Flashcards in Obsessive-Compulsive Disorder Deck (17):
What are obsessions?
Intrusive and recurring thoughts, images, or impulses that come unbidden to the mind, are uncontrollable, and usually appear irrational to the person experiencing them
Which forms do obessions often take? (5)
What are compulsions?
Repetitive, clearly excessive behaviors or mental acts that the person feels driven to perform in order to prevent or reduce anxiety
What is the difference between intrusive thoughts and ritualistic behaviors in the general population and in the OCD population?
In OCD they are psychopathological:
- time consuming
- cause marked distress
- interfere with everyday functioning
What is the lifetime prevalence and mean onset of age of OCD?
Lifetime prevalence: 2-3%
Mean onset of age: 20 years
What are common comorbidities of OCD? (5)
- motor tics (including TS)
- trichotillomania (=compulsive hair pulling)
- body dismorphic disorder
- mood disorders
- anxiety disorders
What is the etiology of OCD?
- genetic component (precise is unknown)
- neurotransmitters: serotonin (and others e.g. DA)
- brain imaging abnormalities: OFC, ACC, striatum)
- cortico-striatal model
What is the cortical-striatal model of OCD?
Abnormal striatal funtioning
-> inefficient gaiting at the level of the thalamus
-> hyperactivity within the OFC and ACC
Name 3 treatment possibilities of OCD`
1) behavior therapy
2) pharmacotherapy (SRI's)
3) deep brain stimulation
What are the 2 forms of modern neurosurgery?
- ablatve procedure
What is the procedure and mechanism of action in DBS?
- placement of one (sometimes two) small electrodes deep into the brain's subcortical structures
- DBS appears to disrupt abnormal patterns of neuronal activity associated with structures implicated in disorder-specific pathophysiology
- effects of DBS are locally and ar distance
What are the advantages (2) of DBS?
- non-ablative procedure
- reversible and adjustable
What kind of adverse effects are there of DBS?
- surgical procedure (bleedings, infections,
What is the role of neuropsychologists in DBS? (3)
- patient selection
- evaluation of outcome
- managment of post-operative effects
What is likely to represent the neurobiological basis of inhibitory failures in OCD?
Abnormalities in neural circuitry connecting cortical to subcortical structures (particularly the lateral-orbitofrontal loop)
What has been found regarding the hypothesis 'impaired implicit learning in patients with OCD'?
Inconsistent findings, evidece suggests that:
because of dysfunctional fronto-striatal systems, patients may use medial temporal networks associated with explicit learning to compensate for striatal dysfunction
-> parallel processing of explicit information may have "preoccupied" frontal-temporal systems, thereby preventing subjects with OCD from employing these structures for implicit learning