Obsessive compulsive disorder

Question 1

What is OCD?

Answer 1

Obsessive Compulsive Disorder (OCD) is a mental health condition that is diagnosed in individuals who experience disruption to their daily functioning as a result of obsessions and/or compulsions

Question 2

Roughly, how many people have OCD?

Answer 2

About 2% of the population at some point in their lives

Question 3

What must someone experience to be diagnosed with OCD?

Answer 3

They must experience clinically significant distress or impairment in functioning on most days for a period of two weeks or more

Question 4

What are the cognitive characteristics of OCD?

Answer 4

• Obsessive thoughts
• Hypervigilance
• Irrational thoughts, including catastrophic thinking

Question 5

What are the behavioural characteristics of OCD?

Answer 5

Compulsions

Question 6

What are the emotional characteristics of OCD?

Answer 6

• Anxiety
• Guilt
• Disgust

Question 7

What does the genetic explanation state about OCD?

Answer 7

The genetic explanation states that OCD is inherited

Question 8

What do genetic explanations focus on?

Answer 8

Identifying candidate genes

Question 9

What are the 2 genes that have been linked with OCD?

Answer 9

COMT and SERT

Question 10

What is the COMT gene responsible for?

Answer 10

Clearing dopamine from synapses and low activity of the COMT gene is associated with OCD - this suggests that high levels of dopamine activity is associated with OCD

Question 11

What happens if COMT fails to clear dopamine from the synapses?

Answer 11

The person will focus on the one thought, which then becomes an obsession

Question 12

What is the SERT gene responsible for?

Answer 12

The SERT gene (also known as the 5-HTT gene) affects the transport of serotonin (hence SERontonin Transporter), causing lower levels of serotonin which is also associated with OCD (and depression)

Question 13

What does serotonin do?

Answer 13

Serotonin regulates mood - lower levels of serotonin are associated with mood disorders, such as depression

Question 14

Where does the support for the role of serotonin in OCD come from?

Answer 14

Research examining anti-depressants, which have found that drugs which increase the level of serotonin are effective in treating patients with OCD

Question 15

What is the neural explanation of OCD?

Answer 15

The OFC converts sensory information into thoughts and actions.

Heighted activity in the OFC generates ‘worry messages’ = obsessions

These ‘worries’ are sent to the basal ganglia which is responsible for facilitating wanted behaviours and stopping unwanted behaviours.

This ‘filter’ is faulty in OCD so worries are passed on to the thalamus which sends signals to the motor cortex (where movements are controlled). The thoughts are converted in to actions = compulsions.

Question 16

According to the neural explanation why are behaviours repeated?

Answer 16

In OCD, completion of the structured event complex relieves anxiety

Question 17

What evidence is there to support the neural explanation?

Answer 17

• Evidence shows that the correlations between cortical brain activity and basal ganglia brain activity are different in people with OCD and healthy individuals. Furthermore, OCD symptoms can also be improved in humans by stimulating a part of the basal ganglia.
• Patients who suffer head injuries in this region often develop OCD-like symptoms, following their recovery. Furthermore, Max et al (1994) found that when the basal ganglia is disconnected from the frontal cortex during surgery, OCD-like symptoms are reduced, providing further support for the role of the basal ganglia in OCD.
• PET scans have found higher activity in the OFC in patients with OCD.

Question 18

What are the implications of the neural explanation?

Answer 18

While we like to think we are in control of our thoughts and behaviours, this explanation suggests that we do not.

This approach views the brain as a biological computer and suggests that we do not have free will

Question 19

What does SSRIs stand for?

Answer 19

Selective serotonin reuptake inhibitors

Question 20

What do SSRIs do?

Answer 20

Selective serotonin reuptake inhibitors (SSRIs) are used to treat the symptoms of OCD by increasing serotonin activity at the synapse

Question 21

How do SSRIs work?

Answer 21

SSRIs prevent the reabsorption and breakdown of serotonin by blocking presynaptic transporter molecules. This causes serotonin to remain active in the synaptic cleft where it is able to repeatedly bind to receptors on the membrane of the post-synaptic neuron. This means that this neuron is repeatedly stimulated and the transmission of mood-related information is increased.
This compensates for the dysfunction in the serotonergic pathways that may be causing the symptoms of OCD

Question 22

When using SSRIs when do symptoms generally start to improve?

Answer 22

SSRIs cause an immediate increase in serotonin activity but an improvement to symptoms is most often only seen after 12 weeks of taking the medication

Question 23

How has it been suggested that the improvement in symptoms from SSRIs is a result of down-regulation?

Answer 23

The brain compensates for the increased serotonin by reducing the amount that is released from the presynaptic neuron

Question 24

What evidence is there to support the effectiveness of SSRIs?

Answer 24

Issari (2016) carried out a meta-analysis of 17 studies and found a significantly greater improvement in patient’s symptoms in the groups after taking SSRIs compared with the placebo group. This research demonstrates that SSRIs, a relatively cheap and low-effort treatment, can provide relief for some people with OCD

Question 25

What are the issues with SSRIs as a treatment for OCD?

Answer 25

• Can causes unpleasant side effects - dizziness, sleeping problems, headaches, agitation and anxiety, and in some cases cause suicidal thoughts or urges to self-harm
• Up to 60% of people report no improvement in the symptoms after taking drug treatments like SSRIs
• For those who do experience relief, the reduction in symptom severity ,ay only be between 20-30%

Question 26

What are alternative treatments for OCD?