OCD Flashcards
what is OCD
characterised by obsessions, impulses and recurrent physical/mental rituals
how frequent must symptoms be for a diagnosis
present on most days for at least a 2 week period
what are obsessions
recurrent, intrusive and distressing ideas, thoughts, images, impulses
unwanted- patient recognises them as coming from their own mind
common obsessions
germs fear of harm excessive concern with order religious thoughts sexual thoughts urge to hoard thoughts of violence/aggression
what are compulsions
repetitive behaviours and mental acts that the individual feels driven to perform
carrying out the compulsions tends to reduce anxiety e.g. hand washing with a germ obsession
resistance to performing a compulsion increases anxiety
common compulsions
washing
checking
counting
cleaning
mean age of onset
20
what is OCD personality disorder
preoccupation with rules, lists, schedules, order
perfectionism interfering with task completion
excessive devotion to work
inflexible, overconscientious
neuroanatomy of OCD
caudate nucleus causing increase in compulsive drive
orbitofrontal cortex causing decreased restraint
3 domains of dysfunctional belief in OCD
- overestimation of the threat/ inflated sense of responsibility
- beliefs about the importance of and need to control intrusive thoughts
- perfectionism and intolerance of uncertainty
5 screening questions for OCD
- do you wash or clean a lot
- do you check things a lot
- is there any thought that keeps bothering you that you would like to get rid of but can’t
- do your daily activities take a long time to finish
- are you concerned about orderliness or symmetry
1st line OCD tx
exposure to obsessional stimuli + prevention of compulsions
2nd line OCD tx
CBT + SSRI
what is given if 2 SSRIs fail
clomipramine (TCA)
