English to French Medical Medical: Pharmaceuticals biology

The greater part of the 20th century was dominated by psychoanalytic theories of OCD. According to psychoanalytic theory, obsessions and compulsions reflect **maladaptive responses** to unresolved conflicts from early stages of psychological development. The symptoms of OCD symbolize the patient's unconscious struggle for control over drives that are unacceptable at a conscious level. Although often intuitively appealing, psychoanalytic theories of OCD have lost favor in the last quarter of the 20th century. Psychoanalysis offers an elaborate metaphor for the mind, but it is not grounded in evidence based on studies of the brain. Psychoanalytic concepts may help explain the content of the patient's obsessions, but they do little to improve understanding of the underlying processes and have not led to reliably effective treatments.

The psychoanalytic focus on the symbolic meaning of obsessions and compulsions has given way to an emphasis on the form of the symptoms: recurrent, distressing and senseless forced thoughts and actions. The content of symptoms may reveal more about what is most important to or feared by an individual (e.g., moral rectitude, children in harm?s way) than why that particular individual developed OCD. Alternatively, the content (e.g., grooming and hoarding) may be related to the activation of fixed action patterns (i.e., innate complex behavioral subroutines) mediated by the brain areas involved in OCD.