OCD and other related disorders

Question 1

Obsessive-Compulsive Disorder

Answer 1

• Recurrent Obsessions or compulsions
• Obsessions/ compulsions are time consuming or distressful/disruptive
• Symptoms are not explained by another disorder

Some may have OCD “with absent insight (delusional beliefs)”

prefrontal-striatal overactivity or serotonin deficiency; rare- after strep infection (PANDAS)

Y-BOCS: useful scale for OCD

Question 2

define obsession

Answer 2

intrusive recurrent thoughts, urges, or images that increase distress

Question 3

define compulsion

Answer 3

repetitive behavior/ mental acts that are performed to decrease distress

Question 4

Treatments for OCD

Answer 4

• CBT and/or SSRIs
• treatment resistant: psychosurgery (lesion ant. cingulate gyrus and anterior limb of internal capsule)
• deep brain stimulation (involves implanted thoracic pacemaker)

Question 5

Hoarding Disorder

Answer 5

• Difficulty parting with possessions due to perceived need to save items or distress about discarding them.
• Accumulation clutters areas and compromises intended use
• Hoarding causes significant functional impairment

Specify if HD is “with absent insight (delusional beliefs)”

Question 6

Body Dysmorphic Disorder

Answer 6

• Preoccupation with a perceived flaw in physical appearance (flaw is minimal/ non observable)
• Repetitive behaviors or mental acts are performed in response to appearance concerns
• The preoccupation is not better accounted for by an eating disorder
• The preoccupation must cause functional impairment
• Specify if “with muscle dysphoria”
• Specify if “with absent insight (delusional beliefs)

Question 7

Excoriation DIsorder

Answer 7

-Recurrent skin picking resulting in skin lesions
-Attempts to stock picking
-Picking results in significant distress/ functional impairment
-Picking isn’t better explained by another disoder (e.g. BDD)
Features: time consuming (usually >1 hr/day), social avoidance, and medical complications (scarring, infection)

Question 8

Trichtotillomania

Answer 8

-Recurrent pulling out of one’s hair, resulting in loss
-Attempts to stop hair pulling
-Pulling causes significant distress/ functional impairment
Features: any body region can be affected and can change, usually occurs during sedentary activities, episodes can be frequent but brief or infrequent but sustained.