Obsessive Compulsive Disorders

Question 1

Describe OCD

Answer 1

Obsessions are recurrent and
persistent ideas, thoughts, impulses, or images that are experienced as intrusive and inappropriate and that cause marked anxiety or distress. Compulsions are repetitive and intentional behaviors (or mental acts) performed in response to obsessions or according to certain rules that must be applied rigidly.

Must be time consuming or cause clinically significant distress or impairment.

Not attributable to substance or other mental health disorder

Question 2

How to distinguish between OCD and Schizophrenia

Answer 2

Schizophrenia is the most important disorder to exclude, because obsessional thoughts can resemble delusional thinking. In most patients the distinction between obsessions and delusions is clear-cut. Obsessions are unwanted, resisted, and recognized by the patient as having an internal origin, whereas delusions are typically not resisted and are looked on as having an external origin. Nonetheless, rare patients appear to have both.

Question 3

Describe Body Dysmorphic Disorder

Answer 3

“Disease of imagined ugliness”

Preoccupation with an imagined defect or flaw that is not observable/or perceived as slight by others.

Patient has engaged in repetitive behaviors like mirror checking, excessive grooming, skin picking.

Causes clinically significant distress or impairment.

Specify if muscle-based. Specify insights.

Question 4

Describe Hoarding Disorder

Answer 4

Collection of objects of limited value and inability to discard.

Objects congest living area and compromises intended use. Causes distress or impairment.

Specify excessive acquisition (shopaholic) and insight.

Question 5

Describe Trichotillomania

Answer 5

Recurrent pulling out hair and repeated attempts to stop. Causes distress and impairment.

SSRIs can reduce urge, but limited long term success.

Question 6

Describe Excoriation

Answer 6

Recurrent skin picking resulting in lesions. Repeated attempts to stop.