Čistoča ali bolestna obsedenost?

As a nation, we have an obsession with all things antibacterial, from toiletries and household cleaners to dish cloths and food wrappers. As a result, we are more scrupulously scrubbed - up than ever.
But, oddly enough, this obsession with cleanliness could be ruining our health, by leaving our immune systems vulnerable to allergies and infections. In fact, soaring rates of allergies are almost certainly linked to our increasingly sterile lifestyles. Thirty years ago, conditions such as asthma and hay fever were rare. But in the past decade, asthma rates have doubled among children under five years.
In a report published last year, researchers dished the dirt on sterile homes and overhygienic lifestyles, suggesting that they might be the cause of the prevalence of asthma and nasal problems in the western world. It isn t the first warning from experts that some health problems are triggered, not by germs themselves, but by a lack of them. By bleaching your kitchen, you may be protecting yourself from bacteria, but you are also preventing the development of a natural resistance to them.
Scientists are increasingly in favour of this theory. If we expose ourselves to a little muck and dust, claims the progrime brigade, then our body will adapt by recognising what really is a danger, so that the immune system won t falter when presented with harmless bugs and bacteria. Too much bug-free food and disinfected surfaces, and things might go amiss. Exposure to simple dirt and grime from the environment is probably good for you.
Almost all research into asthma seems to support the grime theories. Two years ago, a study of 14,000 children showed that those who bathed daily and washed their hands three or four times a day had a one in five chance of getting asthma, while those that bathe only every other day had a one in seven chance of developing it. Children from large families are constantly exposed to minor infections, so its immune system might react inappropriately to different substances.
When the extracts of dead soil bacteria are injected into the bloodstream, it doesn t overreact and won t trigger an allergic response.
All of this is welcome news for those of us who are not quite as nifty with the duster as we would like to be. Still, people believe that you can never be too clean, so it could take some time to convince most people that a layer of grime is a must-have. But if we know what s good for us, we ll whip off the marigolds, stash away the antibacterial kitchen cleaner and head out into the garden for a dirty weekend.

OBSESSIVE COMPULSIVE DISORDER
Obsessions are recurrent thoughts which are distressing and disturbing and which intrude forcibly against conscious resistance. The person experiencing them usually realises that they are irrational (as distinct from the implicit belief that people have in their delusions), but finds that fighting them only increases the anxiety. The obsessions are often accompanied by a compulsive desire to behave in a particular way which is almost impossible to resist.

Obsessions are often made more upsetting because they are associated with things that you find shameful. Thus, a religious person may feel an urge to utter blasphemous words whilst in church or be preoccupied with what he regards as unwholesome sexual ideas.

A common obsession is fear of germs and preoccupation with cleanliness. People with this obsession feel they must wash every time they touch something that may not be scrupulously clean. The action may relieve anxiety about contamination. Sometimes, a you will feel compelled to change your clothes constantly in case they are contaminated. Compulsive washing may develop into a ritual where you have to wash and dry your hands a certain number of times in a particular way and are forced to start all over again if you feel that the ritual has not been carried out properly. You will often occupy an entire day washing your hands until they become chapped and sore. People with obsessive compulsive disorder usually have a combination of obsession and compulsion.WHAT CAUSES OCD?
We all have mild obsessions, particularly as children. They may take the form of superstitions like not walking under ladders, throwing salt over the shoulder or stepping only on certain places in the road. They can be seen as primitive ways of warding off disaster. Similarly, you may feel a need to check that you have locked the front door, posted an important letter properly or feel you need to count a certain number of times before a particular event. Healthy people may have occasional intrusive thoughts, sometimes aggressive or sexual.

The difference between this normal behaviour and that of someone with obsessive compulsive disorder is one of degree: the intensity and distress of the intrusive thoughts; the difficulty of stopping them; the frequency with which they occur; the duration of the symptoms; and the effect on functioning.

People with what can be called a "perfectionist personality" seem to be more likely to develop obsessional disorders. Such individuals are very conscientious, fearful of any transgression against the social code and have very high ideals for themselves and others. It may be that, on a particular occasion, such people have not lived up to their own expectations of themselves or have had thoughts and feelings which have caused anxiety and which have then been transferred into obsessions or compulsions. On the other hand, a third of those with OCD have other types of personality, and people with perfectionist personality are more likely to suffer from depression than obsession.

Once started, compulsions are fuelled by the anxiety created if they cannot be carried out. A depressive illness may sometimes bring out obsessional preoccupations which have previously been under control.HOW IS OCD TREATED
OCD affects 2 or 3 people in 100 at some time in their life. It is more or less equally shared between men and women. About two thirds of cases improve or are cured within a year. Those which have not cleared up during this time may continue for many years but with lengthy remissions. The disorder may go into remission, almost irrespective of treatment. Behavioural treatment can substantially improve compulsive rituals (hand washing, etc.) but are not so effective in controlling obsessional ruminations.

Many doctors favour treatment with the antidepressant clomipramine (Anafranil) a serotonin uptake inhibitor which is very effective but has unpleasant side effects which are unacceptable to many obsessional patients, who are preoccupied with symptoms. Newer drugs, such as paroxetinc (Seroxat), are equally effective, with fewer side effects.

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