Obsessive and Compulsive Disorders Flashcards
Commet on the epidemiology of OCD
- prevalence is about 2-3% of the adult population
- pre-adolescent boys affected 3 times more than females
- after puberty, females have an increased incidence of OCD
- childhood onset incidence just as common as late adolescent/adulthood onset
- often only present for therapeutic help 7-17 years after the first symptoms occur
What are the most common comorbid psychiatric disorders in those with OCD
anxiety disorders
mood disorders
impulse control disorders
substance use disorder
List the DSM 5 criteria for OCD
Criterion A
Presence of obsessions, compulsions or both
Criterion B
The obsessions or compulsions are time-consuming (take more than 1 hour per day) or cause clinically significant distress, impairment in functioning
Criterion C
Not attributable to the physiological effects of a substance or other medical disorder.
Criterion D
Not better explained by symptoms of another mental disorder
What are the specifiers for OCD
- with good or fair insight
- with poor insight
- with absent insight/delusional beliefs
Specify if Tic-related - does the individual have a current or past history of a tic disorder (up to 30% of individuals with OCD have a lifetime tic disorder which is more common in males with onset of OCD in childhood)
Define obsessions as per the DSM 5
1 - recurrent and persistent thoughts, urges or images that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress
2 - the individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or actionD
Define compulsions as per the DSM 5
1 - repetitive behaviors or mental acts that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly
2 - the behaviors or mental acts are aimed at preventing some dreaded event or situation however these behaviors or mental acts are not connected in a realistic was with what they are designed to neutralize or prevent or are clearly excessive.
What scale is used to track, grade and quantify symptoms severity and track progression in OCD
Yale Brown obsessive compulsive scale
Briefly comment on the pathophysiology of OCD
Environmental and genetic factors have an influence on neurotransmitters
Neurotransmitters involved - serotonin, glutamate and dopamine
Disruption of the corticostriato thalamo cortical (CSTC) circuit which leads to hyperactivity of the orbitofrontal cortex.
Comment on the epidemiology of body dysmorphic disorder
Females are more affected than males
The average age of onset is 12-13 years
Specifier is with muscle dysmorphia or not
Specify whether there is good/fair insight, poor insight, absent insight/delusional beliefs
Which important exclusion disorder is built into the criteria for body dysmorphic disorder
Criterion D
The appearance preoccupation is not better explained by concerns with body fat or weight in an individual whose symptoms meet diagnostic criteria for an eating disorder
List the DSM 5 criteria for hoarding disorder
Criterion A
Persistent difficulty discarding or parting with possessions, regardless of their actual value
Criterion B
This difficulty is due to a perceived need to save the items and to distress associated with discarding them
Criterion C
The difficulty discarding possessions results in the accumulation of possessions that congest and clutter active living areas and substantially compromises their intended use. If living areas are uncluttered, it is only because of the interventions of third parties.
Criterion D
Clinically significant distress or impairment
Criterion E
Not attributable to another medical condition
Criterion F
Not better explained by the symptoms of another mental disorder
What are the specifiers for hoarding disorder and comment on the epidemiology briefly
- with excessive acquisition (approximately 80-90% of individuals)
- with good/fair insight
- with poor insight
- with absent insight/delusional belief
onset early adolescence
common in those with dementia, SCZ, social anxiety, dependent personality traits
Approximately 2-6% prevalence
Affects both males and females but some studies have reported a significantly greater prevalence among males. This contrasts to clinical samples which are predominantly females. Females tend to display the excessive acquisition traits more often than do males.
Hoarding symptoms almost 3x more prevalent in older adults compared with younger adults.
The severity of hoarding increases with each decade of life.
Often a chronic course although a waxing and waning course can also present.
List the DSM 5 criteria for trichotillomania (hair-pulling disorder)
Criterion A
Recurrent pulling out of one’s hair, resulting in hair loss
Criterion B
Repeated attempts to decrease or stop hair pulling
Criterion C
The hair pulling causes clinically significant distress or impairment
Criterion D
The hair pulling or hair loss is not attributable to another medical condition
Criterion E
The hair pulling is not better explained by the symptoms or another mental disorder (such as a perceived defect in the case of body dysmorphic disorder)
Comment briefly on the epidemiology of trichotillomania
Women are affected 10x more than males
35-40% chew or swallow the hair - which can lead to bowel obstruction
Usually follows the onset of puberty 4
List the DSM 5 criteria for skin-picking disorder
A - recurrent skin picking resulting in skin lesions
B - repeated attempts to stop or decrease skin picking
C - skin picking causes clinically significant distress or impairment in social, occupational or other important areas of functioning
D - picking not attributable to the physiological effects of a substance or other medical conditions
E - Not better explained by another mental disorder
