OCD Flashcards
General description of OCD
Intrusive thoughts (obsessions) producing anxiety (uneasiness, apprehension, fear, worry) leading to repetitive behaviors (compulsion) engaged in to reduce anxiety
Comorbidities of OCD
Another anxiety disorder
Mood disorder (MDD most common)
Tic disorder
Possible pathogenesis of OCD
- Abnormal serotoninergic and dopaminergic signaling in brain
- Triggers: premenstrual, Group A strep, postpartum, stroke, traumatic event
Signs/Symptoms of OCD
OBSESSIONS - dirt, hoarding, order/symmetry, sexual or aggressive content, religion, food/weight, superstitious fears
COMPULSIONS - repetitive rituals, blinking/staring, excessive lists, counting, rechecking
DSM-5 OCD diagnostic criteria
- presence of obsessions and/or compulsions
- time consuming or cause significant distress or impairment
- Not substance abuse or medical condition
- Not better explained by another mental d/o
Obsessive Compulsive Personality Disorder (OCPD)
Enduring and pervasive maladaptive pattern of excessive perfectionism and rigid control that leads to ritualized behavior
Main OCD treatment
Therapy with meds
CBT: exposure and response prevention, acceptance and commitment therapy)
Meds: SSRI, TCA
Alternative therapy for OCD
deep brain stimulation
Three key components of Hoarding Disorder
- Collecting too many items
- Difficulty getting rid of items
- Problems with organization
Common side effects of SSRI
weight gain, sexual dysfunction
Common side effects of TCA
anti-cholinergic effects (drowsy, dry mouth)
Signs/sx’s of hoarding disorder
- anxiety when attempting to discard items
- difficulty categorizing
- suspicion of other people touching items
- obsessive thoughts
What should be ruled out with suspected hoarding disorder?
brain injury
CV disease
Treatment of hoarding
CBT: motivational interviewing, skills training or “habit reversing”
+/- meds
General definition of Body-Focused Repetitive Disorders
Umbrella term for any chronic behavior that causes a person to consistently cause physical damage to oneself unintentionally through a compulsive act in order to relieve anxiety
Trichotillomania
recurrent pulling out of one’s hair to relieve anxiety
Trichotillomania treatment
Education
CBT
SSRI’s
What is excoriation?
recurrent repetitive skin picking
2 common causes of excoriation?
- injury or disease of skin
- stressful life experience
Differential diagnoses to consider with chronic itching and skin picking
dermatologic disorder autoimmune problems (lupus, scleroderma) cancer BDD substance abuse (esp opiate withdrawal) liver disease hyperthyroid (dry skin) psychosis (think bugs under skin) med reaction lymphoma
Excoriation treatment
CBT
SSRI
anesthetic (lidocaine)
Barriers
