OCD Flashcards
What is OCD
OCD is describe in the DSM-5 as a disorder of intrusive and uncontrollable urges. Repetitive behaviours and mental acts. It can be found in the DSM-5-TR in the anxiety chapter
Symptoms
Obsessions -
intrusive recurring thoughts, impulses and images
Irrational and uncontrollable.
Contamination, hypochondriacal, fear of expressing some unusual or aggressive impulse
Compulsions- a repetitive behaviour or mental act that the person feels driven to perform in order to reduce the distress caused by obsessive thoughts or to prevent some calamity from occurring
Often the activity is not connected with or is excessive of the purpose
Statistics
More common in women OCD is often chronic Only 20% complete recovery 75%have comorbid anxiety disorder 66% have major depression Substance abuse is common 33%have hoarding symptoms
Epidemiology
Mean age of onset is 20
Two thirds of affected people have onset before age 25
OCD occurs less often among black people than white but access to health care may be a confounding variable
Cobb (1978)
Usually sufferers know their rituals are silly or absurd. 78%
Deleterious effects upon life
Jenike (1986)
Encephalitis, head injuries and Brian rumours associated with the development of OCD
Treatment
CBT (cognitive behavioural therapy- response prevention and exposure
Drugs
Psychosurgery
Deep brain stimulation
Most effective treatment
Cognitive behavioural therapy- longer lasting than pills
Though drop out rates are significant
Basal ganglia
Responsible for coordination and movement
Max found that dislocating basal ganglia from the frontal cortex led to OCD like symptoms
Orbitofrontal cortex-converts sensory information
Dysfunction of this area can result in conversion of sensation into actions
Math and janardhan-reddy 2007
40-60% respond to ssris
Bandelow 2008 and Denys 2006
40-50% of people with ocd do not respond to ssris
High chance of relapse
CBT
Longer lasting than pills, drop out rates significant
Aim is 12-20 sessions
