OCD

Question 1

Appetitive systems in brain?

Answer 1

Ascending dopamine

Ventral striatum

Dorsal striatum

Amygdala

Anterior cingulate

Orbitofrontal cortex

Question 2

Aversive systems in brain

Answer 2

Ascending serotonin

Central nucleus of amygdala

Hippocampus

Ventroanterior and medial hypohtalamus

Periaqueductal grey matter

Question 3

What is OCD?

Answer 3

A chronic and disabling disorder, marked by obsessions and/or compulsions that are egodystonic

Question 4

What is egodystonic?

Answer 4

Obsessions that are viewed as repungant or inconsistent with the personality, values and moral perspective of the individual

Question 5

What are obsessions

Answer 5

recurrent, intrusive and distressing thoughts and ideas that are unwanted and USUALLY resisted

Question 6

What are compulsions?

Answer 6

Repetitive and seemingly purposeful behaviours that individual feels driven to perform.

Question 7

Features of OC personality disorder?

Answer 7

Preoccupation with rules, lists and schedules

Perfectionism

Excessive devotion to work

Overconscientious

Stubborn

Question 8

Aetiology of OCD?

Answer 8

MZ and DZ twins

Autoimmune - B haemolytic strep infection and autoantibodies to basal ganglia

Question 9

What does neuroimaging show in OCD?

Answer 9

Increased metabolism and blood flow in orbitofrontal cortex, caudate nucleus and cingulate cortex

Question 10

How is psychotherapy used in OCD?

Answer 10

Delibarate exposure to obsessional stimuli

Prevention of compulsions used to lessen distress associated with feared stimuli

Repeat exposure to obsessional cues whilst employing strict response prevention

Question 11

Treatment of OCD?

Answer 11

Start with SSRI or CBT

If response, then aygment

If not sceond SSRI etc

If not another SSRI

If not investigational alternative

If not neurosurgery