Obsessive Compulsive Disorder

Question 1

Define OCD?

Answer 1

Recurrent obsessional thoughts or compulsive acts i.e. images, ideas, impulsions that enter patients mind again and again

Obsessional thoughts:
o	Ideas or impulses that enter the mind 
o	Almost always distressing
o	Patient tries to resist
o	Recognised as their own thoughts

Question 2

Main Aetiology?

Answer 2

Genetic (50-80%)

Question 3

Clinical features?

Answer 3

Compulsive acts - involuntary, not enjoyable, tries to resist them
Marked anxiety and depression
Obsessional rumination (a deep or considered thought about something)

Question 4

What is not affected about a person?

Answer 4

social interaction

Question 5

Content of obsessions/compulsions? (5)

Answer 5

Do you wash or clean a lot?
Do you check things a lot?
Is there any thought that keeps bothering you that you’d like to get rid of but can’t?
Do your daily activities take a long time to finish?
Are you concerned about putting things in a special order or upset by mess

Question 6

Socio-psychological Mx? (2)

Answer 6

CBT

ERP (exposure & response prevention)

Question 7

1st line Biological Mx?

Answer 7

SSRI e.g. fluoxetene, sertraline

Question 8

2nd line Biological Mx?

Answer 8

TCA e.g. clomipramine

Question 9

When should ECT be used?

Answer 9

if patient is suicidal

Question 10

What is the most effective treatment strategy?

Answer 10

combined drugs and psychotherapy

Question 11

Cardinal difference between OCD and Obsessive compulsive personality disorder?

Answer 11

OCD patients are distressed