Obsessive Compulsive Disorder Flashcards
What is the typical history associated with obsessive-compulsive disorder in adults?
Recurrent, intrusive thoughts (obsessions). Repetitive behaviors or mental acts (compulsions) performed to reduce anxiety. Significant distress or impairment in daily functioning.
What are the key physical examination findings in obsessive-compulsive disorder in adults?
Often normal physical exam. Possible signs of excessive hand washing (e.g., dermatitis). No specific physical findings.
What investigations are necessary for diagnosing obsessive-compulsive disorder in adults?
Clinical diagnosis based on history and symptoms. Screening tools: Y-BOCS (Yale-Brown Obsessive Compulsive Scale). Rule out other psychiatric or medical conditions.
What are the non-pharmacological management strategies for obsessive-compulsive disorder in adults?
Cognitive-behavioral therapy (CBT), specifically exposure and response prevention (ERP). Psychoeducation. Support groups and self-help strategies.
What are the pharmacological management options for obsessive-compulsive disorder in adults?
SSRIs (e.g., fluoxetine, sertraline) at higher doses than for depression. Clomipramine (a tricyclic antidepressant). Augmentation with antipsychotics in treatment-resistant cases.
What are the red flags to look for in obsessive-compulsive disorder patients?
Severe functional impairment. Suicidal ideation or self-harm. Co-occurring psychiatric disorders (e.g., depression, anxiety). Significant distress despite treatment.
When should a patient with obsessive-compulsive disorder be referred to a specialist?
Treatment-resistant OCD. Severe or complex cases. Co-occurring psychiatric disorders. Need for specialized therapeutic interventions.
What is one key piece of pathophysiology related to obsessive-compulsive disorder?
Dysregulation of serotonin in the brain. Overactivity in the cortico-striato-thalamo-cortical (CSTC) circuit. Genetic and environmental factors contribute to development.
