The Awakening - The Birds, The Lovers And The Widow Essays

The Awakening - The Birds, The Lovers And The Widow In the novel, The Awakening there are several motifs or images that assist in developing Edna Pontellier in her awakening, the birds, the lovers and the woman and black all prove to be important parts in this. It is significant that The Awakening opens with two caged birds. Throughout the novel, Edna feels that marriage enslaves her to an identity she for which she is not suited. The parrot is an expensive bird valued for its beauty. The mockingbird is fairly common and plain, and it is valued for the music it provides. These two birds function as metaphors for the position of women in late Victorian society. Women are valued for their physical appearance and the entertainment they can provide for the men in their lives. Like parrots, they are not expected to voice opinions of their own, but to repeat the opinions that social convention defines as proper or respectable. The parrot shrieks Go away! Damnation! These are the first lines of The Awakening, and they signal the essentially tragic nature of the novel. The parrot speaks French, a little Spanish, and a language which nobody understood. Again, the parrot serves as a metaphor for Edna's predicament. As she becomes more defiant, she voices unconventional opinions about the sacred institutions of marriage, gender, and motherhood. Later in the novel, Mademoiselle uses wings as a metaphor for Edna's decision to defy social conventions. She warns Edna, 138 When she asks where Edna wants to soar, she means to ask Edna if she is sure that she can escape her gilded cage. If she fails, she will become one of the sad spectacles of the birds that fail. At the end of the novel, a bird with a broken wing sinks into the surf. The bird symbolizes Edna's failure to achieve the very goal that has driven her actions the entire time. In the end, Edna's freedom takes place in death. This is the choice that social convention allows her. Throughout the entire novel, the two young lovers are usually represented in conjunction with the woman in black. The two lovers are important symbols in The Awakening. Since the lovers always appear in conjunction with the woman in black, they foreshadow the eventual failure of Robert and Edna's love for one another. The contrast between the woman in black and the young lovers has a symbolic relationship to the love between Robert and Edna. The woman in black represents the logical conclusion to the conventional woman's life if her husband dies first. However, there is no old couple to represent Robert and Edna's contented futures. Therefore, the lovers and the woman in black foreshadow the failure of their love. Furthermore, there is no figure to symbolize the old age of the rebellious woman represented in Edna. The absence of this figure foreshadows Edna's suicide at the end of the novel. It implies that Edna must choose between conforming to social conventions or disappearing fro m the symbolic scene of the stages of a Victorian woman's life. English Essays

buy custom The Aggressor in the Family essay

buy custom The Aggressor in the Family essay Domestic violence continues until behaviors of infidelity come to an end. In the worst cases, it continues long after the spouse has stopped engaging in unfaithful behaviors. This is because the other spouse may not have completely lifted the burden of the offense caused off his heart. In most cases, such a cause of domestic violence is very serious and a third party may need to interrupt. The worst scenario is whereby such violence ends up in divorce. Through personal reasons, one of the parties in the family becomes the aggressor. The aggression may be caused by various factors. The aggression may emanate from one family member or it may involve an all against all kind of situation. In most cases, his kind of problem becomes very difficult to deal with. This type of violence may take the form of fights whereby family members intentionally hurt each other, physically, emotionally and psychologically. Physical or mental illness is a common cause of personal aggression in the family. The remedy to this problem is medical attention. Some of the mental conditions that lead to aggression in the family include schizophrenia and Alzheimers disease. Family members may not realize that a mental condition is fuelling the violence until it is too late. Carlson (1984) observes that people who use alcohol or drugs are also a cause of domestic violence in their respective families. This is a personal problem thaat can be remedied simply through a change of behavior. Unfortunately, it is never as simple as that. Alcohol and drugs are not only highly addictive; they take away a huge chunk of a familys resources. One family member may drain all the familys resources by buying drugs, leading to a domestic quarrel. An individual who has been exposed to domestic violence all his life may expose the same behavior towards his family. This is because that individual has been conditioned to a life of violence since early childhood and beyond. For such a person, it is difficult to understand what that there may be another form of life other than one that is characterized by violence. In this case, violence may reign as long as the family exists. Buy custom The Aggressor in the Family essay

Copyright and Creativity Essay Example | Topics and Well Written Essays - 2750 words

Copyright and Creativity - Essay Example It is purported that copyright primarily serves the end of encouraging creativity, because of the inspiration it provides to authors/writers/creators and would-be authors/writers/creators that will see creativity as an opportunity to gain economic advantage as well as an acknowledgment of their talent. This claim, however, is being contested by those who argue that artists have been churning out great works of arts for centuries without the benefit of copyright protection. Worse, there are those who perceive copyright protection as an unwitting tool for stifling creativity as illustrated by recent cases where works have been prohibited from seeing publication on the ground that they infringe the copyright law. The question that is being contemplated by this paper, therefore, is whether or not copyright protection encourages or stifles artistic creativity. Background The US Copyright Law has its roots in the 1710, Statute of Anne, an English law that ended the monopoly of the Statione r’s Company by vesting exclusive right of books to their authors for fourteen years, subject to renewal. After the American Revolution in the 18th century, several states their own copyright laws that took after the Statute of Anne, but the Constitutional Convention decided that a unifying law on copyright should be enacted nationally and thus, attached a clause mandating such passage in Article 1 of the proposed Constitution. The subsequent Copyright Act of 1970 copied the 14-year period of exclusive right to authors renewable for another 14 years and was made applicable solely to books, maps and maritime charts. Eventually, however, the US copyright law was broadened to cover other original works as well. In the Copyright Act of 1909, the coverage of the grant extended to all written works not only in the US but to various written foreign works as well. In addition, it extended the period of the exclusive right to 28 years, which is renewable for another 28 years. The next copyright law, i.e. Copyright Act of 1976 is the precursor of the present US copyright law. This Act eliminated many of the earlier features as well as added new ones. For example, it established a single period of exclusive right for all kinds of works, which is the life of the author plus 50 years, dismissed the formalities and made the right applicable the very moment the work becomes a concrete medium of expression. 1 Before the present consolidated US copyright law came into being, the Copyright Act 1976 went through various amendments and supplementations. These include the following: the Audio Home Recording Act of 1992, which added copyright grant to digital audio recordings; the Sonny Bono Copyright Term Extension Act of 1998, which extended the exclusive right to 20 years, and; the Digital Millennium Copyright Act of 1998, which deals with high-technology works. 2 Features of the Present US Copyright Law Under the present US Copyright Law, which is denominated as Title 17 of the United States Code, the exclusive rights to reproduce, prepare derivative works, distribute copies, perform, display publicly and use in a digital audio transmission of works, are granted only to their authors or creators.3 The copyright grant covers only 8 kinds of words, and their respective derivatives, namely: literary

Stakeholder Essay Example | Topics and Well Written Essays - 500 words - 1

Stakeholder - Essay Example The inclusive definition includes any group or person who can be affected by the organization’s acts or who can affect the acts of an organization and now has expanded including non-humans too. The exclusive definition includes stakeholders that are focused on from the manager’s point of view such as the power of the stakeholder, the dependence of the institution on that stakeholder or even the risk from that particular stakeholder. The organizations that focus on the maximization of their wealth try to reduce and limit the quantity of stakeholders and try to aim on the financial measures. According to some writers, â€Å"stakeholders are recognized by the real or possible harms and gains that they will undergo or expect undergoing as a result of an organization’s activity or inactivity.† But such definitions are criticized due to the lack of specification and due to the challenges in recognizing the various stakeholders. Sometimes stakeholders are referred to as those people, who have the power to affect the institution, who the right of a relationship with the institution or have the importance to claim (Driscoll and Starik, 57). In present day’s nature is also being included in as one or more stakeholder(s) because of its importance not only to human life but also to the objectives, aims and intentions of a business o r a firm. As we previously studied that a stakeholder is an entity which gets affected by the acts or actions of an institution or has an effect on the acts or actions of an institution. Thus, nature has a lot of affects on the acts and actions of a firm and also gets affected to a very big extent by the acts and actions of a firm. Hence, nature and everything that comes in it hold the position of one or more stakeholder(s). But the fact that nature gets represented by social and ethical groups and by the various communities thus it many times does not gain the status of a stakeholder

The Brics In The Global System Economics Essay

The Brics In The Global System Economics Essay In 2006, as BRICs mania gathered momentum, the four governments, at the initiative of former Russian President Vladimir Putin, collectively lifted themselves from the pages of investment reports to hold their first foreign ministers meeting on the sidelines of the annual UN General Assembly session. After a second meeting of the four foreign ministers in New York in September 2007, the BRICs launched a consultative process at the level of deputy foreign ministers to foster regular contacts and multilateral diplomacy. By 2008 the four BRICs foreign ministers, and on a different track the finance ministers, established a process to hold regular meetings to discuss common approaches to international problems, including the global financial crisis. Again at Russias initiative, the four BRIC heads of state met in July on the sidelines of the G8 (the G7 plus Russia) summit in Japan and plans were laid for a formal summit to be held in the Ural mountains city of Ekaterinburg, Russia in June 2009. Despite the groups improbable beginnings, BRICs were on a roll. 2. Successive communiquà ©s from follow-on meetings enumerated demands for an adjustment of global governance structures to better reflect the BRICs rising share of global output, trade, and financial flows. Nearly 60 percent of the total 14 increase in world output in 2000-2008 took place in developing and transitional countries, half of which occurred in the BRICS; their share of global GDP during the same period rose from 16 to 22 percent. Current projections estimate that China will overtake Japan as the worlds second largest economy in about 2010, and within the next two decades the top three economies in the world are expected to be China, the U.S., and India, with Russia and Brazil moving higher within the top ten. 3. BRICS symbolises the collective economic power of Brazil, Russia, India, China, and South Africa. Together the BRICS account for more than 40 per cent of the global population, nearly 30 per cent of the land mass, and a share in world GDP (in PPP terms) that increased from 16 per cent in 2000 to nearly 25 per cent in 2010 and is expected to rise significantly in the near future. The Rise of BRICS 4. BRICS, the five of the most important rising economic powers in the early twenty-first century, have emerged individually as second-tier regional powers and collectively as a joint presence in world politics. Although BRICS diplomacy took wing under Western radar, it now features well-publicised regular summits, communiquà ©s summarising common positions and demands, and activities to promote peer learning and public diplomacy. Goldman Sachss analyses may have indirectly spawned an incentive to collaborate diplomatically, but the bank is not alone in identifying (and promoting) such trends. Even before the global economic downturn, attention had begun to focus on the post-American world, a non-polar world, and especially the rise of China. 15 5. The BRICS countries have a significant strategic position on their continents: the Americas, Asia, Europe and Africa. Taken together, these five countries account for approximately 30 per cent of the earths surface. The importance of this vast territory is related to the amount of their mineral, water and energy resources, the availability of fertile land for agriculture and their biodiversity. All five countries have intensively developed activities in these areas with varying degree of success. The relative importance of agriculture and extractive activities, the transformation of mineral and energy resources and the magnitude of the BRICS agro-diversity are shown by their share in global trade in commodities and in the evolution of industrial activities. Their rich biodiversity also provides the opportunity for the development of very dynamic industries such as pharmaceuticals and biotechnology. 6. The total population of the BRICS is even more significant than their territory. The BRICS percentage of global population remained constant at around 43 percent of the worlds total population over the period 1985-2005. Chinas share of the world population declined from 22.1 percent in 1982 to 19.6 percent in 2005. However the population of all the other BRICS except Russia increased. The most significant increase in population occurred in India, which had 17.4 percent of the world population in 2005. This large share of the population represents both a challenge ad a source of opportunities. Challenges that frequently occur in large populations are those to do with the provision of water, food, energy and sanitation, as well as with the health and education systems. Other undesirable challenges associated with the population problem take the form of unemployment and the high degree of inequality in the distribution of income. These problems are common to the five countries, where a significant portion of the population lacks access to essential goods and services, and demand urgent redress. Data available from the United Nations show that Brazil and South Africa are among the countries with the worst distribution of income and that India and Russia are among those with the 16 largest percentage of the population living below the poverty line, 28.6 percent and 30.9 percent respectively in the mid 2000s. Problems related to the perverse distribution of income and limited access to public services (education, health, housing and urban infrastructure, public safety etc.) are reflected in their low human development index. 7. Huge regional disparities in human and economic development are evident in all five countries. In general, the wealthier are those that are more industrialised. Regional redistribution of income and access to essential goods and services represent a significant challenge that these five countries have in common. 8. Regarding the structure and performance of production, the combined GDP of the BRICS (in terms of purchasing power parity) represented in 2007 approximately 23 per cent of world GDP, more than the United States. In that year, China and India accounted for 10.8 percent and 4.8 percent of world GDP respectively. The economic performance of the BRICS has, however, varied widely in the last decades. China has maintained the fastest growing economy worldwide. India has grown significantly and more regularly. Russia after experiencing a severe crisis in the 1990s, and being faced with significant disorganization of the socialist economy, began a phase of significant growth in this decade propelled by the role of oil and gas in the economy. Brazil and South Africa have seen a small improvement in their economic performance, also well below their potential. 9. The spectacular economic growth in China is mostly due to the competitiveness of its manufacturing sector. It is important to point out that the industrial system in China has diversified to a significant degree during the last 25 years. The most noteworthy change, in recent years, has been the growth in the consumer durables and electronics sectors. In China, the share of technologically 17 intensive sectors in industrial output during the middle of the present decade approached 35 percent of the total value added by the manufacturing sector. This share is between 14 percent and 17 percent in the other four countries. 10. All the BRICS have raised their export and import levels in the last two decades, both in volume terms and as a share of GDP. In China, Russia and South Africa, foreign trade reached, in 2002, more than 50 percent of GDP while in Brazil and India it represented approximately 30 percent of GDP. Except South Africa, which has not increased its share of world exports in the last ten years, all the other four countries experienced high growth in exports? On the import side, all five countries increased their share of world imports, with the exception of Brazil. 11. The BRICS have been the recipient of significant amounts of foreign direct investment (FDI) in the last 50 years. Prior to 1984, Brazil received the greatest amount of FDI of all the BRICS. Although China reached the same level in 1985, Brazil continued to be a major destination for FDI during the 1990s, most notably during the process of privatization that took place during that decade. 12. China became the largest recipient of FDI in the world beginning in1993. The Chinese policy of attracting multinational companies was part of a strategy to expand their technological knowledge and later to strengthen domestic industries and companies. In China and India, where the capital account was not liberalized, FDI seems to have been concentrated in new investments in production and innovation. The other BRICS countries i.e. Brazil, Russia and South Africa, where the economies were liberalized with fewer restrictions, received more portfolio investment. This demonstrates the economic and political importance of the BRICS. The increase in the degree of influence of these countries took place during a period marked by intense transformation in the economy and global society. One of 18 this is the integration in the economy and society of significant proportion of previously marginalised segment of the BRICS population. 13. The crisis that started to affect the world economy in 2007-2008 has repositioned the role and importance of the BRICS. In a new scenario characterised by geopolitical realignment and where the role and function of the state in the economy are being redefined, their economic weight has in fact increased. Also, their capacity to remain immune is seen as a relevant source of ideas about how to survive during the crisis and to find ways of overcoming it. The differentiated role of the BRICS in the configuration of global power and the global economy will in some way constrain the evolution of their domestic system for innovation. Also, their national system of innovation are highly dependent on their historical development and on how the different domestic actors interpret global developments as well as how they position themselves in the national and international economies. On the other hand, more room for manoeuvre for setting up new industrial and technological policies may be e xpected. Significance of BRICS 14. The BRICS countries have consistently displayed high annual growth rate since 1980. China has grown at about 9.8%, followed by India at around 5.8% and Russia also at about the same level as India, while Brazil showed 2.4% growth. In comparison, the large industrialized nations group of seven (G-7) have shown 2.7% average annual growth. China and India have shown sustained growth by maintaining significantly high growth rates over a long period. 19 15. BRICS share of the global economy has increased by 1.5% over the last decade. During the period 2000-03, the BRIC countries contributed 1.4% of the annual global growth rate of 3.3% at purchasing power parity. Over the period 1980-2003, the per capita GDP at purchasing power parity has grown twelve fold in China, quadrupled in India, more than double in Brazil. In Russia, per capita GDP has increased by 50% over the 1998 levels. This indicates an overall increase in prosperity in BRICs. Accordingly the living standards have gone up in the BRIC economies, and the gap between the BRICs and advanced economies is narrowing down.(page 32 Sujatha) 16. This is also perhaps the most opportune time for forging closer links, given that the world economy is in a state of flux and a rebalancing is taking place towards the emerging economies. Their pivotal role in the global recovery has already catapulted the BRICs into the leadership role, which needs further cementing through greater interface among economies. Key Indicators and Statistics http://www.globalsherpa.org/wp-content/uploads/2011/04/BRICs-Development-Indicators-e1304046996149.gif 20 17. Economic Growth and Development of the BRICs (a) From 2000 to 2008, the BRIC countries combined share of total world economic output rose from 16 to 22 percent. Together, the BRIC countries accounted for 30 percent of the increase in global output during the period. (b) To date, the scale of Chinas economy and pace of its development has out-distancebd those of its BRIC peers. China alone contributed more than half of the BRIC countries share and greater than 15 percent of the growth in world economic output from 2000 to 2008. The chart above on key development indicators for the BRIC countries shows the sharp contrast in GDP, merchandise exports and the UNDPs Human Development Index (HDI) between China and the other BRIC countries. 18. Growing BRIC Middle Class (a) The rapid economic growth and demographics of China and India are expected to give rise to a large middle class whose consumption would help drive the BRICs economic development and expansion of the global economy.   The charts below depict how the increase in the middle class population of the BRIC countries is forecasted to more than double that of the developed G7 economies.   21 http://www.globalsherpa.org/wp-content/uploads/2011/04/brics-middle-class-income-bracket-2020-goldman-sachs-5.10-300268.png http://www.globalsherpa.org/wp-content/uploads/2011/04/expanding-world-middle-class-goldman-sachs-5.10-300246.png

Moral Degradation Essay

I think all would consider this fact to be tenable that nowadays more youth and youngsters are involved in crime and hence an extreme phase of social illness is undeniable and inescapable. You can’t just deny this fact. It’s all in the statistics. I mean it is facts and figures that we are talking about; black and white. Nothing remains to hide and no where to run. We are in a reality to face it. Some would debate before they say it moral degradation. However, if they do so you have enough reason to ask them about what morality constitutes and how he or she would label this new unexpected development. Moreover, the increase in juvenile cases recent months is shocking and the news of students killing one another can be seen a chronic disease. Young generation with whom we are used to dream for the future of the country is having a great contribution to this new specter. From ogling, winking, passing comments in the form of sexual innuendos, to touching, groping, ‘eveteasing’, stalking, sending lewd text messages, ‘prank’ calls, display of pornography, threatening and intimidation, acid attacks, and unwanted ‘love’ proposals. Compared to back then, things do not happen like this. Is there any doubt that more youngsters nowadays are involved in social crimes and problems? The disrespectful attitude carried out by youths and students is very much common nowadays if you were to compare again to the last couple of years. I mean what is wrong with youngsters and youths nowadays? Why are they acting in such a way? There is no fear and tear to say it is kind of social moral breakdown and it is taking its shape through such abnormal and undesired manner. Government and society has nothing to do with it or unwilling to do it? May be the last one is closer to the truth than the former one. However, it is the failure of the state to ensure the moral growth of the young girls

Obsessive Compulsive Disorder

IntroductionThroughout history, our conceptualization of obsessive compulsive disorder (OCD) has been changing alongside changes in the way we have viewed the world. With the dawning of the Renaissance in Western Europe, religious explanations based on demonic possession were superseded by a more humanistic understanding. By the early seventeenth century, the obsessions that drove Shakespeare's Lady Macbeth to suicide were recognized to be a product of her guilty mind, for which there was no medical cure.Obsessions and compulsions were first described in the medical literature of the early nineteenth century. They were viewed as an unusual expression of melancholia. By the beginning of the twentieth century, with the development of psychoanalysis, the focus shifted onto psychological explanations based on unconscious conflicts, but this did not provide a useful strategy for treatment. The subsequent application of learning theory to OCD led to the development of effective behavioural treatments in the 1960s and 1970s.Compared with the pace of these historical developments, modern understanding of OCD has expanded with dramatic speed. The development of effective medical treatments of OCD has revolutionized the outlook for sufferers and propelled OCD to the forefront of scientific attention. With the growth of research into the epidemiology, psychopharmacology, neurobiology, neuropsychology and genetics of OCD, reviewed throughout this publication, the emphasis has once again swung back toward a medical model. As we enter the twenty-first century, we now recognize OCD as a common, treatable form of major mental disorder.After the pioneering epidemiological catchment area (ECA) studies carried out by the National Institute of Mental Health in the early 1980s reported that the prevalence of OCD was substantially higher than expected, (Robins, Holzer, & Weissman, 1984) repeated population studies using similar methods have demonstrated a lifetime prevalence of 2-3% worldwide (Weissman, Bland & Canino, 1994).   Taiwan and India were the only exceptions, with rates below 1%. If these estimates are accurate, then OCD affects more than 50 million people in the world today. The prevalence does not appear to be influenced by socioeconomic status, educational achievement, or ethnicity. The disorder is more common than schizophrenia, and about half as common as depression. Yet the illness remains largely under-recognized, and the psychosocial and economic costs to society from untreated OCD are high (Hollander, & Wong, 1998).   It is not surprising that the World Health Organization has now recognized OCD as a public health priority.While there is little doubt that the ‘hidden epidemic' of OCD exists, the actual prevalence of clinically relevant disorder has been called into question. In the ECA studies lay interviewers were trained to make DSM-III diagnoses using the Diagnostic Interview Schedule (DIS). However, clinical reappraisal of DIS -positive cases resulted in less than 25% continuing to meet the criteria for OCD (Nelson & Rice, 1997).One explanation is that the rates of illness reported in the original ECA studies may have been exaggerated. Alternatively, the findings may reflect variability in the severity of the disorder over time.Obsessive compulsive disorder is more common in women, although the differences are not as obvious as in depression or other anxiety disorders. An average female to male ratio of 1.5:1.0 is accepted for the community at large, although the ratio appears roughly equal in the adolescent population, reflecting perhaps the earlier onset in boys. In particularly in males, having obsessions and compulsions or magical thinking, poor social adjustment, and an early chronic course, predicted a worse outcome.A more recent 5-year prospective follow-up study of 100 OCD patients showed that in spite of the introduction of modern treatments, outcomes were similar to Skoog and Skoog's cohort, wit h only 20% reaching full remission of their OCD, 50% showing partial remission, and the remainder unchanged or worse over 5 years. Less severe illness and being married were associated with a better outcome (Steketee Eisen & Dyck, 1999).Most patients suffer a mixture of different obsessions or compulsions. Surveys have consistently identified contamination fears as the most common obsession, with concern about harm to others, pathological doubt, somatic obsessions and the need for symmetry also occurring frequently. Half of all OCD patients admitted for treatment suffer compulsions in the realm of repetitive checking or excessive cleaning and washing. 20 Key themes have been identified that underlie most symptoms. These include abnormal risk assessment, pathological doubt and incompleteness.Patients with OCD usually retain full insight into the absurdity of their symptoms, although this is not always the case (Insel & Akiskal, 1986). The DSM-IV singles out patients with poor insight as a meaningful subgroup. These individuals have more complex symptomatology, which makes diagnosis more difficult, and tend to be more severely ill. They have only a limited sense of the excessiveness and irrationality of their thoughts and behaviours and are therefore difficult to engage in treatment. They may appear to be deluded (and hence receive inappropriate treatment) but longitudinal studies show they do not go on to develop schizophrenia-like illnesses. In a cohort of 475 patients with OCD, (6%) displayed lack of insight.Mild forms of obsessional behaviour, such as repetitive checking or superstitious behaviour commonly occur in everyday life. They only meet the criteria for OCD if they are time-consuming, or associated with impairment or distress.Recurrent, intrusive thoughts, impulses and images also occur in other mental disorders thought to share a relationship with OCD: for example, the preoccupation with bodily appearance, in body dysmorphic disorder; with a feared object, in specific phobia; with illness, in hypochondriasis; or with hair-pulling, in trichotillomania. A diagnosis of OCD should only be contrast; men predominate in surveys of OCD referrals, possibly reflecting a greater severity in males.Women during pregnancy and the puerperium are particularly at risk of developing the disorder. In a study by Neziroglu et al of 59 mothers with OCD, experienced their symptoms for the first time during pregnancy. In many cases, pre-existing obsessional tendencies are unmasked and exaggerated by the events surrounding childbirth.Obsessive compulsive disorder is considered to be one of the most strongly inherited mental disorders (Pauls, Alsobrook, & Goodman, 1995). Approximately one-fifth of nuclear family members of OCD sufferers show signs of OCD, and the younger the sufferer the more likely they are to have a first-degree relative affected. The clustering of OCD and Tourette's syndrome (TS) within families suggests a common inherited factor.Th e course of the illness can vary from a relatively benign form in which the patient experiences infrequent, discrete episodes of illness interspersed with symptom-free periods, to malignant OCD, characterized by unremitting symptoms and substantial social impairment.In a 40-year prospective follow-up study, reported by Skoog and Skoog, the authors managed to locate and examine 144 out of 251 OCD patients who had previously been admitted as inpatients under their care between 1947 and 1953. 1Given that effective treatments for OCD were not developed until the end of the study, much of the data is naturalistic. The authors found that roughly 60% showed signs of general improvement within 10 years of onset of illness, rising to 80% by the end of the study.However, only 20% achieved full remission even after nearly 50 years of illness; 60% continued to experience significant symptoms; 10% showed no improvement whatsoever; and another 10% had worsened. In 60% of cases the content of the obsessions shifted markedly over the follow-up period (Pauls, Alsobrook, & Goodman, 1995).One-fifth of those who had shown an early, sustained improvement subsequently relapsed, even after 20 years without symptoms, suggesting early recovery does not rule out the possibility of very late relapse. Intermittent, episodic disease was common during the early stage of illness, and predicted a more favourable outcome, whereas chronic illness predominated in the later years.Early age of onset, made if there are also unrelated obsessive-compulsive symptoms, in which case more than one diagnosis may be warranted. Activities such as preoccupation with eating, sex, shopping and gambling are not considered genuine compulsions because they are not egodystonic, and the individual usually only tries to resist because of the adverse consequences.Reference:Hollander E, Wong C, 1998). Psychosocial functions and economic costs of obsessive compulsive disorder, CNS Spectrums (3 (5) suppl. 1:48-58.Insel T, Akiskal H, 1986. Obsessive compulsive disorder with psychotic features: a phenomenological analysis, Am J Psychiatry 143:1527-33.Nelson E, Rice J, 1997. Stability of diagnosis of obsessive-compulsive disorder in the Epidemiological Catchment Area Study. Am J Psychiatry 154:826-31.Pauls DL, Alsobrook JP, Goodman W et al, 1995). A family study of obsessive compulsive disorder, Am J Psychiatry 152 : 76-84.Robins LN, Holzer JE, Weissman MM et al, 1984 Lifetime prevalence of specific psychiatric disorders in three sites, Arch Gen Psychiatry (1984) 41 :949-58.Steketee G, Eisen J, Dyck I et al, (1999) Predictors of course in obsessive compulsive disorder, Psychiatr Res   89 (3):229-38.  Weissman MM, Bland RC, Canino GL et al, 1994. The cross national epidemiology of obsessive-compulsive disorder, J Clin Psychiatry 55 :5-10.