Obsessive Compulsive Disorder


OCD is characterised by uncontrolled and repetitive thoughts that cross the mind beyond the control of the patient and causes intense anxiety. These irrepressible thoughts then become obsessions. The affected person may feel compelled to repeat certain actions to drive the obsession out of their mind or reduce the anxiety, these are compulsions. These rituals only relieve anxiety temporarily, sometimes increase and sometimes even exercise real control over the person. This consumes a lot of time, complicates activities of daily living and generates large amounts of psychological distress.

OCD affects 2 to 3% of the population. The disease progresses chronically, usually develops in adulthood, and unfortunately its diagnosis all too often occurs years after the first symptoms appear. The WHO considers this disorder to be one of the most disabling in terms of mental health: it alters the quality of life of individuals and their families with personal, social and professional repercussions with significant medical and economic consequences.

Treatments - the promise of research:


Validated treatments use a combination of medication and behavioural psychotherapy techniques. The treatment is based on deconditioning habits (rituals) that have become invasive. About 30% of patients fail to show satisfactory results following these treatments. Research therefore focusses on the resistance mechanisms that make these patients unable to decondition themselves.

To date, although the mechanisms of OCD and the consequences of the disability associated with OCD remain relatively unknown, its severe and refractory forms are the subject of very promising research that can be summarised along 4 axes :

The first axis consists in identifying the mechanisms at the origin of the symptoms: one of the major expressions of OCD is the ritual of verification. To explore the brain mechanisms of this compulsive verification, researchers reproduce situations in the laboratory that generate verification behaviours in patients, in order to determine the neural bases of the dysfunction. By understanding how symptoms occur, and by identifying dimensions of behaviour that cause symptoms such as processes of inhibition or uncertainty management, personalised therapies can be developed, tailored and proposed according to each patient’s profile.

The second axis concerns the optimisation of Deep Brain Stimulation, a solution for subjects suffering from OCD resistant to medical and psychotherapeutic treatment. For this, the researchers combine a clinical approach aimed at better characterising the physiological processes involved, and a fundamental research approach to determine the optimal parameters for electrical stimulation of neuronal circuits allowing the restoration of physiological functioning.

The third axis develops an original treatment that uses modern technology to connect, evaluate and help the patient compensate for their disability. Researchers are studying how home automation and mobile devices could provide solutions to help patients in their daily lives. This project will be carried out in collaboration with the patients themselves in order to arrive at solutions applicable in their usual environment: home or workplace. This approach is part of a new system of care enhanced by technology that will significantly improve patients’ quality of life.

Finally, the fourth axis aims to constitute the first Swiss network of centres specialising in severe and resistant OCD: to constitute a common clinical database in order to be able to refine neuromodulation protocols (in particular deep brain stimulation and transcranial magnetic stimulation); and to create a biobank to develop research in genetics and immuno-psychiatry in order to refine knowledge on disease biomarkers and their development as well as on response-predictive factors for treatments.

Testimonies:


Testimony of Denis

Film made for the Mental Disorder exhibition at the Cité des sciences et de l'industrie / 3 min (in French)

Testimony of Corinne

"Electricity has helped to treat OCD" / RTS Info / 2 min (in French)