OCD Flashcards
Name that psych disorder:
Presence of obsession compulsions or both
Obsession = recurrent or persistent thoughts urges or images + try to suppress
compulsions = repetitive acts that need to perform in response to obsession
>1hr/day, not substance, not another psych
OCD
must specify with good or fair insight and if tic disorder
Examples of obsession and compulsions
O: obsessions, doubting, symmetry, superstitions, fear of causing harm
C: cleaning, checking, repeated behaviors, ordering arranging
How is OCD assessed/diagnosed in the office?
diagnostic interviews, behavioral assessment techniques, symptom measurement/track treatment response (Y-BOCS), self report questionnaire (OCI-R, FAS)
OCD prevalence if ___%? The onset is highest between ____
1.9-3%
18-29 years old
males have higher early onset (<10)-> has tic and ADHD
Other things on the differential diagnosis for OCD?
Body dysmorphic disorder (focus on appearance, see defects, check mirror)
Trichotillomania and excoriation disorder (hair pulling skin picking)
Hoarding disorder, anxiety, MDD, eating disorder, tics, psychotic, other compulsive, obsessive compulsive personality disorder
What are comorbid disorders with OCD?
anxiety disorders, mood disorders, impulse control. substance use, tic disorder
OCD is heritable and by what percent? What are some of the candidate genes?
50%
SAPAP3, SLITRK5, SLC1A1
How does OCD manifest in the cortico-striato-thalamo-cortical pathway (striatum, GP, etc)? What brain regions?
Overactivity of the direct pathway is the hypothesized situation
orbital frontal cortex, anterior cingulate cortex, ventral medial PFC, dorsolateral PFC)
What is the number one treatment for OCD? What at the components of this treatment?
Cognitive behavioral therapy
-16 sessions weekly with psychoeducation, cognitive training, mapping symptom list, exposure and response prevention
What are the biological treatments for OCD?
Largely the SSRIs
Clomipramine (tricyclic), fluoxetine, fluvoxamine, sertraline, paroxetine, citalopram
Be sure to maximize treatment!!!
What are some adverse events for treating OCD with pharmacotherapy?
physical development + growth stunning, psychiatry symptoms more in children, withdrawal, SI
What factors are related to a bad outcome when attempting to treat OCD?
severe symptoms, poor insight, hoarding sexual and religious symptoms, comorbidities, resistance to change, lack adherence, high family accommodation, males, lack of education
What is the relationship between COVID and OCD?
post infection-> new onset or worse OCD especially w contaminations
Potential effect of inflammation on CNS??
What are some pharmacotherapy treatments that are not FDA approved yet for OCD but they might be used in practice?
atypical anti-psychotics (risperidone, aripiprazole), glutamate modulators (NMDA partial agonist -> D-cycloserine), deep transcranial magnetic stimulation
