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Furthermore, while female patients experienced stressful life events including family problems, pregnancy, and childbirth, male patients mostly reported experiences of changing jobs or relocating before the onset. The results also suggested that most cases of OCD that experienced a traumatic incident before the onset were male children with contamination/fear symptoms. In our previous study ( 10) that examined 36 patients with OCD, over 60% patients also experienced either stressful life events within 1 year or trauma within 1 month, respectively, before the onset. reported that termination of a relationship was associated with a faster speed of progression to OCD ( 9). In the most recent study which included 954 OCD outpatients, Destrée et al. suggested that women may have greater risk of initial onset of OCD after precipitating events ( 8). Another study reported that around 50% of OCD patients had experienced at least one traumatic life event in their lifetime ( 7). found that around 60% of 329 participants in a study developed OCD after experiencing stressful life events ( 6). Then, to what extent do these experiences and events affect the onset of OCD? Recently, Rosso et al. In cases of OCD, while stressful life events and traumatic experiences cause the onset of obsessive symptoms directly, compulsive behaviors caused by these experiences maintain and gradually worsen the symptoms. reported that experiences of abuse, sexual abuse, and family disruption were associated with the severity of obsessive-compulsive symptoms ( 5). In addition to the original meaning of trauma, stressful life events or unexpected exposure to contaminants often are associated with the onset of OCD ( 3, 4).
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Mowrer described this process as a “two-process theory of learning” ( 2).įurthermore, not a few patients with OCD experienced episodes that affected the onset of their OCD. Subsequently, their avoidant behaviors, including compulsions, were maintained because those behaviors temporally alleviated their anxieties and fears. From the aspect of cognitive behavioral theory, patients with OCD were fear conditioned by stimulants typical of the subject of the obsession at its onset. This suggests that male OCD is affected strongly by genetic factors and comorbid neurodevelopmental disorders such as tic and autistic spectrum disorders, while female OCD is influenced by comorbid mood or anxiety disorders and life events such as marriage, pregnancy, and childbirth ( 1). There is a difference in onset peaks between males and females, with male patients having the peak in the mid-teenage years and female patients in the mid-twenties. Most patients with OCD show comparatively early onsets, i.e., during their adolescence. Obsessive-compulsive disorder (OCD) is characterized by persistent intrusive thoughts and repetitive actions, significantly affecting the patient's daily life. To comprehend the pathophysiology of OCD, it is important to understand the stressful life events that precede its onset. Meanwhile, the patients who had had specific traumatic experiences showed a tendency toward hoarding obsessions. Furthermore, the participants who had had stressful life events showed more contamination/fear symptoms compared with those without such life events. As a result, 172 (61.2%) participants had experienced various stressful life events, and 98 (34%) participants had had traumatic experiences before the onset. In the present study, we investigated the onset conditions of 281 patients with OCD and compared clinical characteristics among groups with or without stressful life events including traumatic experiences. It would be useful to understand the experiences surrounding the onset, including stressful life events and traumatic experiences, for comprehension of the pathophysiology of OCD. The onset of OCD is not limited to the original meaning of trauma rather, traumatic experiences such as unexpected exposure to contaminants or various stressful life events often cause the onset of OCD. Not a few patients with obsessive-compulsive disorder (OCD) have experienced events that affected the onset.