Anxiety- phobias and OCD

Question 1

OCD

Answer 1

Presence of either obsessions or compulsions (commonly both)

Question 2

Obsession

Answer 2

Unwanted intrusive thought, image or urge that repeatedly enters the persons mind

Question 3

Compulsion

Answer 3

Repetitive behaviours or mental acts that the person feels driven to perform

Can be overt and observable or covert mental act

Question 4

Aetiology

Answer 4

Genetic

Psyschological trauma

Pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS)

Question 5

Associations

Answer 5

Depression (30%)

Schizophrenia (3%)

Sydenham’s chorea

Tourette’s syndrome

Anorexia nervose

Question 6

Management if mild functional impairment

Answer 6

Low intensity psychological treatments: CBT including exposure and response prevention

If this isn’t sufficient offer choice or course of SSRI or more intensive CBT

Question 7

Management if moderate functional impairment

Answer 7

Choice of either course of SSRI or more intensive CBT (including ERP)

Question 8

Management if severe functional impairment

Answer 8

Combined treatment with an SSRI and CBT (including ERP)

Question 9

SSRI in body dysmorphic syndrome

Answer 9

Fluoxetine

Question 10

Exposure and response prevention

Answer 10

Exposing patient to an anxiety provoking situation and then stopping them engaging in their usual safety behaviour

Helps confront anxiety and the habituation leads to eventual extinction of the response