OCD Flashcards
What is OCD?
Anxiety disorder in which pt suffers from time soncuming anxieties and obsessions interfering with daily life.
What is the aetiology of OCD?
Some genetic basis (serotonin dysfunction) frontal cortex and basal ganglia abnormalities.
Psychoanalytical models see symptoms as outlets for conflicting desires and drives.
What is the epidemiology of OCD?
Associated with anankastic personality trait, comorbid depresion, schizophrenia, tics, Tourette’s. Lifetime prevalence 2-3%. Onset early 20s.
What might you find in the history of an OCD patient?
Obsessions AND compulsions present in most days for >2wk, not acocunted for by presence of another mental illness. These O and Cs are:
· acknowledged as originating in the mind
· Persistent, repetitive and intrusive,
· Patient tries to resist them
· Not intrinsically pleasurable
· Cause distress and interfere with functioning.
Obsessons: Persistent thoughts or ideas. I.e. contamination, bodily fears, aggression, orderliness and symmetry.
Compulsions are stereotyped acts, that cause tension in patient if resisted. These include cleaning, checking, counting, hoarding.
What are the examination findings in OCD?
Poor concentration if distracted by unwanted thoughts. May show increasing signs of anxiety if prevented from compulsions. Patient aware of the own and excessive thoughts.
What investigations would you do for OCD?
FBC, UE, LFT, CA, TFTs.
What is the management of OCD?
Behavioral therapy: exposure and response prevention. Clomipramine or SSRIs are efficacious in 50-80%. Lack of response à add antipsychotic.
Severe OCD with life disruption that is non-responsive to tx may benefit from psychosurgery.
What are the complications/ prognosis of OCD?
Worse pgx if male, early onset, severe symptoms, premorbid obsessive PD
