Topic 3: OCD Flashcards
Obsessions are ….
Intrusive and recurring thoughts, images or impulses that come unbidden to the mind, are uncontrollable, and usually appear irrational to the person experiencing them
Forms of obsessions
Wishes Impulses Images Ideas Doubts
Compulsions are …
Repetitive, clearly excessive behaviors or mental acts that the person feels driven to perform in order to prevent or reduce anxiety
Intrusive thoughts and ritualistic behavior are frequently reported in the general population. Those seen in OCD are considered psychopathological. Why?
They are time consuming, cause marked distress and interfere with everyday functioning
Common comorbidities of OCD
Motor tics (including TS) Trichotillomania Body dysmorphic disorder Mood disorder Anxiety disorder
Etiology of OCD
- genetic component
- neurotransmitters: role of serotonin in pathogenesis of OCD
- structural and functional brain abnormalities in: orbifrontal cortex (OFC), anterior cingulate cortex (ACC), striatum
In OCD, where in the brain can we find structural and functional abnormalities
- orbifrontal cortex (OFC)
- anterior cingulate cortex (ACC)
- striatum
What is the cortico-striatal model in OCD
Abnormal striatal function –> inefficient gaiting at the level of the thalamus –> hyperactivity within the OFC and ACC
DSM 5 diagnosis OCD
A presence of compulsions, obsessions or both
B the compulsions / obsessions are time consuming
Treatment of OCD
Behavior therapy: - exposure and response prevention Pharmacotherapy: - SRI's Deep brain stimulation
Modern neurosurgery takes two forms
- ablative procedure
- neuromodulation (DBS)
DBS is most often used in …
Movement disorders such as Parkinson’s
Advantages of DBS
- DBS is reversible
- adjustable
Adverse effects of DBS
Complications because of:
- surgical procedure
- device/equipment
- stimulation itself
Role of the neuropsychologist in DBS
- patient selection
- evaluation of outcome
- management of post-operative effects
