OCD Flashcards
def: anankastic
4 or more of:
1. feelings of excessive doubt and caution
2. preoccupation with details, rules, lists, order, organisation or schedule
3. perfectionism that interferes with task completion
4. excessive conscientiousness and srupulousness
5. undue preoccupation with productivity to the exclusion of pleasure and interpersonal relationships
6. excessive oedantry and adherence to social conventions
7. rigidity and stubbornness
8. unreasonable insistence that others submit to exactly his or her way of doing things, or unreasonable reluctance to allow others to do things
def: OCD
obsessive compulsive disorder (OCD)
characterised by presence of obsessions, compulsions or both
present most days for at least 2 weeks
associated with distress or functional impairment
not caused by other mental disorders e.g schizophrenia
epidemiology: OCD
lifetime prevalence 2%
mean age onset 20 M=F
def: obsession
recurrent and persistent ideas, impulses or thoughts that are experienced as distressing, intrusive or inappropriate by person having them
MSE: thought content
obsession v delusion
obsession = ego-dystonic - doesn’t match up with what that person is feeling internally/with self
(patient will know that the thought is not in line with how they are - they know it doesn’t make sense) they have insight, resisted though, assoc compulsions and non-psychotic
delusion = ego-syntonic - the delusion doesn’t normally distress them, they have no insight, not resisted, they believe it, they have no compulsions and they are psychotic
def: compulsion
conscious behaviour performed in response to an obsessional thought, the purpose of which is to neutralise the anxiety associated with the obsession
MSE: appearance and behaviour, thought content
examples: obsessions in OCD
- excessive concern with dirt/contaminants
- religion/blasphemy
- need for symmetry or exactness
- numbers/colours
- fear of harming others
- fear of harm coming to self
- doubt
examples: compulsions in OCD
- repetitive/ritualised washing
- checking locks, switches
- repeating routine activities
- counting and recounting
- arrange and rearrange
- mental rituals eg praying
- need to touch/tap/rub
aetiology: OCD
- family hx
- cortico-striatal-thalamo-cortical circuit
- serotonin and glutamate pathways
rx: OCD
1st line - SSRI
2nd line - SSRI or add in clomipramine
treatment resistent - add antipsychotics and ?glutamate antagonists - N-acetylcysteine
psychological - CBT
social - family awareness, support groups etc
def: PANDAS
Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infection
def: YBOCS
Yield Brown Obsessive Compulsive Score
* can use to diagnose OCD
* or use to see if treatment is effective
psychological rx:
CBT
- exposure anad response prevention
- can be used first line or in combination with tx
rx: OCD
biological: 1st line SSRI
2nd line orhter SSRI or clompiramine
resistant - antipsychotics
psychological - CBT: exposure and response prevention
social - relationships, family, school, employment
def: PTS
