OCD

Question 1

What are the DSMIV diagnostic criteria for OCD?

Answer 1

1. Either obsessions or compulsions
2. At some point recognition that obsessions or compulsions are excessive and unreasonable
3. Obsession and compulsions cause marked distress and are time consuming (>1hr per day) or significantly interfere with one’s routine; occupational, academic, social, or relationship
4. Exclusion of other Axis I
5. Exclusion of GMC

Question 2

Has is OCD managed?

Answer 2

Exclude other medical causes
CBT
SSRI’s - fluoxetine (20-80mg daily), sertraline (50-200mg), or fluxoamine (25mg nocte)

Question 3

What type of CBT is suitable for OCD?

Answer 3

Psychoeducation
Cognitive challenging
Graded exposure therapy
Relaxation techniques

Question 4

What makes an obsession an obsession?

Answer 4

• A thought, image, or impulse that is intrusive and inappropriate and causes marked anxiety or distress
• No simply excessive worries about real life
• Person attempts to ignore or suppress with other thoughts or actions
• Recognises that they are a product or their own mind

Question 5

What makes a compulsion a compulsion?

Answer 5

• A repetitive behaviour in response to an obsession that is carried out according to rules that are followed obsessively
• Aimed a reducing anxiety or prevent some dreaded outcome but don’t realistically address this

Question 6

What is the natural history of OCD?

Answer 6

• Usually presents in late teens/early 20s but can be in children
• Varied course;
  
  • Episodic with incomplete remission
  • Phasic with episodes of complete remission
  • Chronic and unremitting illness
• 50-75% cure

Question 7

What is the prevalence of OCD?

Answer 7

1% (lifetime 2.5%)

Question 8

What is found on PET scan in OCD?

Answer 8

Frontal cortex overactivity on PET scan