OCD

Question 1

What is the DSM 5 criteria for OCD?

Answer 1

A.

1. Obsessions

• recurrent intrusive + unwanted + persistent thoughts
• attempts to ignore/suppress/neutralise

1. Complusions

• repetitive behaviours or mental acts
• aim to reduce, prevent, decrease distress

B. Time consuming/ Causes distress/Functional impact

C. not due to substance use/medication

D. not due to another psychiatric illness

Question 2

What is used to Assess OCD?

Answer 2

• Yale-Brown Obsessive compulsive scale

Question 3

OCPD vs OCD? What are other differentials for OCD?

Answer 3

• OCPD is ego-syntonic - consistent with ones self image, surcome to the compulsions/obsessions
• OCD is ego-dystonic - in conflict with the needs and goals.
• GAD
  
  • GAD no compulsions, OCD is obsessions not usually based in reality
• mood disorders
• depression

Question 4

Types of Obsessions?

Answer 4

• SCORCH:
  
  • Symmetry
  • Cleaning (contamination)
  • repugnant - e.g. sexual
  • checking
  • hoarding
    *

Question 5

Management of OCD?

Answer 5

1. Exposure and Response Prevention based CBT
   
   • medicare covers 10 sessions, usually need 12-20.
   • confronts fears through exposure
   • involves recognising and decreasing compulsions
   • Process:
     
     • identify obsessions via checklist with therapist
     • develop list of feared or avoided situations
     • rank in an exposure heirarchy
     • deliberate exposure
     • try not to do compulsions
2. SSRI
3. GP
   
   • relapse prevention plan: triggers, exposure, tasks
   • regular follow/up
   • referral