OCD

Question 1

General description of OCD

Answer 1

Intrusive thoughts (obsessions) producing anxiety (uneasiness, apprehension, fear, worry) leading to repetitive behaviors (compulsion) engaged in to reduce anxiety

Question 2

Comorbidities of OCD

Answer 2

Another anxiety disorder
Mood disorder (MDD most common)
Tic disorder

Question 3

Possible pathogenesis of OCD

Answer 3

• Abnormal serotoninergic and dopaminergic signaling in brain
• Triggers: premenstrual, Group A strep, postpartum, stroke, traumatic event

Question 4

Signs/Symptoms of OCD

Answer 4

OBSESSIONS - dirt, hoarding, order/symmetry, sexual or aggressive content, religion, food/weight, superstitious fears

COMPULSIONS - repetitive rituals, blinking/staring, excessive lists, counting, rechecking

Question 5

DSM-5 OCD diagnostic criteria

Answer 5

• 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

Question 6

Obsessive Compulsive Personality Disorder (OCPD)

Answer 6

Enduring and pervasive maladaptive pattern of excessive perfectionism and rigid control that leads to ritualized behavior

Question 7

Main OCD treatment

Answer 7

Therapy with meds

CBT: exposure and response prevention, acceptance and commitment therapy)
Meds: SSRI, TCA

Question 8

Alternative therapy for OCD

Answer 8

deep brain stimulation

Question 9

Three key components of Hoarding Disorder

Answer 9

• Collecting too many items
• Difficulty getting rid of items
• Problems with organization

Question 10

Common side effects of SSRI

Answer 10

weight gain, sexual dysfunction

Question 11

Common side effects of TCA

Answer 11

anti-cholinergic effects (drowsy, dry mouth)

Question 12

Signs/sx’s of hoarding disorder

Answer 12

• anxiety when attempting to discard items
• difficulty categorizing
• suspicion of other people touching items
• obsessive thoughts

Question 13

What should be ruled out with suspected hoarding disorder?

Answer 13

brain injury

CV disease

Question 14

Treatment of hoarding

Answer 14

CBT: motivational interviewing, skills training or “habit reversing”

+/- meds

Question 15

General definition of Body-Focused Repetitive Disorders

Answer 15

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

Question 16

Trichotillomania

Answer 16

recurrent pulling out of one’s hair to relieve anxiety

Question 17

Trichotillomania treatment

Answer 17

Education
CBT
SSRI’s

Question 18

What is excoriation?

Answer 18

recurrent repetitive skin picking

Question 19

2 common causes of excoriation?

Answer 19

• injury or disease of skin

- stressful life experience

Question 20

Differential diagnoses to consider with chronic itching and skin picking

Answer 20

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

Question 21

Excoriation treatment

Answer 21

CBT
SSRI
anesthetic (lidocaine)
Barriers