Talk:Obsessive–compulsive disorder

The main picture

Repetitive handwashing is a common OCD symptom

I really do not like that hand-washing is being used as the main picture. Having dealt with many severe sufferers of OCD (such as myself) who did not exhibit any tendency towards obsessive hand-washing, I feel like this constitutes a stereotype and I really do not like it.P2.71828182 (talk) 22:31, 2 March 2011 (UTC)

I concur! I must not have been paying attention when that was added or I would've objected as well. As I've said in other parts of this discussion, I have personally observed such images to have an unfortunate effect-- a person will not recognize themselves to have OCD because they do not identify with the commonly portrayed stereotype of the disorder, and will thus fail to get help and treatment. Unless someone objects, let's remove it by the end of the week. aruffo (talk) 03:44, 5 March 2011 (UTC)

Boldly removed the image per above. --Anthonyhcole (talk) 05:14, 5 March 2011 (UTC)

Handwashing is a frequent symptom of OCD mentioned in many sources. One will never find an image of a condition that everyone with that condition presents with. On this logic we would remove all images.Doc James (talk · contribs · email) 14:46, 5 March 2011 (UTC)

Per this ref washing is one of the main subtypes 18464496 Doc James (talk · contribs · email) 14:52, 5 March 2011 (UTC)

James, please address the point made by Aruffo, that hand-washing is so emblematic of OCD, that some may think if you're not a hand-washer, you don't have OCD. No one is saying it isn't a common symptom, they are arguing against reinforcing a possible misconception. If they're right, maybe no illustration is better than a (possibly) misleading one. --Anthonyhcole (talk) 15:59, 5 March 2011 (UTC)

That is my point. There are always exceptions to common or classic presentations. If we do not allow images of common or classic presentations as people may not realize that ALL cases do not present classically than we will illustrate no articles with images. Doc James (talk · contribs · email) 16:36, 5 March 2011 (UTC)

It is not appropriate to illustrate an article on OCD with an image of any one symptom. I would compare using the handwashing image here to illustrating an article about schizophrenia by showing a man impersonating Napoleon Bonaparte. Even if not for the pejorative implications of handwashing particularly, the disorder of OCD is defined by its causes, not its symptoms. Its symptoms are manifold and often unpredictable-- e.g., every time your car hits a bump you believe you have killed a man, or you feel your life will be ruined if you don't collect every designer dinner plate that the Franklin Mint has ever produced. If it were possible to include an image that somehow illuminated the causes of the disorder, this would provide greater understanding. Attempting to illustrate OCD with any symptomatic image is misleading and inappropriate. aruffo (talk) 16:46, 5 March 2011 (UTC)

We illustrate hundreds of articles with a single image of a single symptom. I am not sure how this is any different.Doc James (talk · contribs · email) 17:18, 5 March 2011 (UTC)

What you say is precisely why the image must be omitted. An uninformed observer will not recognize the difference. If, as you indicate, you do not understand the difference, I respectfully request that you refrain from judgment or action until you have gathered enough evidence to support a position. aruffo (talk) 18:03, 5 March 2011 (UTC)

Will request further opinions. I have provided plenty of evidence. Doc James (talk · contribs · email) 21:08, 5 March 2011 (UTC)

So should we take down the picture from Acute stress reaction because not everybody who gets stabbed will be unaware of it or should we recognize that that is an example that people will understand and relate to?

If you’re going to take down the hand washing picture I would like to hear an idea of what the picture should be of. ITasteLikePaint (talk) 21:55, 5 March 2011 (UTC)

Aruffo instructing another editor to "refrain from judgment" is unacceptable breach of etiquette, address issues please, rather than attack those that disagree with you.David Ruben ^Talk 22:12, 5 March 2011 (UTC)

• include picture - the picture seems fine to me, in fact more than that, I expect such a picture to help recognise the topic. The picture illustrates a frequent classic symptom of excessive hand washing, but that is not to suggest all people with OCD have this - this is not therefore a reason not to have the picture. Nor does the picture imply these are people who implement hospital training programmes to ensure clinical staff routinely wash their hands between patients. Of course OCD may also involve repeatedly checking that doors/windows are closed, but a picture of a static closed door is less likely to indicate a process occuring as the hand-washing picture implies, that there is action in teh picture is important - it is not that hands are washed/doors closed or some particular thought occured in the past, it is that they are active ongoing and in the present. As for Affuro's point that "a person will not recognize themselves to have OCD because they do not identify with the commonly portrayed stereotype of the disorder" - firstly of course WP is not written for patients and so it is not for people to self-diagnose (WP:NOTGUIDE and disclaimer WP:MEDICAL), secondly have a look at picture for say Asthma - do people not have asthma if they have not been provided with a peak flow meter or have not had this test - as no child under the age of 5 can reliably use such meters, they play no part in the diagnosis/management of asthma in infants. Chronic obstructive pulmonary disease (COPD) has as its picture a postmortum image of lungs with emphasyma, which is but one classification of the condition and not to imply that COPD does not exist in living people. Pictures in 'disease infobox' are but illustrative of some (but not all-encompassing) aspect(s) of the subjct matter. David Ruben ^Talk 22:12, 5 March 2011 (UTC)

  Just a minor point, but the picture does not claim to be a fixed requirement for the condition, for its caption reads "Repetitive handwashing is a common OCD symptom" David Ruben ^Talk 22:15, 5 March 2011 (UTC)

• Include picture Handwashing is one of the more common symptoms of OCD and certainly one of the easier one to illustrate. It would be helpful if those editors objecting would provide an alternative for a picture to use for the article. Counting would be a little more difficult. A typical picture of the results of hoarding would not be a good alternative. Repetitive checking and excessive doubt are not exactly easy to illustrate. As long as the text of the article doesn't imply that every person with OCD manifests symptoms of excessive hand-washing and the text under the picture states it's just a common symptoms, I don't think it's a problem to have a picture of someone washing his hands. Warfieldian (talk) 02:41, 6 March 2011 (UTC)

The picture is not illustrative of OCD. Nor is the picture illustrative of a symptom of OCD. Hand-washing is but one potential, individualized consequence of the real symptoms of OCD. I am not splitting hairs in saying this; I am saying that the handwashing picture does not illustrate a symptom of OCD. It illustrates a stereotype of OCD sufferers which is objectionable to those who suffer from OCD. In furtherance of this point, it is a misreading of my previous statement to infer that I was mounting a personal attack. I say again: a person who does not understand the difference between the handwashing image here versus images used to illustrate symptoms of other disorders is ill-equipped to pass judgment upon this image. I say again: if a person honestly believes that a handwashing image is an appropriate illustration of OCD, and sees no reason why an image of hand-washing-- as it is indeed a popularly-held conception of the disorder-- should not be presented as representative of the condition, then I would encourage that person to visit the schizophrenia page and replace the sample image there with that of a man in a Napoleon Bonaparte outfit (and, ideally, exhibiting a cockeyed expression). The reponse generated by such an image would soon make clear its indefensibility-- despite its being a storied, popular, and legitimate representation of one manifestation of the disorder.

Does anyone snigger at the thought of a peak flow meter? Does anyone snort with condescension at a post-mortem illustration of diseased lungs? I do not take issue with the points you are making about symptomatic images. If that were the only concern, I certainly wouldn't care in the slightest. The real objection to its inclusion is not one of limitation, but of derision. This is what I implore you to understand. This is the issue which is to be addressed.

I don't know (yet) what an alternative image might be. But I think the schizophrenia article is, again, a good example. The image presented there is itself a consequence of a symptom-- but it is a presentation from which a reader cannot casually conclude that they recognize and understand the phenomenon. It is an image which challenges its viewer to wonder "what could cause that?" and encourages them to read on and learn. If an image were requisite for this article, then it could be more helpful to have an image that would startle a reader into thinking that they actually do NOT know exactly what this disorder is about. The handwashing image would rather encourage them to believe that OCD is indeed that same crazy behavior they've seen (misrepresented) repeatedly in the media. aruffo (talk) 02:51, 6 March 2011 (UTC)

Just one additional comment. It is not helpful to imply that other editors are ill-equipped to weigh in on this issue simply because they disagree with you. I treat people all the time with this disorder but that doesn't make me any more able to comment on the suitability of using the picture for the article. I can say that people with OCD often are embarrassed by the symptoms and often hesitant to bring them up. That doesn't mean that we can't talk about the symptoms or illustrate them in article about the subject of OCD because it might make some people uncomfortable. You haven't suggested a better image to use. I think the article benefits from having some type of picture near the lead. I hope that a consensus can be reached on returning the removed image or finding a similar one that illustrates one of the common symptoms of OCD. Warfieldian (talk) 03:24, 6 March 2011 (UTC)

You're right. It would not be helpful, nor logically sound, to imply that any other editors are ill-equipped because of a disagreement in opinion. This is why I have not done so. Rather, I should think it would be obvious that anyone who does not understand why some thing could be offensive is ill-equipped to judge whether that thing is or is not offensive. I would be surprised if anyone would believe that an informed judgment could be made from a position of ignorance, regardless of the topic.

I repeat: I assert it is no more or less appropriate or helpful to place an image of handwashing here than it is to place an image of a kooky Napoleon on the schizophrenia page. I maintain that the detriment of such an image to an encyclopedic article is that it merely evokes a media stereotype. It may not be easy to imagine an image that is emblematic of an actual symptom of OCD-- an anxiety disorder, the symptoms of which are abnormally heightened emotions, which lead to compulsions-- but perhaps we could figure it out. aruffo (talk) 04:09, 6 March 2011 (UTC)

Hand washing is specifically mentioned in the ICD 10 criteria [httyhcole|Anthonyhcole]] ([[User ta-an05.html]. This is more than "media stereotype". Per this review article "decontamination rituals e.g., excessive washing, bathing, or grooming are present in 46%" The only compulsions is more common is checking at 80%.Markarian Y, Larson MJ, Aldea MA; et al. (2010). "Multiple pathways to functional impairment in obsessive-compulsive disorder". Clin Psychol Rev. 30 (1): 78–88. doi:10.1016/j.cpr.2009.09.005. PMID 19853982. {{cite journal}}: Explicit use of et al. in: |author= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link) Doc James (talk · contribs · email) 04:22, 6 March 2011 (UTC)

As for an alternative image, other articles have used a brain scan highlighting the regions involved in OCD organising precision cleaning trichotillomania checking hoarding symbolic representation. Would any of these be more appropriate? --Anthonyhcole (talk) 05:06, 6 March 2011 (UTC)

If the issue is whether an image should be symptomatic or emblematic, I suspect they're all about the same. That is-- I notice and focus on the quote following the specific mention of hand-washing given in the ICD 10 criteria: "Underlying the overt behaviour is a fear, usually of danger either to or caused by the patient, and the ritual act is an ineffectual or symbolic attempt to avert that danger." That's what's really going on. I suspect it would be most beneficial if an illustration could be provided indicating this symptomatic fear, rather than any emblematic ritual. However, I still don't know what that is, and my imagination is failing me. For now, until such an image could be conceived, I readily concede the "media stereotype" and Napoleon business based on the evidence given and withdraw my opposition to the inclusion of a handwashing image. aruffo (talk) 05:16, 6 March 2011 (UTC)

Restored. --Anthonyhcole (talk) 05:32, 6 March 2011 (UTC)

There are absolutely no good arguments for KEEPING the picture, other than "the picture was there and I want it to stay." The hand-washing image perpetuates a HARMFUL STEREOTYPE: that of the obsessive compulsive as an uptight person obsessed with cleanliness. As a non-uptight and fairly messy person who suffers from severe obsessive compulsive disorder I have encountered alot of difficulty due to non-sufferers assumption that OCD is synonymous with uptight and clean. This picture really should not be the main picture. The main picture should be something liek a brain scan, as noted above.P2.71828182 (talk) 04:44, 7 March 2011 (UTC)

Seeing that the cause is unknown a brain scan says little about this topic. I have provided evidence of how common this symptom / sign is. Can you present evidence that it is a harmful sterotype? Remember Wikipedia is trying to be evidence based.Doc James (talk · contribs · email) 04:49, 7 March 2011 (UTC)

Evidence would need to be provided first. WP:MEDRS outlines what would be suitable. Doc James (talk · contribs · email) 05:18, 7 March 2011 (UTC)

Okay then no brain scan, it has been acknowledged that more than half of people suffering from OCD do not present with the symptom in the main picture. Furthermore, as I stated previously and as has been stated by others, this picture represents a harmful stereotype and it needs to be removed from the top of the article. The importance of this cannot be over-stressed. I will gather some evidence this week, until then I request that this picture be removed as the main picture. Can I also ask why you feel so strongly that this picture must remain the main picture? Many of us have explained why it should not be. As "checking" is a symptom that shows up in 80% or more of sufferers (your stat) and is not a stereotype i suggest that it would be a much better main picture for the article. [User:P2.71828182|P2.71828182]] (talk) 05:15, 7 March 2011 (UTC)

If you can find an equally good picture that involves checking we could reconsider things. BTW these are not my stats but those of the review I have referenced. I consider illustrating articles good editor form. Doc James (talk · contribs · email) 05:26, 7 March 2011 (UTC)

Doc James has presented evidence to support his case that handwashing is a common symptom found in people with OCD. Since the argument of "harmful stereotype" seems more consistent with WP:JDLI. I'd like to see some secondary sources which specifically mention hand-washing as a harmful stereotype and also how this is more harmful than any other symptom of OCD. Warfieldian (talk) 23:59, 7 March 2011 (UTC)

• CONCUR with including picture - An excellent discussion! At this point, after considering all the above, and with all due respect to everyone, I personally (a) do not forsee SIGNIFICANT harm vis-a-vis perpetuating the aforementioned harmful stereotype, and (b) I DO feel it is REASONABLY representative of the disorder. Furthermore, (c) the EVIDENCE presented by Doc James, combined with (d) the ICD-10 mention (above), carry considerable weight with this user. Of course, I would be pleased to reconsider my (value $0.02 U.S.) opinion in the future if I were given additional evidence and/or argument to review. Cliff L. Knickerbocker, MS (talk) 06:18, 11 March 2011 (UTC)

Note added ex post facto - perhaps I should have mentioned I am NOT an admin, merely have "reviewer" rights. Thanks.Cliff L. Knickerbocker, MS (talk) 06:26, 11 March 2011 (UTC)

hello... I have ocd and i find this stereotype to be quite offensive... being a programmer i have the means and know how to wage war upon this page and remove that picture.... if it is replaced... it will be taken down... this is the end of all argument to this picture. —Preceding unsigned comment added by 75.107.54.227 (talk) 00:18, 24 March 2011 (UTC)

• I find it extremely distracting that the top left corner of the picture contains unsightly greyness and there are various black spots throughout the picture. I hope someone will take the initiative to remove those soon. Purpy Pupple (talk) 00:40, 24 March 2011 (UTC)

• I've been too busy to find sources, I will soon. But I would Like to point out that using this picture is simply not illuminating. It is akin to using a picture of a person vomiting as the main illustration in the article about Chemotherapy. Essentially everyone who undergoes Chemotherapy vomits but this is a bad way to represent chemotherapy. Far fewer sufferers of OCD compulsively wash their hands. At the end of the day, in addition to being offensive, it is just a bad picture. P2.71828182 (talk) 12:24, 26 March 2011 (UTC)

• Remove picture

It is rather odd to have a picture of a man washing his hands on an OCD article. There are no other pictures in this article, so why have an extremely random one as the main image. When I visited this page, I wasn't sure whether I was on a "hygiene" article, or if I was at the OCD one. I agree with

P2.71828182, it is a bad way to represent OCD; plus, it could and does offend many people with OCD. Rsercher (talk) 21:40, 20 June 2011 (UTC)

• I do not see how using the hand washing picture which represents one symptom of a very complex disorder is any different than the very offensive use of the term “beaner” to represent a Mexican or other one word, one image stereo-type pejoratives. Most people are familiar with OCD so why not challenge them with a new image that represents the hours that this disorder takes out of ones day if left untreated! The quality of the hand washing picture can be found on reality t.v. 333prime.curios (talk) 15:55, 1 May 2011 (UTC)

The picture, revisited

Like some commentators on this page, I've been diagnosed with OCD. Like some commentators, I'm also familiar with the research litature. I don't see anything offensive or inaccurate about the hand-washing picture. But that, in my estimation, is the problem. The picture is not offensive enough, and at the same time it's just too accurate:

• Unoffensiveness: OCD itself is "offensive". Sufferers literally[1] "take offense" to their condition insofar as they feel hurt or injured by it. In clinical settings, this sort of "offense" often goes by the name of "subjective distress". The current picture, in stark contrast to the topic that it's illustrating, is benign; it betrays no suffering, except perhaps for the distress that accompanies the realization that your life as a contagious pathogen on some guy's palm is over. Indeed, this article attempts to introduce a (psycho)pathological condition with the exact same picture as adorns the article on hygeine!

• Accuracy: The picture strikes me as myopic, both in a literal sense (as a photograph) and in a figurative one (as a symbol):
  • Literal myopia: Hands do not have OCD; humans do. Hands have warts and germs and hangnails. The picture has something of a dermatological quality, I suppose, and lacks the sort of existential or expressive hues which may be found atop the major depressive disorder and anxiety disorders articles. To be sure, neither van Gogh nor Munch set out to illustrate the DSM, and neither man's selected work (At Eternity's Gate and The Scream, respectively) exactly lend themselves to easy "diagnosis". Both artists, however, demonstrated in these works that they could "zoom out" far enough from symptom and from syndrome that they could pinpoint the exact location of pathology and misery as nothing less than the entire human organism as it "hosts" its "illness" in a given setting or environment. The hand-washing illustration could very well be the perfect picture of OCD. But this compact, clear, and "nice and clean" (no pun intended) imagery does not inherently convey that something is off-kilter. "Common knowledge" notwithstanding, it is only in the context of the article that such an image can become discernably relevant to the very concept that it is supposed to make at least a little more accessible from the beginning! The reader is obliged to appreciate the symptom in terms of the syndrome and vice versa, and is thereby trapped within a hermeneutic circle from the outset.
  • Figurative myopia: I know, it's difficult to illustrate an abstract concept, especially given the tangibility of images and the intangibility of ideas. OCD, however, is decidedly bicameral, for even by name it is a creature of cognition and behaviour juxtaposed. Hand-washing might indeed be emblematic of compulsions. However, since OCD's compulsions are, by nature, logical misrepresentations of OCD's obsessions, hand-washing makes for more synecdoche than symbolism: Hand-washing is to OCD as "one small step for a man" is to "one giant leap for mankind"; the connections may be recognizable and even famous, but this does not necessarily mean that the connected entities are semiotically proportionate.

I don't claim to have the slightest clue what an ideal picture for the introduction to this article would look like; rather, I maintain that it has yet to be discovered or suggested, and I encourage further exploration in a continued (if confusing) quest to find an image which may compensate for any superfcial irreverence or imprecision by embodying a deeper logic and more sensitive aesthetics than those apparent in the current choice. With a new image of this sort the lead should spare the reader from the smallest hermeneutic circle and from the slightest semiotic scramble. Cosmic Latte (talk) 23:56, 31 May 2011 (UTC)
Meanwhile, someone who has no obsession about their hands is counting peas on their plate and hording until they have head high stacks falling on them and fires breaking out. Why? Because those with this condition or those who live with them looking for information about them, but all they see is a hand washer. Stereotyping is not helpful. I agree with those who say it is harmful, but it is also deceptive. It is not the only or even the most likely symptom. SEE: http://understanding_ocd.tripod.com/ocd_symptoms.html Why do you need an image at all? JohnLloydScharf (talk) 07:16, 21 August 2011 (UTC)

psychology section is missing

someone deleted the psychology section?? — Preceding unsigned comment added by 174.7.103.230 (talk) 19:35, 31 July 2011 (UTC)

Are you saying that a section used to be present but is no longer there? If so, you should be able to discover what happened by looking through the history of the article. Looie496 (talk) 19:43, 31 July 2011 (UTC)

The section heading is there (above "biological"), but there is no content. The content that was there in the recent history really wasn't useful. The heading could be removed, but I think there should be some information on this. Don't have time to write it myself right now. If someone is interested to work on it, the article on intrusive thoughts has a pretty good description of the psychological processes that have been theorised to cause intrusive thoughts to develop into OCD - this could perhaps be reworked as a starting point to fixing the psychological factors section. Interlope (talk) 03:18, 5 August 2011 (UTC)

OCD LEADS TO ADDICTION,MAYBE ALZHEIMERS?

Since OCD suffers are "addicted" to their comulsions. Does this lead many to addiction? (drugs etc?) Also, since there is temporary loss of memory often associated with OCD . May be this a factor in predicting future alAHEIMER ?SOCALKIDME (talk) 19:03, 17 August 2011 (UTC)

Please note that, as the template at the top of the page says, this is a place to discuss improvements to the article. It is not a forum for general discussion of OCD. --Aurochs (Talk | Block)

Edit request from , 20 October 2011

{{edit semi-protected}}

The external links section should include a link to OCD Chicago. It is one of the biggest resources on the web for information on the subject of OCD.

The link is: http://www.ocdchicago.org/

Dougbertram (talk) 16:18, 20 October 2011 (UTC)

Sorry, that's too local; see Wikipedia:WikiProject Countering systemic bias. If you disagree, please discuss it here and if there's consensus to add it, re-request. Also please refer to WP:EL - it'd have to be justified in those terms. Does it really provide a unique resource beyond what the article would contain if it became a featured article?  Chzz  ►  07:18, 22 October 2011 (UTC)

As Good as it Gets

The reference to Melvin Udall in As Good as it Gets having OCD is not entirely accurate (despite a line in the movie mentioning OCD), and I think that providing an inaccurate example will leave readers with a false impression of the disorder. Udall more likely suffered from OCPD than OCD, most notably because of the egosyntonic nature of his symptoms. He never seemed to have a problem with his behavior, whereas someone with OCD would suffer distress from their obsessions or rituals. In contrast, he alienated many people around him with his intolerance and rigidity, which are more characteristic of OCPD. I think that the reference should stay in the article but be modified to mention the OCPD diagnosis, in order to most effectively combat the misinformation within the movie. EriktheRed53 (talk) 05:25, 15 November 2011 (UTC)

Edit needed in top summary.

"The phrase obsessive–compulsive has become part of the English lexicon, and is often used in an informal or caricatured manner to describe someone who is excessively meticulous, perfectionistic, absorbed, or otherwise fixated.[4] Although these signs are present in OCD, a person who exhibits them does not necessarily have OCD, and may instead have obsessive–compulsive personality disorder (OCPD), an autism spectrum disorder, or no clinical condition"

Here, the main problem has been put in bold. This is both unmentioned in the OCPD article as well as being an unfounded and unsupported statement. Either back it up with a suitable citation and add it to the OCPD article as well, or remove the claim entirely. --83.183.127.178 (talk) 21:11, 22 November 2011 (UTC)