Obsessive Compulsive and Related Disorders

Question 1

Obsessions in OCD

Answer 1

Obsessions = recurrent, persistent, intrusive, and unwanted thoughts, images, or impulses

Question 2

Compulsions in OCD

Answer 2

Compulsions = ritualistic or repetitive behaviors or mental acts that a person carries out continuously in an attempt to neutralize anxiety

Question 3

Obsessive–Compulsive Disorder Common Compulsions

Answer 3

Checking rituals
Counting rituals
Washing/scrubbing
Praying/chanting
Touching/rubbing/tapping
Ordering (arranging and rearranging)
Exhibiting rigid performance
Having aggressive urges

Question 4

When is OCD diagnosed?

Answer 4

OCD is diagnosed once thoughts or behaviors consume the person to the point where the thoughts or actions interfere with personal, social, and/or occupational functioning.

Question 5

What does the person with OCD think of their thoughts and behaviors?

Answer 5

The person realizes that the thoughts/behaviors are unreasonable, but he or she cannot stop/control them.

Question 6

When does OCD usually start

Answer 6

Can start in early childhood

Question 7

In females, when does OCD usually start?

Answer 7

in females, more commonly begins in the 20s

Question 8

How are symptoms of OCD experienced over a person’s lifetime?

Answer 8

Periods of waxing and waning symptoms over lifetime

Question 9

What is the etiology of OCD?

Answer 9

Learning

Hereditary

Traumatic/Stressful life event

Question 10

What does it mean that OCD is learned?

Answer 10

Obsessive fears and compulsive behaviors can be learned from watching family members or gradually learned over time.

Question 11

What does it mean that OCD is hereditary?

Answer 11

Complex network of several genes may contribute to the genetic risk for OCD.

Question 12

In general, what is the treatment of OCD?

Answer 12

Combination of medications and therapy

Question 13

Medications to treat OCD:

Answer 13

1. First line SSRIs
2. Second line SNRIs
3. Second generation antipsychotics

Question 14

What is the first line medication treatment for OCD?

Answer 14

SSRIs (Flovoxamine and Sertraline)

Question 15

What specifically, are the first line SSRIs used for OCD?

Answer 15

(Flovoxamine and Sertraline)

Question 16

What is the second line medication for OCD?

Answer 16

SNRIs (venlafaxine)

Question 17

What is the treatment for treatment resistant OCD:

Answer 17

second generation antipsychotics

Question 18

What are the second generation antipsychotics used for treatment resistant OCD?

Answer 18

(risperidone, quetiapine, olanzapine)

Question 19

What is included in Behavioral therapy for treatment of OCD?

Answer 19

Exposure therapy

Response prevention

Question 20

What is scale is used for assessment of OCD?

Answer 20

Yale-Brown Obsessive–Compulsive Scale

Question 21

What is the general appearance and motor behavior of OCD?

Answer 21

tense, anxious; embarrassment

Question 22

What is the mood and affect of someone with OCD?

Answer 22

overwhelming anxiety

Question 23

What is the thought process and content of OCD?

Answer 23

describe obsessions as rising out of nowhere

Question 24

What is the judgement and insight of someone with OCD:

Answer 24

(recognizes obsessions as irrational but unable to stop them)

Question 25

What is the self concept of someone with OCD?

Answer 25

powerlessness, low self-esteem

Question 26

What is the physiological and self care considerations of someone with OCD?

Answer 26

sleeping problems, appetite and weight changes

Question 27

What is the nursing interventions of OCD?

Answer 27

Therapeutic communication Relaxation techniques Behavioral techniques Exposure techniques Daily routine completion Client and family education

Question 28

What is the client teaching of OCD?

Answer 28

Teach about OCD Review importance of talking openly Emphasize medication compliance Behavioral techniques Tolerating anxiety

Question 29

What is the family teaching of OCD?

Answer 29

Teach to avoid giving advice Teach to avoid trying to “fix” the problem Patience Monitoring anxiety levels among family members Taking breaks

Question 30

Self-Awareness Issues of OCD

Answer 30

Need to understand client cannot simply stop the behavior* The client needs to work on a reduction of the compulsive behaviors Chronic condition Client already knows the thoughts and rituals interfere with life.