Obsessive‐compulsive disorder and men's health. Part 1: Recognition and diagnosis

Abstract

Obsessive‐compulsive disorder (OCD) commonly affects males and can manifest with a range of urological symptoms directly linked to the content of the OCD, including urinary urgency, urinary frequency, urinary retention and sexual dysfunction. Accurate recognition of OCD in such cases is fundamental to avoid misdiagnosis, risks to patients associated with untreated OCD (including suicidal behaviour), unnecessary physical health investigations and delayed treatment. In Part 1 here, the authors discuss the recognition and diagnosis of OCD. Part 2 will consider its treatment.

Obsessive‐compulsive disorder and men's health. Part 2: Treatment and related sexual dysfunction

“…The illness itself may directly impact sexual functioning, for reasons already described in Part 1. 1 In summary, individuals with sexual or contamination-related obsessions or compulsions may find engaging in sexual intercourse particularly challenging as they may be afraid of contact with bodily fluids such as seminal fluid, blood, etc. Obsessions related to aggression can also lead to avoidance of sexual activity, to prevent the imagined risk of loss of control and perpetration of a sexual assault.…”

“…It is important to take into consideration sexual functioning in patients undergoing treatment for OCD. The illness itself may directly impact sexual functioning, for reasons already described in Part 1 1 . In summary, individuals with sexual or contamination‐related obsessions or compulsions may find engaging in sexual intercourse particularly challenging as they may be afraid of contact with bodily fluids such as seminal fluid, blood, etc.…”

“…Part 1 of this article, published in the January/February 2023 issue of Trends in Urology and Men's Health , reviewed the common urological presentations of OCD as a guide for clinicians to aid recognition of the disorder and facilitate appropriate onwards referral and management 1 . However, as OCD is such a commmon disorder, it is also important for clinicians in general to understand the basics of OCD treatment, not only to provide support and guidance to their patients but also because some of these treatments may have physical health repercussions.…”