TRANS 064: OCD

Question 1

Obsessions refer to___________. Compulsion refers to

________

Answer 1

thoughts;

behavior

Question 2

These are recurrent thoughts
and persistent thoughts. So, urges or images that are
experienced and these are intrusive and unwanted and it
causes much anxiety or distress.

Answer 2

obsessions

Question 3

are defined as repetitive behaviors or mental
acts. So, repetitive behaviors, e.g.1, hand washing if I feel like
I’m dirty. Sa iba naman, if their issue is order or symmetry
then that’s what they do they continuously reorder and
reorganize.

Answer 3

Compulsions

Question 4

diagnostic criteria for Obsessive compulsive D/o

Answer 4

presence of obsessions, compulsions or both

OBS: recurrent and prersistent thoughts etc; attempts to suppres
COMP: repetitive behavior, tapos may pag pigil ulit

time consuming ang obsessions and compulsions niya
no physiological effects of a substance

not better explained by the symptoms of another mental disorder

Question 5

what are the symptom subtype of OCD?

Answer 5

Symmetry, exactness, just right

forbidden thoughts or actions

cleaning/contamination

hoarding

Question 6

OCD vs OCPD?

Answer 6

For a OCPD to be diagnosed this must be a pattern that starts during adolescent period, hinde na sya nastart lang ng adult dapat merong nitong ganitong pattern ever since adolescent period and PDs or personality disorders can be diagnosed sa dapat 18 years old and above.

Question 7

There is a pervasive pattern of preoccupation with orderliness, perfectionism, and mental or interpersonal control, at the expense of flexibility, openness, and efficiency.
 Things has to be done perfectly; it has to be in order. If he cannot control things, it causes that person a lot of anxiety.

Answer 7

OCPD

Question 8

My way is the right way.
 Number 1, preoccupied with details, rules, lists, order, organization, or schedules sometimes to the point that the major part of the activity is lost.
 There are some ppl na, “okay, I have a to do list” then isusulat na nila yung mga task nila and then minsan nalolost nila into making sure they write the list perfectly na they’re not able to do what they have to do.

Answer 8

OCPD

Question 9

age of onset in OCD?

Answer 9

male 13 to 15; females 20 - 24

Question 10

OCD may be a co morbid disorder of ?

Answer 10

May be co-morbid with Tic Disorder

Question 11

• Decreased CSF concentration of 5 HIAA (serotonin metabolite)
• Previous streptococcal infection-10-30% Syndenham’s chorea develop OCD
• Altered neurocircuitry on orbitofrontal cortex, caudate and thalamus
• PET scan increased metabolism and blood flow in frontal lobe, caudate/basal ganglia and cingulum
• Significant genetic etiology
• High comorbid anxiety symptoms GAD, body dymorphic, hypochondriasis, eating disorders and depression

these are possible etiology of what disorder?

Answer 11

OCD

Question 12

what does Thought-action-fusion means?

Answer 12

 Just the thought of it equates to it being true
 Eg, thinking about liking their brother for them it’s already happening kaya sya very magnified yung impact ng mga thoughts to them

Question 13

treatment for OCD?

Answer 13

SSRI - high doses
antipsychotics
Behavior therapy
Psychodynamic Pscychotherapy

Question 14

top 3 most common location of imagined defects in patients with body dysmorphic disorder?

Answer 14

Skin
Hair
Nose

Question 15

• Uncommon in mental health clinics
o Usually seen first by plastic surgeons and dermatologists
• Affects males and females equally
o Males - body build, genitals, thinning hair
▪ Tend to be more severe
o Females - focus on various body areas
• Age of onset - early adolescence to 20s, peak at 16-17 years
• Poor quality of life, high percentage of past suicide attempts
• May lead to depression and substance abuse

what disorder?

Answer 15

Body Dismorphic Disorder (BDD)

Question 16

• Cause is unknown
• Steoreotyped concepts of beauty emphasized in certain families and within culture may have an impact
• Psychodynamic theories
o This is the displacement of a sexual or emotional conflict onto a non-related body part

what disorder?

Answer 16

Body dysmorphic disorder

Question 17

• Usually begins during adolescence
• Onset can be gradual or abrupt
• Long and undulating course with few symptom-free intervals
• Part of body concern focus may remain the same or change over time

what disorder?

Answer 17

BDD

Question 18

Tx of body dysmorphic disorder

Answer 18

• Plastic / medical/ dental / surgical surgeries – unsuccessful in addressing perceived defects
• Pharmacotherapy – SSRIs, augmented with lithium, or antipsychotics

Question 19

• Excessive accumulation of items, difficulty discarding anything, living with excessive clutter
• Experience of strong anxiety when throwing away items (potential use or sentimental value)
• Hoarding behavior not deemed to be a problem, part of their identity
• 2-5% of population
• Begins in early life and gets worse through the years Come for treatment late, usually 50s
• Affects males and females equall

what disorder?

Answer 19

Hoarding Disorder

Question 20

• A. Persistent difficulty discarding or parting with possessions, regardless of their actual value.
• B. The difficulty is due to a perceived need to save the items and to distress associated with discarding them.
• C. The difficulty discarding possessions results in the accumulation of possessions that congest and clutter active living areas and substantially compromises their intended use. If living areas are uncluttered, it is only because of the interventions of third parties (e.g., family members, cleaners, authorities.

what disorder?

Answer 20

Hoarding disorder

Question 21

Treatment for Hoarding disorder?

Answer 21

• Poor response to treatment: 18%
• SSRIs - some responded, some did not
• Most effective: CBT
o Training in decision-making and categorizing
o Exposure and habituation to discarding
o Cognitive restructuring
o Goal: to balance amount of possessions and living space

Question 22

• Experience sense of tension and achieve a sense of release or gratification after pulling out their hair
• Not painful

Answer 22

TRICHOTILLOMANIA (HAIR-PULLING DISORDER)

Question 23

Focused Pulling vs Automatic Pulling

Answer 23

Focused pulling - use of an intentional act to control unpleasant personal experiences, such as an urge, bodily sensation or thought

Automatic pulling - occurs outside the person’s awareness and most often during sedentary activities

Question 24

self-mutilation activities that may be present in trichotillomania?

Answer 24

Head banging, nail biting, scratching, gnawing, exocriation and other self-mutilation

Question 25

• A. Recurrent pulling out of one’s hair, resulting in hair loss
• B. Repeated attempts to decrease or stop hair pulling.
• C. The hair pulling causes clinically significant distress or impairment in social, occupational, or other important areas of functioning
• D. The hair pulling or hair loss is not attributable to another medical condition (e.g. a dermatological condition)
• E. The hair pulling is not better explained by the symptoms of another mental disorder (e.g. attempts to improve a perceived defect or flaw in appearance in boy dysmorphic disorder).

diagnostic criteria of?

Answer 25

Trichotillomania

Question 26

what are some etiology of trichotillomania?

Answer 26

• Stressful situations
• Disturbances in mother-child relationships
• Fear of being left alone
• Recent object loss

Question 27

What is the treatment for trichotillomania?

Answer 27

• SSRIs, Anxiolytics, Antipsychotics Management with dermatologists
 Low dose antipsychotics help with impulse control
• Behavioral interventions
o Biofeedback, Self-monitoring, Desensitization, Habit Reversal

Question 28

• A. Recurrent skin picking resulting in skin lesions
• B. Repeated attempts to decrease or stop skin picking
 They wanna stop it but they cannot
• C. The skin picking causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
• D. The skin-picking is not attributable to the physiological effects of a substance (e.g., cocaine) or another medical condition (e.g., scabies).
• E. The skin picking is not better explained by symptoms of another mental disorder (e.g., delusions or tactile hallucinations in a psychotic disorder, attempts to improve a perceived defect or flaw in appearance in body dysmorphic disorder, stereotypies in stereotypic movement disorder, or intention to harm oneself in non- suicidal self-injury.

Diagnostic criteria of what disorder?

Answer 28

Excoriation (skin-picking) disorder

Question 29

• Lifetime prevalence - 1-5% of general population
• 12% occurs in adolescence
• More common in females
• Associated with OCD, trichotillomania, substance dependence, MDD, anxiety disorders, BDD, suicide attempts
• Common areas:
o legs, arms, torso, hands, cuticles, fingers, scalp
• Experience of tension prior to picking and relief after picking
o Afterwards, feeling guilty or embarrassed
o Use of makeup, bandages, clothing to hide picking

what disorder?

Answer 29

Excoriation (skin-picking) disorder

Question 30

Etiology of skin picking disorder? cause and theories?

Answer 30

• Cause is unknown
• Theories
o Suppressed rage at authoritarian parents
o To assert oneself
o To relieve stress, release tension and other negative feelings
o Skin is an erotic organ, and picking or scratching the skin may lead to erotic pleasure (masturbatory equivalent)

Question 31

Treatment for trichotillomania

Answer 31

• Use of SSRIs, opioid antagonist (Naltrexone), Lamotrigine
• CBT and habit reversal
• Difficult to treat
• Most do not seek treatment due to embarrassment and belief that their condition is untreatable