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Troubles anxieux > Trouble obsessionnel-compulsif > Flashcards

Trouble obsessionnel-compulsif Flashcards

1
Q

what is the mean age of onset of OCD

A

about 20 years old
–symptoms can occur before age 10
–few new cases after early 30s

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2
Q

what % of people with OCD seek treatment

A

estimated around 14-56% of patients–> OCD may be udner recognizes and under treated

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3
Q

name 3 risk factors for developing OCD

A

social isolation

hx physical abuse

negative emotionality

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4
Q

what % of people with OCD have attempted suicide

A

up to 25%

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5
Q

what % of people with OCD have attempted suicide

A

up to 25%

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6
Q

what % of people with OCD have a comorbid disorder

A

60-90%–> basically, MOST if not almost ALL

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7
Q

how does CBT compare to pharmacotherapy for OCD treatment?

A

CBT is equivalent or superior to pharmacotherapy

*results with CBT were generally similar in comparisons of interventions with an emphasis on ERP and those with an emphasis on cognitive elements

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8
Q

how does CBT compare to pharmacotherapy for OCD treatment?

A

CBT is equivalent or superior to pharmacotherapy

*results with CBT were generally similar in comparisons of interventions with an emphasis on ERP and those with an emphasis on cognitive elements

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9
Q

what type of CBT was found to be more efficacious than CBT-ERP for OCD with fears of contamination with infectious agents

A

cognitive intervention that had NO direct exposure called DIRT–> “danger ideation reduction therapy”

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10
Q

in which patients with OCD might cognitive interventions be more important to treatment

A

patients who do not have overt compulsions (because this makes ERP more difficult)

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11
Q

other than CBT, what other psychological interventions may be useful for OCD treatment

A

acceptance and committment therapy (ACT)

modular cognitive therapy (CT) addressing OCD beliefs

CT addressing obsessional doubt

organizational training

mindfulness training

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12
Q

are therapist guided or self guided exposures more effective in OCD treatment?

A

both showed significant symptom reduction but THERAPIST-LED exposures were more effective in reducing symptoms

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13
Q

name a factor that has been associated with poorer response to both behavioural and pharmacological treatments for OCD

A

family accommodation
(family members taking part in performance of rituals, avoidance of anxiety provoking situations, or modification of daily routines to assist relative with OCD)

*may want to target family accommodation in order to improve treatment outcomes for some patients

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14
Q

what type of psychological treatment has been shown to improve symptoms of hoarding disorder

A

group CBT

“significantly reduced hoarding and depression symptoms”

(bibliotherapy alone did not)

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15
Q

what is best for OCD treatment: pharmacotherapy alone, CBT alone, or the combo

A

combo treatment is better than meds alone, but not better than CBT alone

therefore, if meds are required or preferred, adding CBT to meds may enhance response rates and reduce relapse rates

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16
Q

adding what medication may hasten onset of improvements with ERP?

A

d-cycloserine

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17
Q

are the benefits of CBT maintained over time after used for treatment of OCD

A

yes–> studies show lasting benefits at 1 and 5 years

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18
Q

list the first line medications for treatment of OCD

A

Every Fixed Fear Panics Sometime

Escitalopram

Fluoxetine

Fluvoxamine

Paroxetine

Sertraline

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19
Q

name the two first line adjunctive agents for treatment of OCD

A

abilify

risperidone

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20
Q

list the 3 second line adjunctive agents for treatment of OCD

A

memantine

quetiapine

topiramate

21
Q

where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD:

abilify

A

first line ADJUNCTIVE

22
Q

where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD:

fluoxetine

A

first line

23
Q

where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD:

clonazepam

A

not recommended

24
Q

where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD:

escitalopram

A

first line

25
Q

where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD:

citalopam

A

second line

(and third line adjunctive)

26
Q

where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD:

memantine

A

second line adjunctive

27
Q

where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD:

risperidone

A

first line adjunctive

28
Q

where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD:

fluvoxamine

A

first line

29
Q

where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD:

sertraline

A

first line

30
Q

where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD:

clomipramine

A

second line

31
Q

where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD:

phenelzine

A

third line

32
Q

where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD:

paroxetine

A

first line

33
Q

where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD:

mirtazapine

A

second line

34
Q

where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD:

venlafaxine XR

A

second line

35
Q

where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD:

quetiapine

A

second line adjunctive

36
Q

where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD:

topiramate

A

second line adjunctive

37
Q

where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD:

lithium

A

not recommended

38
Q

where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD:

buspirone

A

not recommended

39
Q

where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD:

clonidine

A

not recommended

40
Q

where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD:

desipramine

A

not recommended

41
Q

what is the response rate to SSRIs in OCD

A

40-60%

42
Q

what types of OCD symptoms may be associated with poorer response to SSRIs

A

symmetry/hoarding symptoms

43
Q

what types of OCD symptoms may be associated with a BETTER response to SSRIs

A

aggressive, sexual, and religious symptoms

44
Q

why is clomipramine second line for OCD

A

similar efficacy to SSRIs but not as well tolerated

45
Q

compared to abilify, risperidone may better target which: obsessions or compulsions

A

obsessions

46
Q

does topiramate seem to help more with compulsions or obsessions

A

compulsions

47
Q

what invasive procedure may be effective in reducing symptoms in patients with severe, treatment refractory OCD

A

capsulotomy or cingulotomy

*usually considered last resorts

48
Q

what neurostim interventions may be beneficial in treatment of OCD but require more data

A

rTMS

deep brain stimulation

49
Q

what lifestyle intervention may improve OCD symptoms

A

moderate intensity aerobic exercise

Troubles anxieux (3 decks)

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