The purpose of this paper is to discuss the role of the nurse in caring for the adolescent patient with obsessive-compulsive disorder (OCD) and their family members through therapeutic communications. The basic features of OCD, according to the DSM-IV-TR criteria are recurrent obsessions or compulsions (Criterion A) that are of sufficient severity to be time consuming (lasting more than one hour per day) or are severe enough to cause severe distress or impairment (Criterion C) (DSM, 2000, 456-457). If the person has realized at some point that these obsessions or compulsions are unreasonable, then this is Criterion B. Obsessions are defined as persistent thoughts and ideas, impulses or images that are persistent and intrusive enough to cause anxiety and distress. The most common obsessions in this disorder are repeated thoughts about contamination by shaking hands, or repeated doubts about leaving a door unlocked or a light on. Compulsion refers to repetitive behaviors such as hand washing, counting, repeating words silently, etc. A person with OCD feels driven to perform these compulsions to prevent the stress of an obsession about something bad happening if they don't.
By definition, compulsions are not connected to the things they are supposed to prevent in a realistic way (DSM, 2000, 457). By definition, adults with OCD have at some point, recognized that their symptoms are unreasonable, but this is not necessarily the case with children because they may not have developed significant cognitive awareness to make such a judgment. The lifetime prevalence of OCD in children and adolescents is from 1-2.3 percent (460). OCD prevalence rates are similar in many different cultures around the world.
OCD may develop from a malfunction of the brain or from a biochemical malfunction of the chemicals that help a person prepare for danger, i.e. the neurotransmitters epinephrine, norepinephrine and dopamine (Valente, 2002,...