OCD Assessment and treatment model

Question 1

Y-BOCS

Answer 1

Yale-Brown Obsession and Compulsions Scale
- 10 item clinician-administered scale
- Most widely used
- Provides 5 rating dimensions
- Scored on scale form 0 (no symp) to 4 (extr.)
- Max is 40 points. 20 for obsession + 20 for comp.

Question 2

5 Rating dimensions

Answer 2

Time spent or occupied

interference with functioning or relationships

Degree of distress

Resistance to obs/comp

Degree of control of obs/comp

Question 3

Related disorders

Answer 3

Body Dysmorphic Disorder; preoccupied with appearance. More delusion

Hoarding Disorder; extreme focus on possessions

Trichotillomania; hair pulling

Excoriation (skin picking); focus on skin

Substance/medication induced OCD

OC and related due to medical condition

Other specified OCD & R

Unspecified OCD & R

Question 4

Treatment types

Answer 4

Cognitive behaviour therapy (most evidence)
- Cognitive theory (reappraisal)
- Exposure Response prevention (ERP)

Medication

Neuromodulation (rTMS, DBS)

For severe: meds in combo w CBT is best

Question 5

OCD model

Answer 5

Obsessions lead to anxiety and or distress

To relieve this feelings patients start using compulsions

The compulsions give a sense of relief, temporary reduction. This negatively reinforces the compulsions.

Question 6

CBT/cognitive therapy

Answer 6

Normalising intrusive thoughts with psychoeducation (intrusive thoughts are not rare, only if interpreted as threat/significant)

Reparing the dysfunctional beliefs (CT)