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Ask the Mental Health Expert Archives 2001-2004

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OCD Remission

Q. Does OCD go away with age? I have had it for a long time and therapy just keeps me in check. Lately I started to pull my hair out. I thought I was too old to get this (trichotillomania).

A. It would be rare for OCD simply to go away with age--only about 2 in 100 OCD sufferers have a few episodes with complete remission lasting longer than 6 months. Most people with obsessive-compulsive disorder (OCD) have a chronic, waxing and waning course. About 15% of cases tend to show a worsening course over time, but about 5% have few if any symptoms in between episodes. Sometimes, symptoms worsen during times of stress, or let up during periods of calm and well-being. The hair-pulling you describe may or may not be trichotillomania (there are other possible causes), but this disorder can occur in patients with OCD.

Conversely, about 15% of patients with trichotillomania meet criteria for OCD. These two conditions may or may not be part of the same spectrum of disorders. You are right in raising the question of age: most individuals with trichotillomania report onset in young adulthood, with peaks at around 6 and 13 years of age. So if this is, indeed, a late-onset symptom for you, it would be important to discuss the diagnosis with your doctor or a mental health professional with experience in OCD-related disorders.

Medication and cognitive-behavioral therapy are often helpful for both OCD and trichotillomania. If you are not getting good results from your current treatment regimen, this, too, should be discussed with your doctor. I hope you find that your symptoms improve.

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December 2001

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