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
where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD: citalopam
second line (and third line adjunctive)
26
where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD: memantine
second line adjunctive
27
where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD: risperidone
first line adjunctive
28
where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD: fluvoxamine
first line
29
where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD: sertraline
first line
30
where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD: clomipramine
second line
31
where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD: phenelzine
third line
32
where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD: paroxetine
first line
33
where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD: mirtazapine
second line
34
where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD: venlafaxine XR
second line
35
where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD: quetiapine
second line adjunctive
36
where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD: topiramate
second line adjunctive
37
where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD: lithium
not recommended
38
where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD: buspirone
not recommended
39
where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD: clonidine
not recommended
40
where does the following medication fall in terms of treatment for OCD according to the canadian practice guidelines for OCD: desipramine
not recommended
41
what is the response rate to SSRIs in OCD
40-60%
42
what types of OCD symptoms may be associated with poorer response to SSRIs
symmetry/hoarding symptoms
43
what types of OCD symptoms may be associated with a BETTER response to SSRIs
aggressive, sexual, and religious symptoms
44
why is clomipramine second line for OCD
similar efficacy to SSRIs but not as well tolerated
45
compared to abilify, risperidone may better target which: obsessions or compulsions
obsessions
46
does topiramate seem to help more with compulsions or obsessions
compulsions
47
what invasive procedure may be effective in reducing symptoms in patients with severe, treatment refractory OCD
capsulotomy or cingulotomy *usually considered last resorts
48
what neurostim interventions may be beneficial in treatment of OCD but require more data
rTMS deep brain stimulation
49
what lifestyle intervention may improve OCD symptoms
moderate intensity aerobic exercise