OCD ch 12 Flashcards
Obsessions
Intrusive, wanted mental occurrences that cause anxiety and distress.
Many experience it but most push such thoughts away and seen as senseless.
Those with OCD equate thoughts with actions. they believe that negative thoughts and doubts are the same as the corresponding behavior and the thoughts make the event more likely to occur.
Compulsions
Acts or behaviors that temporarily reduce anxiety or distress associated with obsessions and is carried out in a pressured or rigid fashion.
OCD
Tend to have low self esteem, few friends, and problems with family relationships.
They resist change due to the stress it brings.
Need to be certain of things and in control in order to cope.
They have employment et financial problems, home management, relationships, and social activities.
Prevalence - 4th common psych d/o
Age - adolescence or early adulthood. PANDAS in children.
More frequently in women et has later onset than in men.
Half are unmarried, higher remission if married.
Risk = prenatal, perinata, postnatal factors, envir,oanment factors, traumatic events, psych d/o et use of atypical antipsychotics.
Etiology - genetics is 68%, infections, evolutionary theory, false alarm theory, cognitive theory, unified theory.
Bio - cortico-striato-thalamo-cortical circuit abn
Basal ganglia - involved in planning and executing motor strategies et primary site of pathology of OCD.
STriatum - involved in fixed-action patterns or inherited motor sequences et cognitive procedural functions.
Clinical presetnaion - not all pts have good insight into their unreasonableness of their obsessions. , preoccupations with contamination, symmetry, pathologic doubting or uncertainty, somatic obsessions, saving or hoarding, sexual or violent thoughts, sense that something unpleasant may happen if a particular ritual is not performed. Those with hoarding preoccupy. have sever symptoms and greater social and vocational impairment.
Compulsions - repetitve phsycial behaviors, metnal rituals or both.
There is family accommodation to OCD>
Tx- 1st line SRI’s and CBT. CBT 1st line with children. Fluvoxamine, fluoxetine, sertraline, paroxetine. Should try a 12 week trial before changing or augmenting. Can use clomipramine. ECT, TMS
Psychotherapy, CBT, exposure therapy, behavioral therapy, supportive therapy.
Relaspse rate with discontinuation is up to 90%
OCSD Spectrum DO
Preoccupation with bodily sensations or appearance - body dysmorphic disorder, depersonalization, anorexia, hypochondriasis.
Impulsive disorders- sexual compulsions, gambling, trichotillomania, sking picking, SIB, kleptomanis, compulsive shopping.
Nuerological disorder- affect basal ganglia inclidng autism, sydenhams chorea, torticollis, andTS.
Schizo-obsessive disorder - schixophrenia
