Anxiety disorders: OCD

Question 1

Define Obsessive-compulsive disorder

Answer 1

Recurrent obsessional thoughts or compulsive acts, or commonly both

Question 2

Define Obsessions

Answer 2

Unwanted intrusive thoughts or urges that repeatedly enter the patients mind

they are distressing for the individual who attempts to resist them and recognizes them as absurd and a product of their own mind

Question 3

Define Compulsions

Answer 3

Repetitive stereotyped behaviours or mental acts that a person feels driven to perform

they are overt (observable to others) or covert (mental acts not observable)

Question 4

Describe three biological theories behind OCD

Answer 4

• Reduced serotonin and abnormalities of frontal cortex and basal ganglia
• Genetic Element
• PANDAS (Childhood Group A Beta Haemolytic Strep Disorder)

Question 5

Describe a Psychoanalytic and Behavioural theory behind OCD

Answer 5

Filling the mind with obsessional thoughts in order to prevent undesirable ideas from entering

Compulsive behaviour is learned and maintained by Operant Conditioning

Question 6

Describe the ICD10 Criteria for Diagnosis of OCD

Answer 6

A - either Obsessions and/or Compulsions present most days for two weeks
B - Obsessions being contamination/excess fear of harm/excess concern of order and Compulsions being Checking/Cleaning/Counting
C - Cause distress and interfere with social/individual functioning

Question 7

Describe the four clinical features of OCD

(FORD C)

Answer 7

• Failure to resist
• Originate from patients own mind
• Repetitive and Distressing
• Carrying out the obsession/compulsion is not enjoyable but reduces anxiety

Question 8

What questionnaire could be used for OCD patients?

Answer 8

Yale Brown Obsessive Compulsive Scale

10 item questionnaire with each item graded from 0-4

Question 9

Describe the non pharmacological management of OCD

Answer 9

CBT and ERP

Patients are exposed to the stimulus causing the anxiety and prevented from performing the action

Question 10

Name two pharmacological managements for OCD

Answer 10

SSRIs (Fluoxetine, Sertraline)
Clomipramine

Question 11

what is the OCD cycle?

Answer 11

obsession - anxiety - compulsion - relief

obsessions create anxiety which continues to build until compulsion is carried out in order to provide relief

Question 12

Name some obsessions and compulsions

Answer 12

obsessions - contamination, fear of harm, excessive concern

compulsions - checking, cleaning, repeating, mental compulsions, hoarding

Question 13

describe some general points for managing OCD

Answer 13

psychoeducation, distracting techniques and self help books

any potential suicide risk identified and managed

co-morbid depression identified and treated

method depends on severity