Q. Is OCD hereditary?

Answered by
Dr. Seikhoo Bishnoi
and medically reviewed by iCliniq medical review team.
Published on Jun 01, 2018 and last reviewed on: Nov 15, 2019

Hi doctor,

I got married before 1-1/2 years. By seeing the aggressive behaviour of my wife, I took her to a hospital in my town and she was diagnosed with OCPD, EUPD and anger discontrol from childhood. She refused to accept the disease and apprehended to take the medicine. We have been attending the marital counselling session too but without any improve in her condition. I would like to mention few of her behaviour conditions to make you realise the importance of my query. She is finding very difficult to trust people. Extreme suspicious behaviour towards all including me and easily lies on anything and make the conversation complicated. She is emotionally cold towards others and no sense of guilt even if she gets angry on small issues or when committed any mistake. She suffers from mood swing with anger outburst. She slaps herself and bang her head against wall. She believe that she has a sixth sense and prejudge the people by telling something bad is going to happen. She behaves overemotional, dramatic, irrational reasoning and weeping without tears. She has fear of locking herself in toilet or room. So, she will keep the door open at home or outside. She suffers with forgetfulness and unable to concentrate on anything. She used to keep re-checking the things in kitchen. She used to keep things in order and gets very disturbed and upset if things are not in the place. Feel dirt everywhere and keep on cleaning.  She is reluctant on spending money. Despite having hand dermatitis she carries a wet cloth whole day and clean and urge to wash hand repetitively. From 8 AM to 4 PM she will be engaged in household job, But, she do not feel to take rest or sleepy in noon or at night. Once she is exhausted physically and mentally then only she feels sleepy. Her sleep problem urge her watching horror or investigative movies late night. She often gets sad and scary dreams and murmurs at night to herself. She visualises images whenever she is alone and trying to hold the imaginary figure in air and talk to them. She gets negative depressive thoughts often and suicidal threat whenever in anger. I request you to evaluate her condition based on the above and provide further line of treatment accordingly. My further request is to perform personality test if required to confirm her actual personality disorder or any other available tool for her assessment and plan the treatment accordingly.My doubts are, is this ailment hereditary and spread to my kids too? Is this a completely curable one? In her current state of mind when she is not accepting her ailment and occasional anger outburst and suicidal threat, what could be the severity of her disease in future? What should be the future course of management for her? I would appreciate your insight and further assessment. Thanks.

Dr. Seikhoo Bishnoi

Psychiatry Psychotherapy Sexology
#

Hi,

Welcome to icliniq.com. I have read the detailed history that you have mentioned in your query and I can understand your concern.

The symptoms does not fit in a particular personality type and this is the reason why she has been diagnosed with different personalities. As you have mentioned that her symptoms are present since childhood so apart from personality disorders other conditions should also be ruled out like bipolar disorder or some psychotic episode.

  • Her symptoms like difficulty to trust others, suspiciousness, emotionally cold, mood swings, grandiose ideas, argumentativeness, etc., suggest more towards some mood or psychotic disorders. But, this can also occur in personality disorder.
  • Her personality is preserved. as there is no social or personal dysfunction, it rules out psychosis. Some symptoms suggest some anxiety disorder with OCD (obsessive complusion personality disorder) also.

Fear of locking in toilet, mistrust, etc., suggest anxiety. Visualising images, repetitive work pattern, keeping things in order, jealousy, obsessive ideas of cleanliness, feeling dirt everywhere, etc., are pointing towards OCD. She is not accepting her illness and this means she has lost insight related to her illness.

  • The mental disorders are not hereditary. Environmental, genetic, psychological, etc., many factors act to result in this disorder. There is no single Mandelian inheritance pattern.
  • Personality disorders are difficult to treat. Long-term treatment in the form of medicine and psychotherapy helps. OCPD can be treated properly with medicines.
  • This is not like that the disorder will occur in your children. There is no specific genetic transmission so no need to worry.
  • She should be treated properly with medicines otherwise her suspiciousness, ideas of reference and other psychotic symptoms will increase in severity. She might go into social withdrawal, poor interaction, personal and social dysfunction.
  • If she is refusing to take medicine then medicines like Risperidone or Olanzapine can help. These are available in liquid forms and can be given by mixing with food. These are tasteless and odourless preparations. If she refused to take medicines then she can be given these drugs.

For further infomration consult a psychiatrist online --> https://www.icliniq.com/ask-a-doctor-online/psychiatrist

Hi doctor,

She is facing the following problems since young age. Her indications of anger on little issues and repetitive working behaviour pattern of arranging things in order and keep cleaning things. Confrontation and trying explaining on each and every act she does to other and try proving hard or justifying herself that she is right and others are wrong. She is trust deficit. She behaves abnormally by the way of handling anger by locking herself in a bed room for one or two days. I am observing her since day 1 of my marriage. She has severe eating disorder and rigid behaviour. Because of her psychological issues like hitting herself if something goes against her will and giving occasional suicidal threat somehow I convinced her to visit psychiatrist and there OCPD and EUPD was diagnoed. Based on the symptoms narrated she was also diagnosed anger dyscontrol. I cannot plan family in this state of her mind. I am living with my quite old aged parents. Despite their ill medical condition, my wife argue loud and rudely. She will keep restraining either my mother or anyone attending any kitchen job and address my father in very insensitive manner. Towards me again she holds lots of suspicion. She is checking my mobile daily to know whom I am talking to. I am in real estate business and operating from home on call. When I go out she feels very distress and uneasy and keeps on calling and messaging me till the time I am back home.  I am in stress which is affecting both my personal and professional life. I have tried all the available options like counselling, meeting psychologist, etc. Still after all the sessions, she feels the problem is with others not with her. Please guide me to deal with it and to convince her to take proper treatment. I am losing my patience. As anything could happen to parents who are in severe stress or to my wife who can harm herself as she mention out of anger, it is really worrisome to see the family like this. Is there any permanent relief for this condition through medicine?

Dr. Seikhoo Bishnoi

Psychiatry Psychotherapy Sexology
#

Hi,

Welcome back to icliniq.com.

I can understand your concern.

After reading the whole query again in my opinion before making personality disorder as diagnosis we have to rule out some psychosis and possibly schizophrenia.

Her behavior like suspiciousness, doubting you, suspiciousness on you even while you talk to someone, obsessive ideas, very rigid in eating habits, does not allow others in kitchen, etc., can be explained by psychosis.

  • A lot of individuals with psychosis or schizophrenia show obsessions or even OCD as co-morbid complication. Though her behavior like self harm can be explained by borderline personality disorder but other symptoms suggest more towards some psychotic disorder.
  • Try to make her ready to consult a psychiatrist, and if she does not visit a psychiatrist then we have other options also. Visit a psychiatrist by yourself and take all old papers and records.
  • Many medicines like Olanzapine, Risperidone which are antipsychotics can be given to a patient by mixing with food.
  • Please do not lose patience. Remain relaxed. Try to find a good psychiatrist for treatment.

With proper treatment her symptoms will come under control but you have to keep a lot of patience. Treatment is difficult but possible.

For further information consult a psychiatrist online --> https://www.icliniq.com/ask-a-doctor-online/psychiatrist

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