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Behavioral Med > OCD > Flashcards

OCD Flashcards

0
Q

OCD - comorbidities?

A 
another anxiety disorder
mood disorder
tic disorder
bipolar
eating
tourettes 
MDD
generalized anxiety
social anxiety
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1
Q

OCD?

A

intrusive thoughts (obsessions) producing anxiety leading to REPETITIVE behaviors engaged in to reduce anxiety

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2
Q

OCD- pathogenesis?

A 
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
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3
Q

OCD - sx?

A

obsessions:

  • dirt/contamination
  • hoarding/saving
  • sexual content
  • superstitious fears
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4
Q

Getting to the dx of OCD?

A 
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
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5
Q

Obsessive compulsive personality disorder?

A

very hard to tx
excessive perfectionism
rigid control that leads to ritualized behavior

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6
Q

OCD- DSM V dx?

A

obsession, compulsion, both

obsessions, compulsions are time consuming or x significant distress or impairment in social, occupation, and other fxns

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7
Q

OCD tx?

A 
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
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8
Q

OCD - prognosis?

A

70-80% recovery

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9
Q

SSRI ADR?

A

sexual dysfxn

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10
Q

SSRI stopped abruptly?

A

flu like sx

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11
Q

TCA ADR?

A

dries everything - mouth, south

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12
Q

Hoarding disorder?

A

persistent difficulty discarding or parting w/ possessions REGARDLESS OF THEIR ACTUAL VALUE

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13
Q

Hoarding disorder - 3 components?

A

1) collecting too many items
2) difficulty getting rid of items
3) probs w/ organization

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14
Q

Hoarding-trigger?

A 
TBI
glucose metabolism
neuroimaging:
-executive fxning 
-impulse control
-processing of reward value
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15
Q

Hoarding - regions of the brain that is affected?

A

frontal lobe

  • orbitofrontal cortex
  • ventromedial prefrontal cortex
  • anterior cingulate cortex
16
Q

“this bottle cap is the only one ive seen”

A

hoarding

17
Q

“if i throw bottle cap away - something bad will happen”

A

ocd

18
Q

Hoarding sx?

A

inability to throw away possession
anxiety when tempted to discard items
cannot categorize
indecisive whether to keep or where to put things
suspicions of other people touching items

19
Q

Hoarding - DSM V?

A

persistent difficulty discarding or parting w/ personal possession - even though its not important
effects: social, occupational, other imp areas - not safe
sx are NOT d/t brain injury, CV dz

20
Q

Hoarding - comorbidites?

A 
MDD
General anxiety disorder
social phobia
PTSD
ADHD
grooming disorder
dementia
21
Q

Hoarding tx?

A 
CBT
-motivation interviewing 
\+/- meds
-SSRI/SNRI
TCA
22
Q

Trichotillomania?

A

pulling hair - ANYWHERE THAT HAS HAIR

23
Q

Trichotillomania - warning signs?

A 
wearing hats
wearing excessive eye make up or glasses
continually playing w/ one's hair
preoccupation, anxiety, depression
avoidance of windy/wet situations
career or academic decline
24
Q

Trichotillomania - DSM 5?

A

irresistible hair pulling and has hair loss
repeated attempts to decrease or stop hair pulling
hair pulling cxs clinically significant distress or impairment in social, occupational, or other areas of fxning
hair pulling/loss is NOT d/t o another attribute
unconscious; emotionally driven

25
Q

Trichotillomania tx?

A

education: hair pulling barriers
1) CBT
2) meds: SSRI
3) alternative therapies: N-acetylcysteine
support groups

26
Q

Dematillomania?

A

skin and hair pulling

27
Q

Dermatophagia?

A

scab eating

28
Q

Dermaphagia?

A

eating hair

29
Q

Excoriation (SPD)?

A

skin picking by recurrent skin picking resulting in SKIN LESION

  • repetitively touch
  • rub
  • scratching
  • pick
  • dig into skin
  • belief that bug is under skin
30
Q

Excoriation cx?

A

1) injury or disease of the skin

2) stressful life experience (outlet of the emotions)

31
Q

Excoriation- dx?

A
  • repeated attempts to decrease or stop the skin picking
  • cx clinically significant distress or impairment in social, occupational or other important areas of fxning
  • sx must not be better explained by sx of another mental or medical disorder
32
Q

Excoriation investigation?

A

labs:
-CBC (cancer, anemia)
-Chemistry panel
-TSH
-FBG (diabetes)
-ANA (autoimmune)
-ESR (autoimmune)
Imaging:
-CXR (lymphoma)

33
Q

Excoration DDx?

A 
dermatological disorder
autoimmune probs 
BDD
OCD
substance abuse (opiate withdrawal) 
autism 
psychosis
34
Q

Excoriatiotn tx?

A

CBT
meds:
-oral, topical (lidocaine)
-barriers (una sleeves)

35
Q

Interviewing the pt?

A

SOLER

OARS

36
Q

SOLER?

A 
Smile and sit squarely
Open body posture 
Lean slightly
Eye contact 
Relax
37
Q

OARS?

A

Open-ended questions
Affirmations
Reflective listening
Summaries

Behavioral Med (17 decks)

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