have a significant impact on a child’s life.
