Obsessive compulsive DO Flashcards
OCD
Presence of obsessions, compulsions, or both
Time consuming, CSI
No drug/condition
Not better explained by MDO
Obsessions
Recurrent, persistent thought, urges, images experienced as intrusive/unwanted and cause anx/distress
Attempt to ignore thoughts via some other action
Compulsions
Repetitive behaviors/mental acts that must be performed in response to obsession/rules
Aimed at reducing anx/distress/bad situation
However, not connected to what they are trying to prevent/neutralize
Excessive
OCD Facts
More common, comorbid
Men = women
Boys > girls
Coexists w MD, SUD, SP, PD, Eating DO
OCD Facts 2
Normal pattern
Distinguish from OCPD
Most commonly see contamination, doubt, obessions w/out compulsion, symmetry
OCD Prognosis
MDO + OCD= suicide thoughts
Poor= yield to compulsions, childhood onset, bizarre compulsions, hospitalizations, MD, delusions, Pers DO
Good= social/occup adj, precipitating event, episodic nature
OCD Tx
Pharmaco/behv/Psycho
SSRI 1st line
Behav- inpatient/outpatient, usually exposure/response prevention
ECT or psychosurgery
Body dysmorphic DO
Preoccupation w 1 or more perceived flaws in physical appearance that are not observable/slight to others
Repetitive behaviors (look in mirror, pick skin) or mental acts (compare) in response to concern
CSI, not explained by other DO
BDD
More common gender, age, comorbid
Preoccupation with imagined defect, exaggeration of minor defect
Women more common
15-20, never marry
usually MDO, anx, Psych DO
BDD Facts
Body parts
Concerns
Most common- hair/nose/skin/face
Assoc- concern other notice, avoidance of self, mirror checking
Some housebound, some suicide
BDD Tx
Medical procedures unsuccessful (no surgery!)
SSRIs helpful
treat underlying DO
Hoarding DO
Persistent difficulty discarding/parting w possessions, regard of value
Perceive need to save items, distress w discarding
Possessions accumulate and clutter
CSI, no MC, other MDO
Hoarding DO Facts
Display excessive acquisition, (buying then free items)
Mostly males, early (11-15)
Traumatic/stressful event precedes onset/exacerbation
50% have family member who hoards
Females more excessive display
Hoarding DO Comorbid
Comorbid Anx/mood DO
Some OCD
Hoarding Tx
SSRIs CBT w exposure/response prevention (ERP) Assessment of clutter Discard items New behaviors (schedules, chores)
Trichotillomania
Recurrent pulling out of hair, resulting in hair loss
Repeated attempts to stop
CSI, no MC, other MDO
Tricho facts
Not in front of others, deny it Hide alopecia Assoc w mood/anx/pers DO/mental retard Eyebrows/eyelashes may be gone Thin/absent hair on limbs/torso Adults- w>m (kids equal)
Tricho facts 2
OCD vs Tricho
Evaluate Psych/stressors/fam history/OCD/MC
OCD= more anx/MD T= less OCD symptoms, + pleasure
T Onset/facts/Treatment
Childhood Can be continuous/come and go SSRIs/lithium/Haldol Steroid cream for itch Behav= habit reversal (competing response)
Excoriation DO
Recurrent skin picking, leading to lesions
Repeated attempts to stop/dec
CSI, no drug/MC, MDO
Excoriation Facts
Body parts
On/With what
Mostly face/arms/hands (multiple) Healthy/scabs/lesions Use fingernails/tweezers etc Skin rubbing/squeezing/lancing/biting Sig amount of time
Excoriation facts 2
Presence of
More common gender
Comorbid
Not in presence of others, only family
Skin picking of others
Female
Typically with OCD, 1st deg family members, MD, trico
Excor facts 3
Damage
Distress
Tissue damage, scarring
AB for infection or surgery
Excor tx`
Nonjudg, empath enviro
Refer to MHP
Pharma (SSRIs, antipsych)
Hypnosis
