Obsessional disorders and PTSD

Question 1

What is obsessional personality disorder?

Answer 1

Anankastic personality disorder arising from compulsion in an obsession or compulsive neurosis but not characterized by obsessions and compulsions

Question 2

Features of obsessional personality disorder?

Answer 2

Pay a lot of attention to finite details
Follow rules, lists
Perfectionist
Focus on work to the point of excluding pleasure
Rigid and stubborn

Question 3

Difference between obsessional personality disorder and OCD?

Answer 3

Obsessional personality disorder is not characterised by obsessions and compulsions but OCD is

Question 4

How long do you have to suffer OCD symptoms to be diagnosd?

Answer 4

Most days for 2 weeks

Question 5

Difference between obsessions and compulsions and how are they identified on MSE?

Answer 5

Obsessions = constantly thinking about something, recurrent persistent ideas, impulses, thoughts in TC of MSE
Compulsions = the acts associated to relieve the obsessive thoughts - cleaning, checking locks, routine, in the appearance/behaviour and TC of MSE

Question 6

Difference between an obsession and delusion?

Answer 6

Delusions lack insight, obsessions are egodystonic whilst delusions are egosyntonic, obsessions are resisted but delusions are not, obsessions come with compulsions but delusions dont and delusions can have psychotic associations

Question 7

Which pathways have been shown to be effected in OCD?

Answer 7

glutamate and serotonin

Question 8

What does PANDA stand for?

Answer 8

paediatric autoimmune neuropsychiatric schizophrenia disorder associated to strep infection

Question 9

1st line treatment in OCD?

Answer 9

SSRI

Question 10

2nd line treatment in OCD?

Answer 10

SSRI or (tca) Clomipramine

Question 11

3rd line treatment in OCD?

Answer 11

Antipsychotics or glutamate antagonists

Question 12

Symptoms of PTSD?

Answer 12

Flashbacks, vivid memories, dreams, triggers
avoidance of circumstances resembling trigger
impaired recollection of event
Hyperarousal symptoms - decreased sleep, increased startle response

Question 13

What condition do you need to ensure it is not in order to diagnose PTSD?

Answer 13

Psychosis - hallucinations or trauma dreams, hyperactive startle response or persecutory delusions

Question 14

What biological pathways are effected in PTSD? Structures in the brain that change in activity?

Answer 14

serotonin
noradrenaline
glutamate
GABA
HPA axis - increased stress response
Raised Na causing increased startle
Decreased serotonin - increased startle and intrusive memories
Hippocampus reduces in volume and activity
Amygdala has increased activity - cant discriminate threat

Question 15

First and second line treatment for PTSD?

Answer 15

SSRI/SNRI

Antipsychotics and Prazocin

Question 16

What 2 psychological interventions can be put in place to combat PTSD?

Answer 16

CBT

EMDR - eye movement desenitization reprocessing