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NB3 > OCD & Somat8c Symptom Disorders > Flashcards

OCD & Somat8c Symptom Disorders Flashcards

1
Q

What are the diagnostic criteria of the OCD?

A

Diagnostic Criteria:
1. Recurrent obsessions and/or compulsions:
➢ Obsessions: Intrusive recurrent thoughts, urges, or images that increase distress (e.g., fear of contamination)

➢ Compulsions: Repetitive behaviors/ mental acts that are performed to decrease distress (e.g., washing)

2) Obsessions/compulsions are time consuming or distressful/disruptive
3) Symptoms are not explained by another disorder
(e. g., weight preoccupation in eating disorders

(Note: Compulsions aren’t always logically related to the obsession)

The obsessional belief can be of delusional intensity (100% certainty) and is denoted using the following specifier: OCD “with absent insight (delusional beliefs)”

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2
Q

What are the components of the Cortico-striate-thalamus-cortical (CSTC)?

A

Cortico-striato-thalamo-cortical (CSTC) circuit overactivity

Orbitofrontal—> cingulate—> striatum—> Thalamus—> orbitofrontal

Serotonin deficiency

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3
Q

What is standard OCD treatment?

A
  1. Behavioral therapy (Exposure and Response Prevention
    [ERP])
    • Expose patient to obsession without allowing patient to engage in compulsion
    • Exposure can be in vivo (live), virtual, or imaginal

2) Medications
• Antidepressants that selectively increase serotonin (e.g., the selective serotonin reuptake inhibitors [SSRIs], such as fluoxetine)

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4
Q

What are the treatment options of refractory OCD?

A

Techniques that interrupt CSTC circuitry through:
1) Neurosurgery
Lesions of either of the following regions:

‒ Ant.cingulategyrus (cingulotomy)
‒ Ant. limb of the internal capsule (capsulotomy)
Lesions are created surgically or through radiation

2) Deep Brain Stimulation

Electrical stimulation of select brain regions (e.g., subthalamus)
‒ Implanted electrode connected to a pacemaker device under skin of chest
– Risk of infection, brain hemorrhage
– Several months to see therapeutic effects
– Treatment is indefinite

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5
Q

What is the essential feature of BDD?

A

O-C behavior about perceived defect in appearance

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6
Q

What is the essential feature of Hoarding?

A

O-C behavior resulting in the excessive accumulation of possessions

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7
Q

What is the essential features of excoriation?

A

Compulsive picking

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8
Q

Whaat is the essential features of Trichotillomania?

A

Compulsive hair pulling

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9
Q

What. Disorders are related to somatic symptom disorder?

A

Illness anxiety disorde
Conversion disorder—> functional neurological symptom disorder
Factitious disorder

The common feature of these disorders is the prominence of somatic/health-related symptoms associated with significant distress or impairment

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10
Q

What are the diagnostic criteria of Somatic Symptom Disorder?

A

Diagnostic Criteria
➢ >1 distressing/disruptive somatic symptom ➢ At least one indicator of excessive thoughts/
feelings/behaviors about the symptom(s) such as:
– Disproportionate thoughts about the seriousness of the
symptom
– High levels of anxiety about the symptom or health
– Excessive time/energy devoted to the symptom

The diagnosis of SSD focuses on the abnormal behaviors/thoughts/feelings in response to the distressing somatic symptom(s)

➢ The focus is NOT on whether there is a medical explanation for the somatic symptom(s). The person COULD have a medical explanation for the symptom and still have SS

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11
Q

What is the diagnostic criteria of illness anxiety disorder?

A

Diagnostic Criteria
➢ Preoccupation with having/acquiring a serious illness
➢ Somatic symptoms are NOT present or, if present, the
symptoms are mild:

– A normal physiological sensation (e.g., orthostatic dizziness)
– A benign, self-limited dysfunction (transient tinnitus)
– Bodily discomfort not usually indicative of disase (e.g., belching)
➢ Patient performs excessive health-related behaviors or shows maladaptive avoidance

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12
Q

Compare SSD vs. IAD

A

SSD vs IAD Compared
➢ SSD: Patient has a distressing physical complaint with “excessiveness” in response to that distressing physical complaint

➢ IAD: Patient does NOT have a distressing physical complaint but nonetheless worries about one’s health

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13
Q

What is body Dysmorphic disorder?

A

BodyDysmorphicDisorder(BDD)
– An Obsessive-Compulsive related disorder characterized by excessive concern about a perceived flaw in one’s appearance

– In BDD, the concern relates to one’s appearance; In SSD & IAD, the concern relates to a somatic symptom or health

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14
Q

What is Delusional disorder, somatic type?

A 
Delusional Disorder (DD), Somatic Type
– A Schizophrenia Spectrum disorder characterized by a persistent fixed, false belief about body/health

– In DD, the belief is held with delusional intensity (100% certainty); In SSD and IAD, the belief is less strongly believed

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15
Q

What is the diagnostic criteria of conversion disorder?

A

Diagnostic Criteria
➢ Altered voluntary motor or sensory function
➢ Evidence of incompatibility between the symptom and neurological conditions

Incompatibility of the symptom with neurological disease is a key feature of this diagnosis

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16
Q

What are the subtypes of conversion diagnostic criteria?

A 
Subtypes
• With weakness or paralysis
• With abnormal movement
• With swallowing symptoms
• With speech symptom
• With attacks or seizures
• With anesthesia or sensory loss
• With special sensory symptom (e.g., visual)
• With mixed symptoms
17
Q

What are the Factitious disorders?

A

A person fakes/induces (feigns) physical or psychological symptoms, in self or others, in the absence of obvious “external” rewards

– Satisfaction is from gaining medical attention and being in the patient role (“primary gain”)

– Unconscious motivation

❑ Factitious Disorder Imposed on Self (“Munchausen’s
Syndrome”): Person feigns symptoms in oneself
❑ Factitious Disorder Imposed on Another (“Munchausen’s Syndrome, by proxy”): Person feigns symptoms in another individual

18
Q

What is Malingering?

A

A person fakes/induces (feigns) physical or psychological symptoms in self/others for “external” rewards (e.g., avoiding work)
Known as “secondary gain”
Conscious motivation
Complaints cease after gaining reward
❑ Malingering: Person feigns symptoms in oneself
❑ Malingering (by proxy): Person feigns symptoms in another individual

NB3 (33 decks)

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