OCD disorders Flashcards
insight with OCD
typically good
4 most common symptom categories in OCD
contamination/cleansing
pathologic doubt/checking
intrusive forbidden thoughts
symmetry/ordering
(in that order)
common symptoms associated with body dysmorphic disorder
ideas/delusions of reference
mirror checking
avoiding reflection
attempts to hide perceived deformity
insight in body dysmorphic disorder
not typically as good as in OCD
insight in hoarding disorder
poor
focused pulling in trichotillomania
intentional act to control unpleasant experience
automatic pulling in trichotillomania
done without awareness usually during sedentary activities
most have combo of both
trichophagia
mouthing/eating hair
olfactory reference syndrome
false belief that one emits a foul odor. The preoccupation causes repetitive behaviors (washing, changing, etc.)
mean age of onset for olfactory reference syndrome
25
pharmacotherapy in OCD
clomipramine and SSRIs
SSRI dose in OCD as opposed to depression
higher doses required
OCD response to SSRIs
slower than depression
give at least 12 week trial
adjunct antipsychotics typically seen in adult OCD
risperidone
aripiprazole
what type of therapy is particularly helpful in OCD
exposure and response prevention
what is best first line treatment option for OCD in children
CBT
pharmacotherapy for body dysmorphic disorder
SSRIs
dosage and course of SSRI tx for body dysmorphic disorder compared to MDD
higher dose for a longer course
what may be a helpful adjunct medication in body dysmorphic disorder partial responders
buspirone
pharmacotherapy for hoarding disorder
limited data suggests efficacy of SSRIs and venlafaxine
most effective treatment approach for hoarding disorders
CBT
pharmacotherapy for trichotillomania
low dose D2 blockers for treatment refractory cases
CBT technique used for trichotillomania
habit reversal training
pharmacotherapy for excoriation disorder
some support for fluoxetine
nonpharmacologic tx of excoriation disorder
CBT
habit reversal training
what areas of the brain are implicated in OCD
anterior cingulate, orbitofrontal cortex, and striatum
neurotransmitter systems implicated in OCD
serotonergic, dopaminergic, glutamatergic, and GABAergic
first line pharmacotherapy for OCD treatment refractory cases
augmenting SSRIs with D2 blockers