OCD

Question 1

Define “obsessions”

Answer 1

Unwanted intrusive thoughts/images/urges, which are distressing and recurrent or persistent.
The patient acknowledges they are egodystonic and a product of their own mind, and tries to resist them.

Question 2

Define “compulsions”

Answer 2

Repetitive, stereotyped behaviours or mental acts, e.g. cleaning/counting, that a person feels driven to perform overtly or covertly.
They are not enjoyable, but relieve anxiety caused by the obsessions.

Question 3

Give some examples of common obsessions

Answer 3

• Fear of contamination
• Fear of harm
• Excessive concern with order

Question 4

Explain the OCD cycle

Answer 4

Obsession –> anxiety –> compulsion –> relief –> obsessive thought recurs

Question 5

Outline the ICD-10 criteria for OCD diagnosis

Answer 5

• Obsessions and/or compulsions present most days for at least 2 weeks
• Distressing enough to interfere with functioning
• Acknowledged as coming from patient’s own mind
• Not pleasurable

Question 6

Outline some possible aetiological factors for OCD

Answer 6

• Genetics
• Failure to control undesirable thoughts
• Compulsive behaviour learned and maintained via operant conditioning

Question 7

Which questionnaire is helpful in OCD diagnosis?

Answer 7

Yale-Brown

Question 8

List 2 questions that you would ask someone you suspect might have OCD

Answer 8

• Do you have distressing thoughts that enter your mind despite you trying hard to resist them?
• Do your daily activities take a long time to finish?

Question 9

List 4 DDx for OCD

Answer 9

• ED
• Anankastic PD
• Body dysmorphic disorder
• Other psych condition
• Tourettes

Question 10

Outline the management of OCD, depending on degree of functional impairment

Answer 10

• Mild - low intensity psych intervention
• Moderate - SSRI or intensive CBT
• Severe - SSRI AND CBT