OCD Flashcards
OCD - comorbidities?
another anxiety disorder mood disorder tic disorder bipolar eating tourettes MDD generalized anxiety social anxiety
OCD?
intrusive thoughts (obsessions) producing anxiety leading to REPETITIVE behaviors engaged in to reduce anxiety
OCD- pathogenesis?
neurobiology -abnormal activity in brain circuit recruitment during cognitive tasks -abnormal serotoninergic and dopaminergic signaling genetics post group a strep premenstrual postpartum stroke traumatic event TBI
OCD - sx?
obsessions:
- dirt/contamination
- hoarding/saving
- sexual content
- superstitious fears
Getting to the dx of OCD?
ask specific questions about intrusive thoughts, urges, images about repetitive behaviors and mental rituals document frequency (acute/chronic), amount of time used, extent of actions that interferes w/ADLs
Obsessive compulsive personality disorder?
very hard to tx
excessive perfectionism
rigid control that leads to ritualized behavior
OCD- DSM V dx?
obsession, compulsion, both
obsessions, compulsions are time consuming or x significant distress or impairment in social, occupation, and other fxns
OCD tx?
CBT -exposure and response prevention (expose the pt to the obsession/trigger --> replace negative compulsion w/ positive) -acceptance and commitment therapy meds -first line: SSRI -second line: TCA -third lien: SNRI
OCD - prognosis?
70-80% recovery
SSRI ADR?
sexual dysfxn
SSRI stopped abruptly?
flu like sx
TCA ADR?
dries everything - mouth, south
Hoarding disorder?
persistent difficulty discarding or parting w/ possessions REGARDLESS OF THEIR ACTUAL VALUE
Hoarding disorder - 3 components?
1) collecting too many items
2) difficulty getting rid of items
3) probs w/ organization
Hoarding-trigger?
TBI glucose metabolism neuroimaging: -executive fxning -impulse control -processing of reward value