Obsessive Compulsive Disorder Flashcards
What is OCD
A disorder characterised by obsessional ruminations and compulsive rituals which cause significant distress.
what is OCD associated with
Depression eating disorders Tourette/s schizophrenia autism hypochondriasis body dysmorphia
What is an ‘obsession’
recurrent, intrusive, distressing thoughts, ideas or images, memories, impulses
unwanted
usually resisted
recognised as originating from own mind ie not a hallucination
distress/cause anxiety for the patient
What are some common obsessions in ocd
contamination from dirt, germs fear of harm (door unlocked) order/symmetry body/physical symptoms religious/blasphemous thoughts sexual ie being a paedophile or homosexual hoarding violence (stabbing one's baby)
what is a compulsion
repetive, seemingly purposeful behaviours that an individual feels driven to perform
physical or mental
carrying out ritual reduces anxiety temporarily
if not performed anxiety increased
recognised as irrational
what are common compulsions
checkin cleaning repeating acts mental ordering/symmetry hoarding counting
when is the average age of onset
20yrs old
what is ego systonia
ideas behaviours etc which are in harmony with a persons ego
what is ego dystonia
ideas, behaviours which are in conflict with someone ego
eg OCD obsessions are egodystonic eg you are dirty, you are a paedophile
what is ocd personality disorder
preoccupation with lists, rules, order perfectionism excessive devotion to work overconscientous inflexible unable to discard worthless objects need to be in control miserliness rigid stubborn
what is the hallmark of psychotherapy treatment in ocd
deliberate exposure to stimuli eg dirt
prevention of compulsion eg washing
repeated continuously until anxiety to stimuli decreases
what is the aetiology of ocd
high hereditability
autoimmunity- beta haemolytic strep infection and autoantibodies to basal ganglia
what is seen on neuroimagine in ocd
increased metabolism and blood flow in orbitofrontal cortex, caudate nucleus and cingulate cortex
what pharmacological treatment is used in ocd
TCA- clomipramine
SSRIs
What are the problems with the usue of antidepressants in ocd
high relapse after discontinuation
requires higher doses than in depression