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Mental Health > Obsessive compulsive disorder > Flashcards

Obsessive compulsive disorder Flashcards

1
Q

Obsessive compulsive disorders

A

6B20 Obsessive Compulsive Disorder
6B21 Body Dysmorphic Disorder
6B22 Olfactory Reference Disorder
6B23 Hypochondriasis
6B24 Hoarding Disorder
6B25 Body – focused Repetitive Behavioural Disorder

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2
Q

Clinical features of obsessive compulsive disroders

A

Obsessive thoughts
Compulsive acts - rituals, repetitive behaviours, mental acts
Interference with functioning
Distress

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3
Q

What are obsessive thoughts?

A

Ideas/images/impulses that intrude unwanted, forcubly into the mind

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4
Q

What is teh OCD cycle?

A

Obsessive thought ->
Anxiety ->
Compulsion ->
Temporary relief

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5
Q

Diagnostic OCD

A

Symptoms for weeks
Obsessions and compulsions time consuming (at least 1 hour)
Interference with activities
Good premorbid functioning
Episodic symptoms and precipiating event (trigger)

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6
Q

Associations with OCD

A

Avoidant, dependent and histrionic traits in personaluty
Anankastic/obsessive-compulsice traits

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7
Q

Co-morbidities with OCD

A

Depression (50-70%)
Alcohol and substance misuse
Social phobia, specific phpbia, panic disorder

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8
Q

What is histrionic personality trait?

A

excessive attention-seeking behaviors

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9
Q

What is ERP?

A

Exposure response prevention

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10
Q

How is OCD graded and managed based on this

A

Level of functional impairment
mild - brief CBT + ERP
mod + sev - intensive psychological therapy and/or SSRI (sev - referral)

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11
Q

How does ERP work?

A

Face their fears and let obsessive thoughts occur without neutralising compulsions.
Confronting items and situations that cause anxiety
Anxiety that patient feels able to tolerate
After the first few times, patient will find anxiety does not climb as high and does not last as long
Patient will then move on to more difficult exposure exercises.

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12
Q

CBT

A

Behavioural experiment - find out what happen if dont do ritual
Challenges belief

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13
Q

Typical age of onset

A

late teens, early 20s

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14
Q

What age is considered late onset?

A

> 35

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15
Q

Treatment for OCD

A

TCA = clopipramine

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16
Q

Presentation of OCD

A

waxing and waning

17
Q

What to check if a child presents with OCD?

A

Is parent projecting OCD behaviour onto them or if it originates from themselves

18
Q

Mean age of onset OCD?

A

20 years

19
Q

Obsessive compulsive disorder how long symptoms

A

Obsessions and compulsions - time consuming
(at least 1 hour)
Interference with activities
Positive prognostic factors include good pre morbid functioning
Episodic symptoms and have a precipitating event

20
Q

How many people with OCD improve?

A

40-50% show moderate improvement

21
Q

Step 1 of OCD treatment

A

Awareness and recognition

22
Q

Who is at higher risk of OCD?

A

Depression
Anxiety
Alcohol
Substance misuse
BDD
Eating disorder

23
Q

Questions to ask about OCD?

A

Do you wash or clean a lot?
Do you check things a lot?
Is there any thought that keeps bothering you that you would like to get rid of but cannot?
Do your daily activities take a long time to finish?
Are you concerned about putting things in a special order or are you very upset by mess?
Do these problems trouble you?

24
Q

Risk assessmnet OCD

A

Self harm
Suicide
Impact of compulsice behaviours on others
Comorbid conditions and psychosocial factors

25
Q

Assessmetn of people high risk for BDD

A

Do you worry a lot about the way you look and wish you could think about it less?
What specific concerns do you have about your appearance?
On a typical day, how many hours a day is your appearance on your mind? (More than 1 hour a day is considered excessive.)
What effect does it have on your life?
Does it make it hard to do your work or be with friends?

26
Q

Initial treatment for adults with OCD with mild functional impairment and interest in low intensity

A

Brief individual CBT inluding ERP using structured self help materials
brief individual CBT (including ERP) by telephone
group CBT (including ERP; note, the patient may be receiving more than 10 hours of therapy in this format

27
Q

Treatment for adults with mild functional impairment and OCD who low intensity treatment ineffective or moderate functional impairment for what offer

A

SSRI or more intensive CBT incl 10 hrs ERP per patient

28
Q

Signs to look for when start na SSRI with OCD

A

seek out signs of akathisia or restlessness, suicidal ideation and increased anxiety and agitation.

29
Q

Which SSRI should be used in body dysmorphic disorder vs OCD?

A

BDD - fluoxteine - best effectiveness
OCD - any out of fluoxetine, flucoxamine, paroxetine, sertraline or citralopram

Mental Health (57 decks)

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